Although minorities are just as likely as non-minorities to experience mental health disorders, they are far less likely to receive treatment. While depression rates are lower in the African American population (24.6%) and Hispanics (19.6%) than in whites (34.7%), the rate of seeking treatment is much less and the disability as a result of the mental illness much higher. In 2015, 48% of white adults with mental illness received treatment, 37% of blacks and Hispanics received treatment and only 22% of Asians received treatment. (1)
Despite the existence of effective treatments, disparities lie in the availability, accessibility and quality of mental health services for racial and ethnic minorities. The Agency of Healthcare Research and Quality (AHRQ) reports that in the U.S., racial and ethnic groups are less likely to have access to mental health services, less likely to use community mental health services, more likely to use emergency departments and more likely to receive a lower quality of care. (2)
Minorities most disenfranchised from mental health treatment as reported by a number of studies are Asian Americans followed by Hispanic Americans and African Americans. In 2015, the National Survey on Drug Use and Health (NSDUH) conducted a study to examine the use of mental health services for adults 18 years or older for a variety of racial/ethnic groups in the U.S. The study used combined data from 2008-2012 to provide percentages of how often adults sought mental health services in the last year. The study found that the adults most likely to seek mental health services (17.7%) were those reporting two or more races, followed by white adults (16.6%), Native Americans or Alaska Native adults (15.6%), black (8.6%), Hispanic (7.3%) and Asian (4.9%). Outpatient mental health services and the use of psychiatric prescription medications follow the same racial/ethnic levels, however black adults (1.4%) were twice as likely as white adults (0.7%) to seek inpatient mental health services. Also in this study, across all racial/ethnic groups, the most commonly sighted reason for not seeking mental health care was the cost of services or the cost of insurance. The belief that mental health services would not help was the least frequent reason for not accessing treatment. (1)
In addition to the lack of insurance or being underinsured, other factors that create barriers to receiving mental health care include language, mental health stigma within the minority community, poverty, distrust in the health care system, lack of diversity among mental health providers, and lack of cultural competency among providers. (3)
Environmental and cultural factors also influence one’s willingness to seek psychological help. Those who have been raised in an environment where violence and trauma are common, frequently suffer from depression and anxiety. Statistics provided by the Centers for Disease Control indicate that African Americans living below the poverty level are twice as likely to report psychological distress. In 2017, suicide was the second leading cause of death for African Americans, ages 15-24. Death by suicide for African American men was four times higher than African American women. The overall rate of suicide in the African American population however, is 60% lower than non-Hispanic white individuals. (4)
Breaking down the stigma of mental illness in all communities is vital to reducing disparities in treatment for all populations. We are encouraged that more insurance companies are including mental health treatment under their covered services. Our growing minority population in this country will hopefully increase the level of cultural competence of our community mental health providers, which in turn will help those in racially/ethnically diverse communities start to feel more comfortable seeking mental health treatment.
References
- A New Look at Racial/Ethnic Differences in Mental Health Service Use among Adults: https://www.nimh.nih.gov/news/science-news/2015/a-new-look-at-racial-ethnic-differences-in-mental-health-service-use-among-adults.shtml
- Minority Mental Health Month – July: https://www.minorityhealth.hhs.gov/omh/content.aspx?ID=9447
- Mental Health Disparities: Diverse Populations. https://www.psychiatry.org/psychiatrists/cultural-competency/education/mental-health-facts
- Mental and Behavioral Health – African Americans: https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=24
Robin Morris, LCSW-C, CCTP, is a licensed clinical social worker who provided mental health counseling services at Brook Lane’s North Village outpatient facility for many years. She has over 25 years of experience in the field of human services and is a certified clinical trauma professional. Her areas of interest include minority mental health, trauma informed treatment, grief and bereavement, and child/adolescent conflict resolution. Robin has worked with many Washington County community enrichment organizations including the Child Fatality Review Committee, The Hagerstown Youth Development Coalition the Washington County Diversion Program Mentoring Initiative and the Hagerstown Gang Task Force Committee.
