Healthcare disparities are inequities in the health care system. Healthcare disparities is an extremely complicated topic that leads to social and environmental disadvantages in health care. At Lenses, we have previously discussed this topic in articles by Nirja Divekar and Achraf Azzaoui.
As opposed to physical health disparities, access to health insurance, or access to care, which can be as simple as not having a hospital, pediatrician, or healthcare provider near your house, mental health disparities are extremely different and take the issue to another level.
To better understand how race-related mental health disparities are addressed and how race is one of the biggest contributors to healthcare disparities, Lenses interviewed Dr. Norah Mulvaney-Day, Director of Behavioral Health Research at IBM Watson Health. Having earned a Masters from Harvard in Theology and a PhD in Mental Health Policy, Day is an expert in this field.
Her experience in the field of healthcare disparities itself is extensive, as she was part of many national studies. One study she was involved in focused on mental health disparities and substance use disorders in Latino populations in the U.S. This study conducted with Harvard Medical School and the Cambridge Health Alliance, a safety net hospital, found that Latino immigrants had lower rates of mental illness as compared to Latino Americans who spent more time in the U.S. This suggests that some facet of the United States worsened the mental state of the immigrants who moved here at an adolescent age or older.
Mulvaney Day stated that what makes mental illness different is that it can’t be easily diagnosed through a physical check up. It requires extensive observation and willingness of a patient to talk about their feelings, which isn’t easy.
Additionally, rates of mental health treatment of ethnic minorities are extremely lower than white people. According to Mulvaney-Day, the stigma associated with mental health especially in immigrant families contributes to the disparities as well. For example, in Asian American families, mental health is often stigmatized and frowned upon to see a mental health specialist or therapist.
According to the National Alliance on Mental Illness, 1 in 5 U.S. adults suffer from some sort of mental illness, and 1 in 25 suffer from a serious mental illness. Furthermore, mental illness rates for each race are very similar, with rates of mental illness for whites, Hispanics, Blacks, and Asians, being in between 15 and 20%. So if rates are similar, why are there disparities?
Mulvaney-Day explained that one of the biggest problems that she has seen is that immigrants and minorities often don’t have access to any mental health facilities that they can use. This is because most mental health facilities don’t have professionals who can speak other languages. According to Mulvaney-Day, “When you’re seeing disorder recognition, particularly in mental health it’s so dependent on how people talk about their feelings and what they identify as their problem. If you don’t have the language to say ‘Hey I feel really depressed,’ you’re in a system that’s not recognizing what depression looks like in your culture. You then won’t receive the treatment you deserve and that’s where the disparity started to show.”
Even though these healthcare disparities are systematic and would require change on a nationwide level, Mulvaney-Day offers a simple yet effective solution for mental health care to improve and better cater for the needs of minorities and immigrants.
“It’s as simple as this. Having diversity in mental health facilities is essential. It’s necessary to improve the service delivery among diverse populations if you know where your patient is coming from and their culture, and are able to talk about it. How are you supposed to get help if you can’t communicate your feelings? How can you get the help you need if you don’t know what you are feeling? ”
She also noted the importance of talking about mental health without stigma. “If you are working 3 jobs a day how will you have time for your mental health? How will you properly address it and talk about it if you never have talked about it before. We must break down these barriers and make mental health a priority for all people.”
Through Teen Lenses: Are you aware of the racial inequalities present in the Mental Health Care system? How do you believe systematic problems like these can be combated?
“Yes, I’m aware of the issue, but I’m sure that many others are not. We need to spread awareness to teachers, families, and mental health professionals as well as the vulnerable kids who might experience this. We should work together to let people know that their experiences are valid and that they deserve help regardless of cultural background.” Emma Cox, Rising Sophomore at Thomas Jefferson High School for Science and Technology, 15, Alexandria, Virginia
“I believe the racial inequalities in the mental healthcare system have to do with a lot of things. First of all racial redlining has caused systemic poverty and the privatization of mental healthcare makes it almost impossible for those stuck in the poverty cycle to access quality medical care. Secondly, it’s a white dominated field so a lot of race-specific issues aren’t as widely discussed within the mental health community. and then in certain communities reaching out for mental health help is HEAVILY stigmatized (it is obviously in society itself but in some racial communities it’s even more stigmatized).” Riley Cooper, Rising Sophomore at Thomas Jefferson High School for Science and Technology, 15, Alexandria, Virginia