By Jennifer Fiorillo
Mental Health
Jennifer Fiorillo
There are a multitude of reasons why some people may not access appropriate mental health care. A few of these reasons could include challenges as simple as not having enough time to locate a therapist or provider, to more complex barriers to care such as lack of insurance coverage or access to low-cost transportation.
With the increasing popularity of telehealth, it has become easier to access services without needing to leave the house, provided a person has the necessary technology and the ability to properly employ that technology.
The examples above only scratch the surface of access issues that can lead to mental health disparities. The reality is that a number of diverse populations are less likely to access mental health services for reasons beyond those mentioned above. According to the American Psychiatric Association, 48 percent of White Americans with mental illness received services compared to 31 percent of both Black and Hispanic/Latinx populations. Just 22 percent of Asians received services in 2017.
The APA also reports that people of color experience more persistent symptoms and have a disproportionately higher rate of disability from a mental health disorder. The highest rate of reported mental illness was among Native and Indigenous Americans at 23 percent. The Depression and Bipolar Support Alliance reports that LGBTQ people are more than two times more likely to experience depression, substance abuse and anxiety compared to heterosexuals.
So what are the factors impacting both access and a disproportionally higher rate of disability from mental health issues? They primarily revolve around social determinants of health, including job and income, housing and food stability, adequate transportation and access to appropriate healthcare.
The stress related to not having stable housing and food in the Hispanic/Latinx population is higher than adults in other racial and ethnic groups. Black people reported not having enough food three times more frequently than White people in 2019 based on the Centers of Disease Control’s Morbidity and Mortality Weekly Report. These issues have only been amplified by the COVID-19 pandemic and added to the equation, which compounds the increased risk for chronic stress leading to more severe mental health challenges and poor health outcomes.
Both communities of color and members of the LGBTQ community experience stigma and discrimination when they access healthcare. In some cultures, accessing mental health services is not an acceptable way to manage stress, anxiety and depression. It is also common for individuals of minority populations to go undiagnosed, underdiagnosed or misdiagnosed for historical and cultural reasons.
The health care community must respond to these barriers by offering as many culturally and linguistically appropriate supports as possible to facilitate the delivery of services, and it should seek to understand the unique challenges and trauma that many in these communities have experienced. It is essential to offer more supportive services to work on meeting basic needs and overcoming other barriers to care if we want to increase self-sufficiency and resiliency in communities that are so disproportionally impacted by housing and food insecurity.
Adequately addressing mental health disparities in diverse populations ultimately requires a collaborative community approach and multi-level interventions that can touch hard-to-reach populations through tailored outreach, education and person-centered treatment.
Jennifer Fiorillo, MBA, MPH is the president and CEO of Bridges Healthcare in Milford, and may be reached at Jfiorillo@bridgesmilford.org.