Want to know an interesting fact about mental health illnesses? They are completely indiscriminate. Anxiety, depression, and other mental health issues impact people of all races, genders, cultures, and ages. And even though mental health rates are roughly the same between white individuals and persons of color — that is where equality stops. Minorities face an uphill battle for access to mental healthcare.
In America, one in six people suffer from a treatable mental health illness. On average, 60 percent receive mental healthcare and help when they need it. Yet, for minorities, including African Americans, that number plummets to 40 percent (APA, 2018). Combine the lack of care with the trauma of racism and we can begin to realize the struggle.
You may be reading this shaking your head. How is this possible? Everyone has access to care, right? Or maybe this is your personal story and you are nodding your head in agreement. Whatever the case, let’s break down what we know and how we can do better.
Don’t minorities have access to care like everyone else?
In a word, no. Here are some of the reasons that people of color and other minorities do not receive or seek mental healthcare as reported by the American Psychiatry Association and National Alliance on Mental Health:
- Minorities are more likely to be uninsured or underinsured. Over half of the uninsured population are persons of color (African American, Asian American, Native American).
- Minorities experience long wait times for care. Significantly more people of color live near the poverty level and in communities with not enough providers. Closures of public mental health facilities have made this problem even worse.
- Sometimes, a person of color can find a provider but is unable to overcome transportation issues to get to appointments.
- There is little diversity and limited culturally competent mental health providers. It is important for all people to have a provider that understands them, such as another minority or someone who has taken the time to learn and understand their culture. If the person can’t find the provider they need, they might not get care.
- A person of color is more likely to be arrested for mental health issues than treated. Let’s say an African American man is having a bad day. His car breaks down and someone calls him a racial slur. The man reaches his ‘limit’ and starts yelling. Chances are, he will be arrested instead of being offered support.
- In some cases, language barriers prevent access to care. Mental healthcare is about communication. Without it, issues are not understood.
- A person of color may have had a bad prior experience leading to distrust of healthcare. Add to that a history of abuse within the medical field that has built a generational legacy of mistrust. Examples include the Tuskeegee experiments, forced sterilizations, and experiments performed on enslaved African Americans.
Understanding Cultural Bias
Cultural bias, intentional or not plays a big role in access to care. Let’s look at an example of a 7-year-old African American girl whose mom brings her to the ER with scalding injuries to her scalp. The mother then informs the care team that she had put boiling water on the child’s hair. Immediately, the provider picks up the phone to call child welfare services to report abuse…
Just in the nick of time, the lone African American staff member in the room informs the rest of the team that it’s normal to use boiling water to seal synthetic braid hair extensions. Without the staff person in the room who understood the situation, the wrong conclusions would have been made due to a cultural misunderstanding.
What would have happened to the little girl if no one had been there to speak up for her mom? What would have happened to the mother? Similar gaps in understanding can contribute to a poor experience within mental healthcare.
Medical bias continues to plague people of color seeking care and directly leads to higher death rates. Having a provider who is culturally informed is so very important to prevent bias.
The Common Denominator: Racism
Among all the reasons listed above, there is one common element — racism. When people who have experienced racism seek mental healthcare, they are not only struggling with the fear of being unable to find a provider who can understand their experience, they are also coping with the very real fear of discrimination.
Racism has many faces. It can be something as simple as an unintentional assumption based on race (the child in the ER) to calling someone a derogatory and discriminatory term. Racism requires the power to create systemic inequity, and the healthcare industry has played a part both historically and in the present day.
Many times, these negative effects and symptoms are perpetuated by the lack of understanding, especially among those who have never experienced racism or discrimination. To shift the tide, everyone needs to play a role. It’s not just about reducing the stigma of mental healthcare. It’s about building a community where all people, including minorities, feel safe to ask for help.
There are powerful movements happening right now in America and across the globe that are working to improve equity. The work to build equality is also important in the mental health field.
What can I do to help minorities gain access to mental healthcare?
You CAN be a voice of change and support. Whether you are a person of color or a champion of change, you can play a role in ensuring minorities have access to quality mental healthcare. Here are a few ways to help:
- Join the cause. The National Alliance on Mental Illness has launched the You are Not Alone campaign. This campaign focuses on the connection and awareness of minorities fighting mental illness with education and community. Share their graphics on your social media pages to shine a light on this issue.
- Be vocal. Speak out on behalf of yourself or a friend or family member who needs access to mental healthcare.
- Educate yourself. Are you in the mental health field? Take this moment in time as an opportunity to listen and seek education to become a better and more culturally competent provider.
How can I get the help I need?
Access to mental healthcare services can be difficult for everyone. The color of your skin or language you speak should never keep you from receiving care. You can be your own advocate.
Unfortunately, we know that persons of color are more likely to experience a healthcare provider who talks at them rather than listening. At Covenant Family Solutions, all people are welcome. Please reach out, we will listen.
As a minority person seeking mental healthcare, you have every right to ask for a provider who has taken the time to understand your story. Please ask for what you need, it is your right as a human being.
American Psychological Association, 2018, Disparities in Mental Health Status and Mental Health Care, https://www.apa.org/advocacy/health-disparities/health-care-reform.
National Alliance on Mental Illness, 2020, Minority Mental Health Awareness Month, https://www.nami.org/Get-Involved/Awareness-Events/Minority-Mental-Health-Awareness-Month.
National Alliance on Mental Illness, 2020, Disparities Within Minority Mental Health Care, https://www.nami.org/Blogs/NAMI-Blog/July-2017/Disparities-Within-Minority-Mental-Health-Care.