According to the National Institute of Mental Health, “Members of racial and ethnic minority groups in the U.S. are less likely to have access to mental health services, less likely to use community mental health services, more likely to use inpatient hospitalization and emergency rooms, and more likely to receive lower quality care.” It’s challenging for anyone to get proper mental and behavioral health care in the United States; sadly, it’s worse for racial, ethnic, religious, and gender minorities. Depression is more likely to be chronic, severe, and untreated within black Americans compared to white Americans. In 2015, among all adults with a mental illness, 48% of Whites received mental health care as opposed to 31% of Blacks and Hispanics and 22% of Asians. BIPOC is an acronym for Black, Indigenous, and People of Color.
There are many reasons leading to this gap in mental health care between communities. The National Alliance on Mental Illness identifies several barriers preventing minority groups from receiving adequate care including: lack of availability; high level of mental illness stigma in minority communities; racism, bias, and discrimination in treatment settings; lack of adequate health insurance coverage; and a health care system catered towards non-minority groups.
Mental illnesses are some of the most neglected health problems even today. There is an inadequate workforce to deliver inpatient and outpatient mental health care throughout the country, which makes it hard for most people to get proper support. In addition, the negative stigma surrounding mental illness can make people reluctant to talk to their family, friends, and health care providers about struggles they are facing. Many refuse to seek treatment due to self-stigma, or negative feelings about one’s own mental illness. Asian-Americans and Latinos reported higher levels of self-stigma (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568160/).
There is an unfortunate gap in how minorities are treated by their health care providers. Black and minority ethnic groups are less likely to be offered psychotherapy, more likely to be offered drugs, and more likely to be treated with coercion (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1839175/). One study even found that physicians were 23% more verbally dominant and engaged in 33% less patient-centered communication with African American patients than white patients. In addition, there tends to be a lack of cultural understanding by health care providers. This leads to misdiagnosis or underdiagnosis of mental illness in people from racially and ethnically diverse groups. Language barriers between providers and patients seems to be a huge contributor to this. These issues cause minority communities to feel a sense of distrust in the health care system.
The high cost of behavioral and mental health services prevents most people from seeking treatment, especially those who are uninsured. As of 2015, non-elderly minorities were more likely to lack insurance compared to whites. Even among those with insurance, the cost of deductibles and copayments are extra barriers to getting appropriate care. You can read more about the costs here: https://www.ncsl.org/Portals/1/HTML_LargeReports/DisparitiesBehHealth_Final.htm.