Racial and Ethnic Disparities in Mental Health Care

Racial and Ethnic Disparities in Mental Health Care

January 24, 2021  |  Blog Post 

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The implications of the 1932 Tuskegee Syphilis Study for African Americans were, and continue to be, extremely profound. Because of this study and many other medically-rooted instances associated with white supremacy, mistrust in healthcare practitioners and their respective institutions is extremely widespread. This reality is further intensified by statistics given by the NCBI, which include that “black women [die] at a higher rate than any other race during or after childbirth,” are “often underdiagnosed and overlooked when it comes to having eating disorders,” and are generally less likely to receive satisfactory care, specifically when it comes to mental health interventions. Generational trauma, too, such as the recent killings of individuals including but not limited to Breonna Taylor and George Floyd, contributes greatly to these sentiments of distrust. A 2018 study published in The Lancet, titled “Police Killings and their Spillover Effects on the Mental Health of Black Americans: A Population-Based, Quasi-Experimental Study,” elaborates on how these events have very tangible and long-lasting effects on people living in the same state during the killing.

For those BIPOC individuals who attempt to seek out counseling services pertaining to the subject of racial trauma, it can be difficult to find a professional of similar racial background who can truly understand and appreciate their perspective. This is especially apparent considering the current demographic composition of the psychology workforce. The American Psychological Association offers numbers to illustrate this reality; “In 2015, 86 percent of psychologists in the U.S. workforce were white, 5 percent were Asian, 5 percent were Hispanic, 4 percent were black/African-American and 1 percent were multiracial or from other racial/ethnic groups. This is less diverse than the U.S. population as a whole, which is 62 percent white and 38 percent racial/ethnic minority.” There are significant repercussions to be had from this industry trend. Counseling Today summarizes the succinctly. Firstly, patients in need of treatment may hesitate to receive it because of generationally backed “fear and mistrust” of those who generally administer it. Secondly, white mental health practitioner’s “Different cultural perceptions about mental illness” might translate into misdiagnoses, overprescription, the presentation of bias (even if unintended), and potential discirimination.”

There is evidence, however, that successfully forging relationships with same-race mental health practitioners can have extremely positive effects for those individuals receiving treatment. Dr. Shawn Blue, a clinical assistant professor in the Department of Psychiatry and Human Behavior at Thomas Jefferson University offers her perspective on these benefits. She states: “For my BIPOC students and clients, it’s so important to have that space to talk about how the events around them are affecting their mental health...With my white patients, some are very open to talking about it and expressing support, others kind of tip-toe around the issue, and some may have differing opinions. But most of the time, even if we disagree, it doesn’t get in the way of treatment. And in cases where the patient wants to specifically work on race issues, there has been progress or a positive impact of therapy.”

This is not to say that white therapists are incapable of offering the same or similar levels of care to their BIPOC patients. On the contrary, the benefits of regularly attending therapy with any trusted professional can lead to overwhelmingly positive results. However, it is important to take into consideration the importance of cultural competency training in those professionals who might not be as intuitively familiar with BIPOC realities in the United States.

Ultimately, with the right training, it is more than possible that mental health professionals across the board, regardless of race or ethnicity, can provide effective treatment to all, if not most of their patients. This is demonstrated by study results such as Jonathan W. Kanter’s from the BMC Medical Education Journal, which studied training innovations focused on microaggressions and interracial patient-provider interactions translated in patient outcomes. It found greater improvements in “ observed emotional rapport and responsiveness… self-reported explicit attitudes toward minoritized groups, and improved self-reported working alliance and closeness with the Black standardized patients.” Adopting similarly holistic training programs on a national basis, then, would better equip mental health practitioners to recognize the very real cultural differences that exist among their very diverse clienteles.

 

Authors

Julia Radu

Healthcare Analyst at CHI