Research Confirms Racial Inequities in Mental Health Treatments

  • Asian Americans were 51% less likely than Whites to access mental health services.
  • Experiences of racism were associated with lower emotional well-being.
  • Stronger levels of ethnic identification were associated with higher overall well-being.
  • Racial issues impact the effectiveness of psychotherapy.
  • Public payment for health services eliminated racial inequities for economically disadvantaged individuals.

Millions of Americans suffer from mental illness. Many seek therapy, but racial background influences availability and quality of treatment.  In 1999 and 2001, the U.S. Surgeon General’s Office issued reports highlighting racial inequities: Racial minorities have less access to mental health services than Whites.

A new summary of research representing over 4.7 million individuals has provided data on the severity of the racial inequities: Asian Americans were less than half as likely as Whites to use mental health services, Hispanic/Latino(a) Americans were 25% less likely, and African Americans were 21% less likely.  In a finding that is particularly troubling, African Americans suffering from mental illness were found in mental health services less often when they most needed help.

Joseph E. Trimble, research co-author and Distinguished University Professor of Psychology at Western Washington University stated, “We felt grateful that the racial inequities were actually smaller than we imagined them to be.  Except for Asian Americans, race accounts for relatively smaller differences in mental health service utilization.”

The racial inequities remained after accounting for alternative explanatory factors such as socioeconomic status. However, public assistance for mental health services eliminated racial inequities for African Americans and other clients of color.

“Access to mental health treatment is a major public health issue,” said researcher Timothy B. Smith of Brigham Young University. “Conditions such as depression and anxiety have been increasing in recent decades.  Making mental health treatments accessible for all populations will benefit society through associated decreases in suicide, substance abuse, and physical illness.” Beyond the psychological benefits, financial savings from equitable access to mental healthcare services include decreased medical and insurance costs and fewer missed work days.

The inequities across race may be partially explained by differences such as cultural beliefs about mental illness or limited availability of mental health clinics in locations with predominantly racial minority populations. A separate analysis showed that immigrant populations with limited acculturation to the U.S. may be particularly at risk for poorer experiences in mental health treatment.

Professor Trimble acknowledges that the findings raise several questions: What are the mental health experiences of immigrant populations? What about acculturation stress? Sociocultural change? Social and cultural changes are occurring in the U.S., but what explanations best account for the racial and ethnic differences and their consequences?

The data appear a book recently published by the American Psychological Association, Foundations of Multicultural Psychology.  Additional data in the book confirm that experiences of racism reported by minorities in the U.S. are associated with decreased levels of emotional well-being.  However, stronger levels of ethnic identification were associated with higher overall well-being.  People of color whose therapists’ explicitly accounted for cultural considerations achieved greater mental health benefits than when they attended traditional therapy that did not consider cultural background.

“As much as we would like to think otherwise, race still matters in terms of psychological health,” says Smith, “but when we openly address racial and cultural issues, the data confirm more effective outcomes in therapy.” Public health policies can better promote access to mental health services among all people in need of services. 

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