Mental Illness and Minorities

Minorities Have Trouble Getting Mental Health Help

Although minorities are just a likely as non-minorities to experience severe mental disorders such as anxiety, depression, bipolar disorder and schizophrenia, they are far less likely to receive treatment. For instance, the percentage of African Americans receiving needed care is only half that of whites, and 24% of Hispanics with depression and anxiety receive appropriate care compared to 34% of whites with the same diagnosis. Reasons include a lack of access to services, cultural and language barriers, and limited research concerning mental health and minorities.

Many studies have found that lack of access to services is strongly associated with one's level of income and access to medical insurance. Racial and ethnic minorities have higher rates of poverty and a much greater likelihood of being uninsured. For instance, 8% of whites live below the poverty level compared to 22% of African Americans and 27% of Mexican and Native Americans. The percentage of uninsured minorities is over half that of whites.

Individuals experiencing symptoms of a mental disorder are most likely to seek help from their primary care physician, but close to 30% of Hispanics and 20% of African Americans do not have a usual source of healthcare. Even when minorities seek care from a primary care physician, they are less likely to receive appropriate treatment. Also, many minorities live in rural, isolated areas where access to mental health services is limited.

Language is a significant barrier to receiving appropriate mental healthcare. Diagnosis and treatment of mental disorders greatly depends on the ability of the patient to explain their symptoms to their physician and understand steps for treatment. The language barrier often deters individuals from seeking treatment. Thirty-five percent of Asian Americans and Pacific Islanders (AA/PIs) live in households where the primary language is not English and 40% of Hispanics living in the U.S. do not speak English.

Culture, a system of shared meanings, is defined as a common heritage or set of beliefs, expectations for behavior, and values. Culture significantly influences the definition and treatment of mental illness, affecting the way individuals describe their symptoms and the symptoms they exhibit. For instance, African Americans experience symptoms uncommon among other groups such as isolated sleep paralysis, or the inability to move while falling asleep or waking up. Some Hispanics experience symptoms of anxiety that include uncontrollable screaming, crying, trembling, and seizure-like fainting. Cultural beliefs about mental health strongly affect whether or not some people seek treatment, a person's coping styles and social supports, and the stigma they attach to mental illness.

Many people from different cultures see mental illness as shameful and delay treatment until symptoms reach crisis proportions. The culture of physicians and mental health professionals influences how they interpret symptoms and interact with patients.

Research to evaluate different minority groups' response to treatment is limited. Very few studies exist that investigate the appropriateness of certain types of treatment. For example, some research suggests that African Americans metabolize psychiatric medications more slowly than whites, but often receive higher dosages than do whites, leading to more severe side effects. More extensive research is needed to insure minorities receive appropriate treatment.

Finally, while all groups experience mental disorders, minorities are over represented in populations at high risk for experiencing mental illness, including people who are exposed to violence, homeless, in prison or jail, foster care, or the child welfare system. At risk populations are far less likely to receive services than the general population. For more information on this topic, read the Surgeon General's special report on culture, race and ethnicity.

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