Mental Health Inequities among BIPOC and LGBTQ+ Communities

“We must pay close attention to our communities’ mental well-being as it is continuously being challenged. Additionally, we must be aware of compounding events that negatively affect BIPoC communities’ mental health, such as pandemics, police brutality, environmental disasters, culture differences, etc.”

-Quote from the Latinx Health Board & Community Health Board Coalition (CHCB) Mental Health Toolkit

Because communities of color and marginalized groups, such as those identifying as LGBTQ+, face many systemic and structural stressors (e.g. income inequality; discrimination; lack of healthcare access, etc.), as well as trauma, they are at risk for experiencing higher rates of mental illness. Other reasons for this include:

• According to a number of studies, including statistics by NAMI, people of color do not receive the same level of access to care or quality of mental health care as white people.
• The mental health workforce is much less diverse than the U.S. population at large, adding to barriers to treatment for communities of color.
• The Surgeon General’s landmark report on mental health concluded that even when POC are able to access mental health care — it is more likely to be poor quality care. There are a few factors that lead to poorer quality of care, including:
  • Lack of cultural competency among mental health providers.
  • Lack of diversity among mental health professionals: In 2015, 86% of psychologists in the U.S. workforce were white, 5% were Asian, 5% were Hispanic, 4% were Black/African-American and 1% were multiracial or from other racial/ethnic groups, which is less diverse than the U.S. population as a whole.
  • Provider discrimination, including bias and stereotyping.

It is critical that public policies and laws work to eliminate mental health inequities perpetuated by racism and racial discrimination. To address inequities, we must push for and vote for policies that support more inclusive and just mental health services and care. We can achieve this by increasing access to culturally- informed, evidence-based mental health care, creating a more racially and ethnically diverse mental health workforce, and working to eliminate stigma and discrimination. 

Leading Causes that Can Contribute to Poor Mental Health

• Language barrier and/or non-existent language access services
• Lack of insurance coverage
• Lack of knowledge of where to seek treatment
• Lack of proximity to treatment centers
• Lack of available Spanish speaking providers who are culturally and linguistically trained to meet the needs of Latinos
• Misdiagnosis
• Mental health stigma
• Cultural barriers
• Social isolation or loneliness
• Experiencing discrimination and/or stigma
• Severe or long-term stress
• Unemployment or losing your job
• Loss of identity within the community and family

Source: Cabassa, L. J., Zayas, L. H., & Hansen, M. C. (2006). Latino adults’ access to mental health care: a review of epidemiological studies. Administration and policy in mental health, 33(3), 316–330. https://doi.org/10.1007/s10488-006-0040-8

Basic Warning Signs of Poor Mental Health

• Feeling very sad or withdrawn for more than two weeks
• Seriously trying to harm oneself or making plans to do so
• Severe out-of-control, risk-taking behaviors
• Sudden, overwhelming fear for no reason
• No eating, throwing up, or using laxatives to lose weight; significant weight loss or gain
• Seeing, hearing or believing things that are not real
• Repeated use of drugs or alcohol
• Drastic changes in mood, behavior, personality or sleeping habits
• Extreme difficulty in concentrating or staying still 
• Intense worries or fears that get in the way of daily activities
• Withdrawal from friends, family, and community
• An extended period of negative mood
• Many physical complaints (i.e., headaches and stomach aches)
• Lack of interest in regular hobbies, activities, or pastimes
• Change in hygiene, lack of personal self-care 
• Frequent outbursts of anger, aggression
• Adverse life events (loss of a job, etc.)
• Changes in sexual behavior/ risky sexual behavior (unsafe sex, multiple partners) 
• Abuse of alcohol and or drugs
• Thoughts of or preoccupation with death or suicide

Sources: American Foundation on Suicide Prevention (AFSP) and the LxHB and CHBC Mental Health and Wellness Toolkit

If the person is experiencing any of the symptoms above, it’s important to help the individual seek the care and resources they need. Often a medical doctor can make a referral to a mental health professional who can support them with gaining healthier life skills and address some of the physical manifestations of mental troubles. Even if the individual does not have a regular healthcare provider, there are resources and people available who can help. You can find resources specific to Washington State and Snohomish County. We will also go over resources in more detail in Lesson 5. 

These conversations about mental health aren’t easy, but they’re critical to have. You can make a positive difference for someone you care about. No one should face a mental health challenge alone. Thanks to you, your loved ones won’t have to.