Disparities in Mental Healthcare of Minorities in the US

Disparities in Mental Health Care of Minorities in the US By: Eunice Mao Historically, healthcare in the US has exhibited discrimination against people of color, leading to persistent racial disparities driven by prejudiced incidents and enduring systemic health issues. This discrimination against minority groups further reinforces the barrier to accessing mental health care, presenting a challenge deeply ingrained within our societal framework. KFF, an independent source for health policy research found that “ Among adults with any mental illness, Black (39%), Hispanic (36%), and Asian (25%) adults were less likely than White (52%) adults to receive mental health services as of 2021. ” Access to mental healthcare is inherently limited based on race in this country. Wealth, Housing, Education Structural racism prevents minorities, especially African Americans from obtaining equal access to resources such as wealth, housing, education. Which results in the prevention of adequate health and mental health care among minority groups. According to The American Journal of Economics and Sociology, “Research suggests that racial wealth inequalities have grown over the last 30 years because of racism. The average wealth of Caucasian families has grown by 84 percent—three times the rate of growth for the African American population. If the average wealth of African American families continues to grow at the same pace that it has for the last 30 years, it will take African American families 228 years to amass the same amount of wealth Caucasian families have today, which is 17 years shorter than the 245-year span of slavery in the United States.” A lack of wealth limits the flexibility to get mental health assistance or counselling. African Americans may have to work more jobs and longer hours for lower pay to cover for their living expenses. The same study expands on the fact that African Americans have a harder time obtaining employment, are often placed into a lower position then

applied for and are paid less than Whites for equal work. Access to health insurance is limited for minority populations, either due to absence of employer-provided coverage or financial constraints to pay for healthcare. Segregation: The Rising Costs for America linked many attributes back to housing. “Housing is the centerpiece of opportunity in America. Housing is the key to asset accumulation for the typical American family and is the key to access quality education, good jobs, convenient transportation, valuable social networks, diverse and well-maintained recreational facilities, and quality physical and mental health centers.” Expanding upon the premise that wealth affords access to housing and better neighborhoods, improved housing conditions correlate with enhanced job opportunities, comprehensive insurance coverage, greater awareness of mental health resources, and superior mental healthcare facilities. An American Journal of Psychiatry commentary stated that “members of racial and ethnic minority groups have less access to mental health services than do their white counterparts, are less likely to receive needed care, and are more likely to receive poor quality of care when treated.” This can be caused by historically disadvantaged housing and the lack of superior health resources in poor neighborhoods. Redlining is the discriminatory practice of denying Black and minorities access to credit by banks because of where they lived. It got more and more difficult for people in redlined neighborhoods to move out and start a new life. The FiveThirtyEight Project analyzed the University of Richmond’s Mapping Inequality and “found that nearly all formerly redlined zones in the country are still disproportionately Black, Latino or Asian compared with their surrounding metropolitan area, while two-thirds of greenlined zones — neighborhoods that HOLC deemed “best” for mortgage lending — are still overwhelmingly white.” Historical

department services was much higher than that of Whites” (Lu et al., 2021). When comparing African Americans and their White counterpart’s depression, “Black Americans were found to have lower rates of lifetime major depression than were their White counterparts living in similar areas, but the rates of major depression in the past year were similar across groups, indicating more persistent illness. Relative to Whites, Blacks were more likely to rate their depression as very severe and disabling” (McGuire & Miranda, 2014). This arises from disparities in accessing mental health care and the pervasive stigma that obstructs African Americans from seeking assistance. When they eventually do seek mental health services, the mental illness has often endured for an extended duration, resulting in severe symptoms. Mistrust of Governmental Authorities Throughout the history of the US, there has endured mistrust of the healthcare system and the criminal justice system. Medical mistrust by African Americans stems from the Tuskegee Syphilis Study. In summary, in exchange for medical care and survivors’ insurance, African 600 American men participated in a study of how syphilis progressed in Black individuals. The participants were not told if they had syphilis and when the study began, there were no treatments for the disease. Penicillin was determined as a cure for the disease later, participants were not treated, and many passed away as a result. The study was fueled and influenced by racist ideologies. “During the time of slavery, many doctors believed that black people possessed irregular physiological and anatomical features based on which they justified the slavery system. In the late 19th and early 20th centuries, medical texts, then, were written comparing black people’s anatomy to Caucasians” (Lee et al, 2018). The Tuskegee Study “revealed racial inequities inherent in the provision of healthcare. As long as biased beliefs, policies, and practices are still prevalent in the U.S. healthcare system, mistrust is a rational response that may continue to contribute to health disparities” (Alsan & Wanamaker, 2017). More recently, a

Rutgers University study suggested that “African Americans with severe depression are more likely to be misdiagnosed as having schizophrenia.” This misdiagnosis came from the bias and “tendency for clinicians to overemphasize the relevance of psychotic symptoms and overlook symptoms of major depression in African Americans compared with other racial or ethnic groups. ” There was a greater emphasis on psychotic symptoms over depressive symptoms. This suggests that racial bias still plays a significant role in the treatment of African Americans in mental health care today. The prevalent mistrust of the criminal justice system also significantly contributes to African Americans' reluctance to engage with mental health services. According to the Prison Policy Initiative, 13% of the US population consists of Blacks but 38% of people in prison are Blacks. African Americans are being disproportionately held in prisons and they try to stay away from any possibility of ending up there. Professor Ruth White at USC states, “ This [criminalization] disparity has stoked the fear that openly acknowledging mental health struggles will be met with harsh legal repercussions rather than needed treatment: ‘If an African American person with a mental illness acts out in violence, they are much more likely to be criminalized than to be given the opportunity to receive mental health care.’” Once in the criminal justice system, “there is evidence that they are less likely to be identified as having a mental health problem. Also, they are less likely to receive access to treatment once incarcerated,” The National Alliance on Mental Illness describes. This leads to a distressing mental illness incarceration cycle where, individuals with mental illness, once tossed into the system, often don’t receive the proper care. Upon reintegration into society, their problems exacerbate, and they frequently lack the necessary support to access the mental health assistance required for improvement.

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