Mental health affects individuals across all racial and ethnic groups. However, while some may find it easy to access professional treatment, it’s important to acknowledge that Hispanic, Black, Asian, American Indian or Alaska Native (AIAN), and Native Hawaiian or Pacific Islander (NHPI) communities in the U.S. often face unique challenges that can impact their ability to receive necessary care.
Discrimination
Many internal and external factors contribute to an individual’s mental health struggles. However, when discussing this topic, it is crucial to highlight a major underlying factor that significantly impacts the well-being of minority groups: the effects of racism and discrimination.
People who experience discrimination in daily life are more likely than those who rarely or never experience discrimination to report that worry and/or stress has led to:
- Sleep problems
- Poor appetite or overeating
- Frequent headaches or stomachaches
- Difficulty controlling temper
- Worsening of chronic conditions
- Increase in alcohol or drug use
Similarly, those with discrimination experiences in their daily life are more than three times as likely as others to say they always or often felt lonely or depressed in the past year.
Decades of research have found that being a target of discrimination – overt or subtle – can lead to a higher risk for developing stress-related disorders such as anxiety and depression. It is important to note that discrimination is incredibly complex and experienced in so many ways, that it can be difficult to recognize the impact it can have on an individual. For example, hate occurring in a community is certain to affect the mental health status of the victim and the victim’s family, it can also have a spillover effect for acquaintances and additional members in the community.
External Barriers to Accessing Mental Health Care
Lack of Provider Representation
In the United States, people of color face disparities in access to health care, the quality of care received, and health outcomes. A 2023 study found that most Hispanic, Black, Asian, and AIAN adults report that less than half of their healthcare visits in the past three years were with providers who shared their racial or ethnic background. The lack of diversity amongst providers comes with disadvantages such as communication barriers, lack of trust doubt?, lack of rapport, and discomfort for patients from minority communities.
Representation is important, as studies have shown that patients with providers who share their background are more likely to feel that their doctor explains things clearly, involves them in decision-making, and respects their cultural values and beliefs.
Limited Health Literacy Proficiency & Healthcare Coverage
Health literacy (HL) proficiency is the ability to find, understand, and use health information to make informed decisions. Racial/ethnic minority populations in the USA exhibit disproportionate rates of limited HL proficiency due to limited educational opportunities, a lack of cultural perspective on health information, mistrust of the health system, and discrimination.
These barriers contribute to lowered health literacy proficiency in these groups, which has been linked to a lack of insurance coverage. As a result, nonelderly AIAN, Hispanic, NHPI, and Black people remain more likely to be uninsured compared to their White counterparts, and are more likely to report not seeing a doctor in the past 12 months due to cost.
Internal Barriers to Accessing Mental Health Care
Cultural and Linguistic Barriers
Social and cultural factors, such as exposure to poverty, violence, and pre-immigration trauma, significantly contribute to the onset of mental health issues like major depression and PTSD among minority communities. Nearly half (48%) of adults with limited English proficiency report difficulties navigating healthcare due to language barriers, further complicating their ability to access mental health services.
Mistrust and Historical Trauma
Historical persecution and ongoing experiences of racism and discrimination have resulted in a deep mistrust of healthcare providers among racial and ethnic minorities. This mistrust leads to delays in seeking treatment until symptoms become severe. Furthermore, instead of turning to mental health specialists, studies indicate that minorities rely on informal sources of care such as clergy, traditional healers, and family and friends.
Health Disparities and Their Impact on Mental Health
Racial and ethnic minorities in the United States face a higher burden of physical illnesses, including cardiovascular disease, cancer, asthma, diabetes, stroke, and much more. The prevalence of chronic physical illnesses in minority communities significantly impacts mental health, as these conditions are risk factors for mental disorders such as depression and anxiety. Consequently, poor physical health exacerbates mental health challenges in these populations.
While this is just the tip of the iceberg, numerous additional factors hinder minority groups from receiving the mental health care they need. Discrimination profoundly impacts mental health, resulting in increased stress-related disorders and a reliance on informal care sources.
