By Marie Taylor
PuLSE Junior Fellow
October 10 is regarded by the World Health Organization as World Mental Health Day. According to the WHO, “ The overall objective of World Mental Health Day is to raise awareness of mental health issues around the world and to mobilize efforts in support of mental health.”
The issue is that we cannot raise awareness globally without bringing attention to the disparities in mental health in our local communities, which will not subside until something is done on the systemic and institutional level. For ages, minorities and low-income communities have been at the receiving end of incessant disparity in the mental health industry.
In fact, 42.0% of mental illnesses in the Detroit area go untreated. Mental illness can be a great obstacle for people to overcome and can contribute to many factors that make it difficult to receive treatment. For example, a mental illness like depression may render a job extremely difficult to perform, making it harder for the person to make money, which makes it harder for that person to pay for treatment. In order to create systemic equality, some changes need to be implemented in the mental health industry.
Examples of Some of the Specific Disparities
The mental health industry consistently misdiagnoses, under-diagnoses, and over-diagnoses people of color and is severely inaccessible to people of low socioeconomic status. It is very common for these people to have immense trouble getting mental treatment in the first place, let alone good treatment.
Not only are these communities underserved by the mental health industry, they are often more susceptible to mental illnesses than others. These disparities affect many different demographics, and this is a list of only a tiny fraction of the disparities:
• Among Indigenous Americans, prevalent psychiatric disorders are around ten percent greater than America’s overall population.
• Both Hispanic and Non-Hispanic Black people have a higher life prevalence of bipolar disorder than Non-Hispanic White people.
• Black men are far more likely to be misdiagnosed with schizophrenia spectrum disorder than white patients.
• Black people are much less likely to receive evidence-based treatment.
• Estimates say less than 15% impoverished children who are in need of mental health care receive services.
Why The Problem Persists
Due to their likelihood to be subjected to socioeconomic differences, people of color often have greater trouble accessing the treatment they require than their white peers. It was recorded that 11.4% of Black adults lacked healthcare in 2019. Apart from the absence of healthcare, Black and other people of color still have to face discrimination from their healthcare providers. Provider bias often results in the previously mentioned mistakes in diagnosis, contributing to hesitancy for people of color to seek treatment. This adds on to the already existing hesitation—especially in Black communities— caused by negative beliefs towards mental illness. A survey by the National Mental Health Association reported that 63% of African Americans felt depression was a personal weakness. Due to the stigma surrounding mental illness, people in these communities may feel anxious to seek professional help.
The majority of the under diagnoses in low income communities stems from the lack of access to services. People working low wage jobs generally do not have flexibility in their working hours, and most mental health clinics are only open during the day. This can be a huge barrier for workers to get treatment, especially since multiple clinic visits are usually required before treatments are administered. Of course, cost is also an issue. Low wage workers in the U.S. often lack insurance to cover or fully cover their mental health expenses, and services are often too expensive for them to pay out of pocket. Hence, they struggle to get diagnoses and treatment.
It is well known that Black people are disproportionately represented in American prisons. Whilst only making up 12% of the U.S. population, they represent around 33% of the prison population. Furthermore, three-fifths of the prison population is low income. In prison, less than half of the people taking mental health medication before incarceration continued to receive it in prison. Less than 36% of prisoners who reported a mental health condition received counseling services. A large percentage of the prison population—mostly low income and people of color—do not receive treatment for their mental health conditions, adding onto the disparities these communities already face.
Needed Changes in the Mental Health Industry
Disparities in the mental health industry are often systemic issues, so to completely fix the problem, there needs to be systemic change, but there are some surface level changes that can mitigate the problems. The mental health industry needs to:
• Push for employment of minority mental health professionals.
• Train mental health professionals to work with minority patients so as to not misdiagnose them.
• Implement policies to make mental health services more widely accessible through things like universal healthcare.
• Push Evidence based treatments for all demographics.
• Include proper study of minority communities, so information will not be biased towards one group.
• Properly implement mental health services into prisons.
• Make mental health services more widely and geographically available through online services and increased staffing in areas void of mental health professionals.
We Must Confront the Problem
Apart from changes by the mental health industry itself, individuals can help ameliorate mistakes in diagnosis by pressuring their providers to meet their needs. If a person feels they are being dismissed, they should consistently ask for medical tests, documentation of the doctor’s reasons for refusals of tests, specialist referrals, or even switch providers. Individuals should pressure politicians to implement policies that will make mental health services accessible to underserved communities. People can help reduce the stigma in their own communities by educating their peers and normalizing openness about personal mental health. Although individual efforts may not fix the disparities, they are needed to begin the changes that will do so.
Minority and low income communities are more susceptible to mental illnesses, yet they usually have a much harder time than others getting proper treatment. Implementing properly researched evidence based treatment, more minority representation, better training, and increased accessibility will alleviate these disparities. At the same time, individuals should pressure politicians, and educate themselves and their peers.
Editor’s Note: Marie Taylor is a Junior Fellow at The PuLSE Institute.