Mental health care disparities deserve our attention

July 28, 2023

Swedish Behavioral Health Team

[6 MIN READ]

In this article:

Factors such as race, gender and identity can make accessing mental health care more difficult.
Working for mental health equity strengthens our relationships, builds more resilient communities and, ultimately, improves the world for everyone.
While finding mental health care can be a challenge for underrepresented groups, there are resources and services available to connect people to care and address their specific needs.

Our mental health is a vital aspect of our well-being, regardless of our race, gender or identity. But those factors can come with obstacles to accessing the care we need. Whether due to language barriers, discrimination or a lack of diversity among providers, people of racial and ethnic minority groups often encounter difficulties in finding adequate mental health treatment.

To shine a light on these challenges and how they are being addressed, we spoke with Lyndsey E Williams, LICSW PMH-C, a licensed clinical social worker and member of the behavioral health integration team at Swedish and the care team at the OB/GYN clinic at First Hill.

Minority groups face unique challenges that impact mental health

Mental health encompasses our emotional, psychological and social well-being, including how we think, feel, relate to others and make decisions. Just like our physical health, it plays a vital role in our overall health, happiness and contentment.

There are certain stressors in life that can impact our mental well-being, such as challenging circumstances like poverty, the loss of a loved one, unemployment and the profound effects of a pandemic like COVID-19. These stressors can also exacerbate existing mental health conditions.

While mental health issues vary greatly and can present differently in every person, it's important to recognize that living with mental illness is a common experience, affecting 1 in 5 Americans who have received a formal diagnosis. Among underrepresented[KA2] groups, the prevalence of mental health conditions can be even higher. For instance, U.S. adults who identify as two or more races have the highest rates of mental health conditions when compared to other demographic groups.

Specific communities in the United States face unique challenges such as:

Minority groups may experience more disabilities resulting from mental health illness.
Depression tends to be more persistent in Black and Hispanic individuals.
Native Americans and Alaska Natives have higher rates of post-traumatic stress disorder and substance use disorder.

In addition, people identifying as LGBTQ+ are twice as likely as their heterosexual counterparts to report a mental health illness.

For some, the barriers to mental health care are long and winding

Mental health illnesses are often treatable, but the real challenge lies in accessing the care that can make a significant difference.

Studies have shed light on the fact that racial and ethnic minority groups face significant barriers when it comes to accessing quality health care services, including much-needed diagnoses and treatments for mental health illnesses. In addition to long-existing, systemic disparities, some communities face language barriers, which may make it harder for people to seek mental health services.

“Many non-white groups find it difficult to access mental health care that is culturally affirming,” says Williams. “Minority patients may experience a series of barriers, including finding providers that look like them, language differences and feeling misunderstood or unheard by health care providers.”

“These factors influence patients’ comfort with sharing vulnerable details about their health, which in turn may keep them from receiving the support they need.”

Bias is another major factor in patients’ access to care.

“In some cities, groups we call ‘minorities’ make up half or more of the population, but despite population numbers and even if patients can access the needed service, they can experience bias from staff and providers,” says Williams. “Studies have shown that minorities are less likely to be referred to specialty services or are often diagnosed with various health problems in later stages. After a series of these uncomfortable experiences patients may wait until their symptoms need urgent attention or avoid accessing health care altogether.”

Another aspect that contributes to mental health disparities is the cultural stigma that unfortunately exists within certain minority groups surrounding mental health. For instance, in the United States, Asian Americans are among the least likely to seek mental health services, according to Mental Health America. One key reason behind this trend is the fear of self-identifying as a person with a mental health illness or other disability, which highlights the need for understanding and empathy.

Other factors that can influence minority groups’ access to care include:

Distrust in the public health care system.
Employment status and/or financial strain.
Lack of cultural competence in providers.
Lack of diversity among providers.
Lack of insurance coverage or underinsurance.
Proximity to services.
Unstable housing.

Better access to mental health care is possible

Mental health equity benefits us all, and equal access to care empowers everyone. The U.S. Centers for Disease Control and Prevention (CDC) has made one of their crucial goals to ensure that every individual has a fair and just opportunity to reach their highest level of mental health and emotional well-being.

“At Swedish we address inequities in mental health care in a number of ways,” says Williams. “Our behavioral health integration program helps patients receive same-day access to care and we offer a host of mental health support groups allowing patients to receive additional supportive services.”

“Swedish also accepts most health care insurance plans and we provide additional programming to support the under or uninsured.”

Embracing mental health equity fosters stronger relationships and creates more resilient communities, paving the way for a stronger, more compassionate world that values the well-being of every individual. By advocating for mental health, reaching out to those in need, and taking action to support those facing disparities, we can collectively work toward more equitable care.

As individuals, we can:

Learn about the forms of discrimination that can prevent certain people from seeking appropriate care, including implicit bias (the unintentional but automatic bias we may have that can impact how we view and treat others).
Educate ourselves about mental health and the challenges faced by some underserved groups to get care.
Share information and resources about mental health with family, friends and community members.

As communities, we can:

Address social determinants of health, such as housing and food insecurity.
Engage in health literacy education and training to reduce unconscious bias (called bias reduction training).
Increase community-based services and access to crisis resources.
Increase peoples’ access to culturally appropriate services, including hiring linguistic and cultural interpreters as needed.

For patients who are seeking mental health care, Williams encourages them to do their research.

“Look for providers who are aligned with your values,” she says. “Psychology Today remains one of the most popular websites for finding mental health providers and patients can set search filters to help them find a provider who is the best fit. Then review your insurance benefits and plan enhancements to ensure you are taking advantage of everything offered.”

Minority mental health resources

“Locally in Washington state, there are a few programs that fund free and low-cost therapy for minority groups, and they are great resources to get started with,” says Williams.

These include:

The Washington Therapy Fund, which serves individuals of African descent.
Indian Health Board, which serves Native people.
The Loveland Therapy Fund, which serves communities of color.
Deconstructing the Mental Health System (DMHS), which offers free therapy.
The Lotus Therapy Fund, which serves individuals of Asian descent.
Somali Health Board, which serves King County's Somali community.

At the regional and national levels, there are a number of organizations dedicated to helping people access care and resources for mental illness, including members of diverse, underserved populations.

For example:

From the American Foundation for Suicide Prevention:

General resources

Black community

Hispanic community

National Alliance for Hispanic Health
National Hispanic and Latino Prevention Technology Transfer Center
Therapy for Latinx

Native American, Native Hawaiian and Pacific Islander communities

Native and Indigenous communities

From the National Alliance on Mental Illness (NAMI):

NAMI HelpLine, Monday through Friday, 10 a.m. – 10 p.m. ET
Call 1-800-950-NAMI (6264)
Email helpline@nami.org
Text 62640
Chat nami.org/help

From The Trevor Project (for LGBTQ+ youth):

Reach a crisis counselor 24/7, 365 days a year, from anywhere in the United States
Call: 1-866-488-7386
Text: 678-678
Chat: thetrevorproject.org/webchat

Health disparity fact sheets from the U.S. Department of Health and Human Services Office of Minority Health:

Learn more and find a provider

If you have questions about mental health, contact the behavioral health department at Swedish. We can accommodate both in-person and virtual visits.

With Swedish Virtual Care, you can connect face-to-face with a nurse practitioner who can review your family and health history. To find a provider, try searching our provider directory.

Join our Patient and Family Advisory Council.