Research Finds Persistent Differences in Mental Health Treatment Use Across Racial and Ethnic Groups
Editor’s Note: This article uses the term “mental disorder” to describe characteristic groups of mental or behavioral symptoms that can be classified as such by a medical professional. Individuals with mental disorders are often stigmatized and stereotyped; these are harmful misconceptions that this article seeks to discredit.
By Annalise Lane
The field that studies mental disorders on a large scale, including their causes, treatments, and how they vary across populations, is called psychiatric epidemiology. One key goal within psychiatric epidemiology is to better understand the use of mental health treatment by individuals with mental disorders and, in particular, how treatment usage varies across different populations. In pursuit of this goal, a recently published scientific journal article titled “Trends in Racial-Ethnic Disparities in Adult Mental Health Treatment Use From 2005 to 2019” by researchers from Columbia University Mailman School of Public Health took a close look at differences in treatment use among United States adults aged 18 years or older in the time between 2005 and 2019. This study paid specific attention to the influence of race and ethnicity on mental health treatment use in adults with a mental disorder.
This study found some important trends. First, in every year between 2005 and 2019, study participants who were White used mental health treatment (which was considered inpatient or outpatient treatment, counseling, or prescription medication use) more than study participants who belonged to any other racial or ethnic background. In addition, this study found that between 2005 and 2019, the use of mental health treatment increased in all study participants, regardless of racial or ethnic background. In almost all cases, however, the gap between treatment use in racial and ethnic minority versus White participants either did not change or, in a few cases, grew larger between 2005 and 2019. These findings indicate that minority groups may experience more barriers to accessing mental health care than White people, such as cost of care or lack of insurance, and that these barriers have not dissipated over time.
There are a few key reasons why this study is important. First, it emphasizes that additional efforts are needed to address barriers to mental health treatment that racial and ethnic minority groups experience. Additionally, this study used information from tens of thousands of study participants to examine these relationships. The large number of study participants means that the findings represent the experiences of a diverse array of people—young, old, male, female, and other gender identities, and people from across the United States—and not just a specific group. As a result, the findings from the Columbia study can be used to make decisions about how to build programs and policies and distribute federal funds to improve mental health outcomes across large groups of people. For example, implementation of discrimination and stigma reduction trainings among mental health care providers can improve willingness of individuals with mental health conditions, especially those who belong to racial and ethnic minority groups, to utilize mental health care. In addition, expanded access to virtual counseling appointments in mental health clinics and treatment centers can enhance access to mental health care, especially among racial and ethnic minority groups who may live in remote areas or not have access to transportation.
When considering the results of this study, however, one should keep in mind that race and ethnicity are social constructs. This means that the concepts of race and ethnicity can be defined in a variety of ways, such as by physical or behavioral traits or cultural values. Because of this, different people perceive race and ethnicity differently. It is possible, then, that if this study were to be conducted again with a new set of participants who define their race and ethnicity in a different way than the participants included in Columbia’s study, results could be different. Importantly, though, a lot of other psychiatric epidemiology research has produced results similar to those in the Columbia study, which supports the idea that there is a relationship between race and ethnicity and mental health treatment use and suggests perceptions of race and ethnicity alone do not significantly impact this relationship.
By emphasizing the longstanding and persistent differences in mental health treatment use across racial and ethnic groups, this study informs the future work of psychiatric epidemiologists who may now turn to studying why these patterns exist. Understanding how these differences arise will allow researchers and policy makers to design and implement targeted efforts to enhance treatment usage in racial and ethnic minority groups, and thus improve mental health for many people across the United States.
Annalise is a second year Master of Public Health in Epidemiology student at the University of Michigan School of Public Health, where her primary concentration is psychiatric epidemiology. In her free time, Annalise enjoys listening to music, running, and spending time with friends and family.