Which ethnic and racial group is least likely to support mental health treatment in the United States?

Mental illness can happen to anyone, regardless of age, gender, race, ethnicity, or any other demographic categorization. While all racial and ethnic groups experience mental illness,  people of color are less likely to receive the help they need to get better. A higher percentage of white people receive mental health treatment than most groups of people of color.

People of Color *are* Less Likely to Receive Mental Health Treatment 

While all communities experience mental illness, some communities are affected at higher rates, including multiracial individuals who experience mental illness at a prevalence of 26.8%, versus 20.4% for white individuals. Not only does the prevalence of mental illness differ for different races, but the likelihood of receiving treatment also does as well. People of color are less likely to access treatment for their mental illnesses than white people.

On average, 43% of all adults with a mental illness receive mental healthcare. White people with a mental illness are the most likely group to get care, with nearly half receiving the care that they need.

Asian Americans and Pacific Islanders have the lowest percentage of reported mental illness, at 15%. They also are least likely to get mental healthcare, with only a quarter receiving the services they need.

16% of Black Americans report having a mental illness. This is close to the average of all adults who report a mental illness, 19%. While 43% of all adults with a mental illness receive services, only 31% of Black people with a mental illness receive services. 

The Native/Indigenous community has a higher rate of reported mental illness at 22%. There is not enough research on the rate of people who receive the care that they need, but it’s estimated to be low. 

While 17% of people in the Hispanic and Latinx community report having a mental illness, only 33% of those who need it receive services.

People who identify as mixed-race or multiracial have the largest percentage of mental illness compared to other racial groups, with 27% reporting having a mental illness. 32% of people who are mixed race and have a mental illness get the treatment they need. Though still low, this percentage is highest among people of color.

Why do Fewer People of Color Access Mental Health Care?

We know that people of color access treatment at lower rates than their white counterparts. There are many reasons for this, including economic disparities, stigma, lack of diversity in the mental health profession, language barriers, and distrust in the healthcare system.

Mental illness affects each individual and community differently. But, one thing is clear: it’s harder for people of color to access treatment. 

One reason for this may be lack of insurance. For example, 7.5% of white people are uninsured, compared to 11.5% of Black people, 18% of Hispanic and Latinx people, and 14.9% of Native or Indigenous people. Mental health care can be expensive, and being uninsured can mean people can’t access treatment.

Another reason is the lack of diversity among mental health providers and lack of culturally competent providers. The vast majority of mental health care workers are white. This can have negative impacts on people of color who seek care. Providers who aren’t educated in how to treat people from backgrounds different than their own can misdiagnose, under-diagnose, or dismiss the problems of patients of color.

Stigma in communities of color can pose another barrier. Mental illness is viewed differently in different communities. 

They also may struggle with language barriers, which can prevent people from finding adequate care. Racism in the healthcare system can also cause people of color to distrust the system and refrain from seeking services.

If You’re a Person of Color with a Mental Illness, We Recommend This

First, acknowledge where you’re at. Recognize and reflect on what’s happening in your life. Then, if you feel safe enough, reach out. Connect with a family member, friend, or doctor who you believe can relate to you. This may mean you seek out someone to talk to who has a shared experience as you or someone that you feel like can understand. You might connect with a doctor or therapist. . It’s okay to try multiple therapists to find one you are comfortable with!

Find a supportive community or network. Having a support system of friends and family members who you can discuss your illness with can make all the difference. 

Know you have a voice. It’s not uncommon for doctors to dismiss the pain of people of color. Implicit provider bias against racial or ethnic groups can make it harder to get the right treatment. You know what’s right for you. Trust your gut! Unfortunately, you may have to see multiple doctors to find one who can truly work with you to address your mental illness. You can call our Community Access team at 651-925-8490 to discuss your options or use this online tool to find a therapist or doctor who is right for you. 

At Guild, we strive to put equity at the center of our services. And, we understand mental illness and what it takes to heal. Lastly, we understand that appointments, medications, and therapy can be prohibitively expensive. If that is the case, here are some resources that may help:

If you are still struggling to find something that works for you, reach out to us. By emailing or messaging us on social media, we can work together to help you discover what options are available to you. 

Sources:

Racial and Ethnic Differences in Mental Illness Stigma and Discrimination Among Californians Experiencing Mental Health Challenges, Rand Health Quarterly.

Black/African American, National Alliance on Mental Illness. 

Black and African American Communities and Mental Health, Mental Health America. 

Mental Health Facts for African Americans, American Psychiatry Association. 

Mental Health Facts for Diverse Populations, American Psychiatry Association.

Latinx/Hispanic Communities and Mental Health, Mental Health America.

Mental Health Facts for Hispanic/Latinos, American Psychological Association. 

Asian American/Pacific Islander Communities and Mental Health, Mental Health America.

Mental Health Facts for American Indian and Alaska Natives, American Psychiatry Association.

Native and Indigenous Communities and Mental Health, Mental Health America.

How Diverse is the Psychology Workforce? American Psychological Association.

BIPOC Mental Health, Mental Health America.

Mental Health Care Matters, National Alliance on Mental Illness.

Latino Health Disparities, League of United Latin American Citizens.

It’s Time to Address the Role of Implicit Bias Within Health Care Delivery, Health Affairs. 

Home Education Statistics About Disparities in Mental Health Care

On average, racial and ethnic minority populations report experiencing mental health problems at the same rate, and sometimes less frequently, than their white counterparts. Despite this, the consequences are often more severe and longer lasting.

• The U.S. population gets more diverse each year. By 2044, it is projected that more than half of all Americans will belong to an ethnic group other than non-Hispanic White.
  (US Census. Projections of the Size and Composition of the US Population: 2014 to 2060. Current Population Reports. By Colby, SL and Ortman, JM. 2015.)
• People from racial and ethnic minority groups are less likely to receive mental health care. In 2015, among adults with any mental illness, 48% of whites received mental health services, compared with 31% of blacks and Hispanics, and 22% of Asians.
  (Agency for Healthcare Research and Quality. 2015 National Healthcare Quality and Disparities Report. 2016)
• Although rates of depression are lower in blacks (24.6%) and Hispanics (19.6%) than in whites (34.7%), depression in blacks and Hispanics is likely to be more persistent.
  (Budhwani H, Hearld K, and Chavez-Yenter D.Depression in Racial and Ethnic Minorities: the Impact of Nativity and Discrimination. Racial Ethn Health Disparities. 2015. 2(1):34-42.)
• Rates of mental illnesses in African Americans are similar with those of the general population. However, when African Americans seek care, they often receive poorer quality of care and experience a lack of access to culturally competent care.
  (Primm A, et al. “African Americans,” chapter in Disparities in Psychiatric Care. Ruiz and Primm editors. Washington, DC: Lippincott, Williams & Wilkins. 2010)
• Only one out of three African Americans who need mental health care receive it.
  (Dalencour M, et al. “The Role of Faith-Based Organizations in the Depression Care of African Americans and Hispanics in Los Angeles.” Psychiatric Services. 2017. 68(4):368-374.)
• Compared with the rest of the population, African Americans are less likely to be offered either evidence-based medication therapy or psychotherapy.
  (Wang PS, Berglund P, Kessler RC. “Recent care of common mental disorders in the United States: Prevalence and conformance with evidence- based recommendations.” J Gen Intern Med. 2000. 15(5), 284-292.)
• Black people with mental health conditions — especially those with schizophrenia, bipolar disorders, and other psychoses — are more likely to be incarcerated than people of other races. (U.S. Department of Justice. “Prisoners in 2015.” NCJ 250229 (Bureau of Justice Statistics Bulletin). 2016. https://www.bjs.gov/content/pub/pdf/p15.pdf.

  Hawthorne W, et al. “Incarceration among adults who are in the public mental health system: rates, risk factors, and short-term outcomes.” Psychiatric Serv. 2012 Jan;63(1):26-32.)

• Roughly 2.7 million people who identify as Asian American/Pacific Islander have a mental and/or substance use disorder.
  (Substance Abuse and Mental Health Services Administration. (2019). 2018 National Survey on Drug Use and Health: Methodological summary and definitions. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www. samhsa.gov/data)
• Asian Americans, alone, report fewer mental health conditions when compared with non-Hispanic whites and other racial and ethnic groups. Hawaiian/Pacific Islander adults report similar rates of mental illness as compared with non-Hispanic whites.
  (Mental and Behavioral Health – Mental and Behavioral Health – Native Hawaiians/Pacific Islanders https://www.minorityhealth.hhs.gov/omh/browse. aspx?lvl=4&lvlid=172)
• Asian American/Pacific Islanders are least likely to seek mental health services than any other racial/ethnic group. They are also three times less likely to access mental health services than their white counterparts.
  (Urban Institute, Health Policy. (2019) Fighting the Stigma: Mental Health among Asian Americans and Pacific Islanders)
• Trauma also has an outsized impact on diverse populations. For example, Southeast Asian refugees are likely to receive a diagnosis with PTSD relating to their experiences with immigration. A study reported 70% of Southeast Asian refugees receiving mental health treatment were diagnosed with PTSD.
  (Mental and Behavioral Health – Asian Americans. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=54)
• About one out of three asylum-seekers and refugees experience high rates of depression, anxiety, and post-traumatic stress disorders (PTSD)
  (Turrini, G., Purgato, M., Ballette, F., Nose, M., Ostuzzi, G. & Barbui, C. (2017). Common mental disorders in asylum seekers and refugees: umbrella review of prevalence and intervention studies. International Journal of Mental Health Systems, 11: 51)
• LGBTQ people are twice as likely to have a mental health disorder in their lifetime when compared to heterosexual men and women.
  (Semlyen J, et al. “Sexual Orientation and Symptoms Of Common Mental Disorder or Low Wellbeing: Combined Meta-Analysis Of 12 UK Population Health Surveys.” BMC Psychiatry. 2016. 24;16:67. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4806482/)
• LGBTQ individuals are 2.5 times more likely to experience depression, anxiety, and substance use compared to heterosexual individuals.
  (Kates, J, et al. “Health and Access To Care And Coverage For Lesbian, Gay, Bisexual, and Transgender Individuals in the U.S. Retrieved.” Kaiser Family Foundation. 2016. http://kff.org/report-section/health-and-access-to-care-and-coverage-for-lesbian-gay-bisexual-and-transgender-healthchallenges/)
• Many LGBTQ people experience stigma and discrimination when accessing health care, leading some to delay necessary care or forego it altogether.
  (Safer J, et al. “Barriers to Health Care for Transgender Individuals.” Curr Opin Endocrinol Diabetes Obes. 2016. 23(2):168-171. https://www.ncbi. nlm.nih.gov/pubmed/26910276)
• The most common mental health condition in women is depression. Twice as many women experience depression in their lifetime than men. Approximately 1 in 9 adult women have had at least one major depressive episode in the past year.
  (National Institutes of Health. 2008. Males and Eating Disorders. Medline Plus, 3(2):18. www.nlm.nih.gov/medlineplus/magazine/issues/spring08/ articles/spring08pg18.html)
• Each year, 1 in 5 women in the U.S. has a mental health condition such as depression, PTSD, or an eating disorder.
  (National Center for PTSD. 2015. Women, Trauma, and PTSD. http://www.ptsd.va.gov/public/PTSD-overview/women/women-trauma-and-ptsd.asp)

The disparities in mental healthcare are systemic and complex. Racial, ethnic, gender and sexual minority groups experience negative mental health outcomes because of a variety of factors, including: the inaccessibility of high quality mental health care services, stigmas surrounding mental health, and discrimination.

To learn more about what DBSA is doing to address disparities in healthcare and how you can get involved, visit our advocacy center.

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