“Racial and ethnic minority groups in the U.S. are less likely to have access to mental health services, less likely to use community mental health services, more likely to use the emergency room department, and more likely to receive lower quality of care.” – U.S. Department of Health and Human Services Office of Minority Health, 2019
Note: Resources are listed at the bottom of this post.
In honor of Bebe Moore Campbell, a writer and mental health advocate, National Minority Mental Health Awareness Month was established in 2008 to bring awareness to the mental health barriers that minorities face in America.
What are the barriers?
- Lack of insurance or being underinsured
- Mental health stigma
- Lack of adversity among providers
- Language barriers
- Distrust in the healthcare system
- Inadequate support for mental health services
- Misdiagnosis
Lack of insurance or being underinsured
African Americans and people of Hispanic origin are less likely to have insurance coverage compared to Whites; and a disruption in insurance, and a change in doctors, makes it less likely to develop a relationship with their doctor.2 This can make them less likely to seek mental health care.
Mental health stigma
There’s stigma in seeking mental health care because of race, culture, masculinity, religious beliefs, discrimination, and other factors. Many of these factors are ingrained in our society and who we are as a people.
Lack of adversity among providers
A lack of adversity is probably something that people don’t think about. However, it has been shown that if a doctor is of the same race as a patient, the patient is more likely to report higher levels of trust and satisfaction.3
Language barriers
Language barriers also pose a significant issue. Being unable to communicate effectively because of language and/or culture, or being unable to comprehend health information due to medical terms, is also another factor that can put a person’s mental health at risk.4
Distrust in the healthcare system
The history of the American healthcare system is steeped in racism, sexism, and classism; and because of that history, some minorities may feel uneasy from seeking mental services.
Inadequate support for mental health services
Access to healthcare is one of the biggest issues some Americans are faced with. Inadequate access to mental health services make it harder for people to receive the mental health care that they need.
Misdiagnosis
Minorities are more likely to be undiagnosed, misdiagnosed, or under-diagnosed because of cultural, linguistic, or even historical reasons.5 A Rutgers University study found that African Americans were more likely to be misdiagnosed with schizophrenia than their White counterparts.6
This post by no means discredits what White Americans may experience regarding mental health. However, it was written to address the barriers and issues that minorities are faced with. For example, White Americans have higher rates of depression, and are more likely to die from suicide, than Black and Hispanics. However, depression in Black and Hispanic Americans are more likely to be persistent.6
Visit the National Alliance on Mental Health for more information.
What is being done, and what can be done?
- Training for healthcare professionals on cultural competency and the barriers that minorities are faced with
- Providing resources specifically designed to address the needs of specific populations/cultures/races
- Advocating to address the needs, concerns, and inequalities of various populations
- Providing mental health resources in religious settings and common gathering places
- Providing access to healthcare in rural communities
- Educating individuals and families on the importance of seeking mental healthcare, and providing education to break stigma
- Connecting individuals and families with healthcare professionals they can relate to
- Connecting individuals and families with resources that are appropriate for them
- Providing access to tools and resources to healthcare professionals, individuals, and families
- Developing relationships between healthcare professionals and patients
Right now, we don’t have a perfect solution on how to combat the issue of inequalities in the healthcare system and the disparities that minorities face regarding mental health. There are systemic issues that we will have to continue to uncover and address for us to make progress in providing adequate mental healthcare for all.
A big thank you to Bebe Moore Campbell and all the mental health professionals and advocates who have and are shedding light on minority mental health issues.
Books on culture & race in the healthcare system:
Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to Present by Harriet A. Washington
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures by Anne Fadiman
The Immortal Life of Henrietta Lacks by Rebecca Skloot
Mental Health Resources:
Mental Health America https://www.mhanational.org/bipoc-mental-health
Resources for Black and African American Communities https://mhanational.org/issues/black-and-african-american-communities-and-mental-health
Resources for Latinx/Hispanic Communities https://mhanational.org/issues/latinxhispanic-communities-and-mental-health
Resources for Asian American/Pacific Islander Communities https://mhanational.org/issues/asian-americanpacific-islander-communities-and-mental-health
Resources for Native and Indigenous Communities https://mhanational.org/issues/native-and-indigenous-communities-and-mental-health
Sources:
U.S. Department of Health and Human Services Office of Minority Health. (2020). Minority Mental Health Awareness Month. Retrieved from https://www.minorityhealth.hhs.gov/omh/content.aspx?ID=9447
Sohn, H. (2017). Racial and Ethnic Disparities in Health Insurance Coverage: Dynamics of Gaining and Losing Coverage over the Life-Course. Popul Res Policy Rev. 2017 Apr; 36(2): 181–201.
Rothman, P. (2016). Diversity in Medicine has Measurable Benefits. Retrieved from https://www.hopkinsmedicine.org/news/articles/diversity-in-medicine-has-measurable-benefits#:~:text=Studies%20show%20that%20students%20trained,by%202.2%20minutes%2C%20on%20average.
Partida, Y. (2007). Language Barriers and the Patient Encounter. American Medical Association. Retrieved from https://journalofethics.ama-assn.org/article/language-barriers-and-patient-encounter/2007-08
American Psychological Association. (2017). Disparities in Mental Health Status and Mental Health Care. Retrieved from https://www.apa.org/advocacy/health-disparities/health-care-reform
Mental Health Today. (2019). Depression or schizophrenia? Black patients are more likely to be misdiagnosed. Retrieved from https://www.mentalhealthtoday.co.uk/news/awareness/depression-or-schizophrenia-black-patients-more-likely-to-be-misdiagnosed#:~:text=Black%20patients%20more%20likely%20to%20be%20misdiagnosed&text=Researchers%20examined%20the%20medical%20records,with%20schizophrenia%20than%20white%20patients.
The World of Public Health 