By Christine Schulz on Tue, Oct 18, 2022
Individuals seeking health care encounter a number of barriers which may prevent them from receiving the help that they need. Patients of color, in particular, face compounding obstacles to accessing health care. These patterns of disparity are not only prevalent in traditional health care settings, but in mental health care settings as well. While many institutions have made it a priority to address racial disparities, there is still much work to be done. In order to overcome these obstacles, it is vital for physicians to understand the problems that their patients are facing so they can work together in providing adequate resources and access to mental health care.
Disparities in Mental Health
A large body of scientific research has evaluated health disparities among racial groups in the United States. When addressing physical health, studies show that minorities - particularly Black Americans and Hispanics - have generally poorer health outcomes than their white counterparts. However, when evaluating mental health outcomes, nearly the opposite is found to be true. In fact, minority groups have overall equivalent, and sometimes lower, reported rates of mental disorders when compared to whites.
Despite similar prevalence rates of mental illness, people of color who experience mental health challenges often have a greater burden of illness than whites do: they are more likely to suffer from prolonged, chronic and debilitating symptoms which more severely impact their day to day life. In part, this burden can be attributed to the quality of their mental health care, as minorities often receive less care, and the care they do receive is usually of lower quality.
Disparities in Mental Health Care
There are a number of factors that contribute to quality of care. One of which is socioeconomic status. In January 2022, the United States Census Bureau reported that 19.5% of Black Americans and 17% of Hispanic Americans were living below the poverty line. Individuals living in poverty often report that making an appointment to see any type of doctor is a very stressful task. It can require them to take time off work, travel far distances, and find child care during their absence. Due to these obstacles, individuals struggling financially may not have the ability to schedule appointments for their mental health, or maintain appointments regularly.
Furthermore, reports show that roughly 11% of Black Americans and 20% of Hispanic Americans are uninsured. Lack of insurance poses a significant barrier to mental health access and substantially increases the cost of care, making it inaccessible to those already struggling financially. In addition to this, mental health providers who do not accept insurance often establish their offices in communities where individuals can afford to pay the full price out of pocket. This contributes to a lack of providers in minority communities, which further limits their ability to access quality care.
Even in communities with adequate access to mental health providers, a very small percentage of providers are people of color. In 2019, the American Psychological Association reported that out of 110,000 psychologists in the U.S., 83% were white. Only 3% were Black, 7% Hispanic, 4% Asian, and 2% belonged to other races and ethnicities. This lack of diversity leads to further disparities in care, which stem from language barriers and cultural misunderstandings. While patients of color do not always feel that it’s necessary to have a provider of the same race or ethnicity, many report that it helps them communicate their experience more clearly and build rapport. This in turn allows them to feel better understood and more adequately cared for.
Mental health is addressed differently across cultures, and not all communities are as open to discussing mental health struggles. For instance, studies have shown that white Americans generally regard mental illness as a medical condition rooted in genetics, while communities of color may see mental illness as more of a personal flaw, or a failure to thrive. For those who are a part of a community that stigmatizes mental illness, seeking mental health services could be embarrassing, shameful, or uncomfortable. These feelings alone can lead those who need mental health care to avoid getting the help that they need.
Closing the Gap
How, then, can physicians minimize the racial disparities apparent in mental health care? The first step is to expand mental health services to communities of need by establishing accessible mental health facilities in underserved communities. In addition to this, we must continue to diversify the field of mental health care. Hiring and encouraging a diverse board of mental health providers will ensure that all patients receive comprehensive care, and feel heard and supported by their provider. Providers can further encourage minorities to seek care by openly addressing stigma and dispelling common misconceptions regarding mental illness. Lastly, White providers should continuously educate themselves on cultural differences surrounding mental health and embrace the practice of consulting their colleagues and friends of color to develop a well rounded understanding of mental health across cultures.
Many people of color struggle to access mental health care due to a number of barriers such as socioeconomic challenges, a lack of diverse providers, and cultural stigmas regarding mental health. In light of these challenges, today’s mental health providers have the unique opportunity to improve care for minorities and minimize the racial disparities. Some possible solutions for improvement are by extending care to underserved communities, fostering diverse networks, addressing stigma and continuing to educate themselves on cultural differences surrounding mental health care.