While mental illness does not discriminate, our mental healthcare system does. Fewer than half of all adults in the U.S. who experience a mental health disorder receive treatment, but individuals belonging to various racial and ethnic minority groups receive treatment at significantly lower rates than non-Hispanic whites, though the rate of need for services may not be that different.
How do they compare? On average, by race, groups experience mental illness at varying, but sometimes similar, rates to non-Hispanic Whites, but African Americans receive treatment at a 50% lower rate than Non-Hispanic Whites; Hispanics or Latinos at a rate of 60% lower; American Indian/Alaska Native 40% lower, and Asian Americans 70% lower.(US Department of Health and Human Services Office of Minority Health)
Some of the critical barriers faced by ethnic minority communities include:
- Less access to treatment: access refers not just to the availability of mental health services, but to logistical barriers such as transportation, childcare, obtaining time off from work, etc.
- Less likely to seek treatment: one attitude regarding mental health services, prevalent among 108 individuals from vulnerable populations (immigrants, individuals with a mental health diagnosis, victims of violence or impoverished persons) who were polled in a 2014 study published by American Psychological Association, indicated that these individuals did not believe mental health treatment would help them.
- Poor quality care: many factors may contribute to poor quality care including less participation in treatment decisions and not understanding a diagnoses or treatment.
- Higher levels of stigma: spiritual, religious or cultural beliefs about mental illness vary among groups and a lack of accurate information can inhibit persons in need from seeking treatment.
- Culturally homogeneous mental healthcare system: ethnic minorities are under-represented in the provider population who “often know little about the cultural values and backgrounds of the patients they are treating, or about the traditions of healing and the meaning of illness within their cultures” Satcher, Dr. David, DHHS (2001)
- Racism, bias, or discrimination in treatment settings: low income and ethnic/racial minority individuals may be hesitant to engage in mental health care because of fear or mistrust due to historical persecution and racism (Santiago et al., 2013) within the mental health care system, which has led to misdiagnosis and inappropriate treatments.
- Language barriers: mental health professionals that can provide direct care in languages other than English are lacking in many areas, even where minority group populations whose first language is not English are high.
- Lower rates of health insurance: poverty is not only a contributor to mental illness, but “lack of money” is often an important reason provided by many individuals belonging to minority groups for not seeking treatment.
What can be done. More focus should be placed on building a culturally competent mental health care system by:
- Educating providers on the potential barriers for varying populations and teaching providers to seek information from the individuals they treat regarding their concerns and any trust issues they may have.
- Training and hiring therapists who speak persons served preferred languages and who are from the same culture as those whom they are serving. “Diversity may make more of a difference in addressing minority patients’ concerns about trust” (American Psychological Association) as well as patient concerns about providers’ level of understanding of their lived experience.
- Developing outreach programs that educate communities about mental illness, recovery, and treatment.
- Helping community mental health organizations eliminate logistical barriers through increased funding.
- Integrate primary care and mental health care through community partnerships.
If it’s not culturally and linguistically appropriate, it isn’t healthcare.” -Marjory Bancroft, Founder Voices of Love & Cross Cultural Communications, Columbia, MD.