The US mental health care system has failed black people and people of color. It’s failing everyone who isn’t privileged, and failing those who don’t know how to seek help for their mental health challenges.

The current system provides access to people of a certain socio-economic background – well-employed, employed and fully insured. It generally does not include the large population of Black, Indigenous or People of Color (BIPOC), even though they experience similar rates of mental health disorders as whites. Existing disparities in services lead people of color to receive lower quality care and lack access to culturally appropriate care.

When you combine these decades of systemic injustice, socioeconomic disparities, extremely limited access to affordable care, as well as communities lacking the resources to provide safe spaces, it’s not a mountain to climb. That’s not even considering finding a provider who looks like you, who understands what you’re going through or where you’re coming from. These challenges make it close to impossible for anyone to get affordable, accessible mental health care. This ‘impossible’ feeling makes people less likely to seek treatment, less likely to receive or access high quality care, and less likely to complete treatment. In fact, only one in three black people need mental health care.

In my work, I have experienced first-hand the systemic challenges BIPOC patients experience when trying to access mental health care, and I have seen how lost patients end up in poorly conceived outpatient care systems. All of this contributes to a revolving door that sees people from underserved and neglected communities walking in and out of hospitals and constantly incarcerated. We need to do better by these communities and start providing affordable, high-quality and culturally-competent services to patients in need of care.

Acknowledge the problem

Before we can address these issues, we must first acknowledge and address the issues that prevent BIPOC patients from seeking and receiving mental health care.

People struggling with their mental health in these communities often delay or avoid care altogether because of the cultural stigma associated with mental health treatment. They struggle in silence until their condition becomes so severe that their first touchpoint of care is the emergency room (ER) instead of a counselor. Blacks are particularly likely to receive health care from hospital outpatients and emergency departments.

When someone experiences mental health issues so intensely that their cognition is impaired, they may end up in the prison system instead. Symptoms of mental illness, especially untreated schizophrenia and bipolar disorder, are closely related to the same behaviors associated with substance abuse, which can easily lead to incarceration rather than treatment. Blacks are overrepresented among those involuntarily committed and among those admitted for inpatient psychiatric hospitalization. Through use of emergency services, black people with serious conditions are more likely to be incarcerated than people of other races.

There are also substantial gaps for populations that need greater assistance, such as the unemployed, homeless and those living below the poverty line. Even if they receive inpatient care, the outpatient process is so confusing and difficult that some patients don’t understand where or how to get their medications. They may not be able to go to a clinic for an injection every month, as they navigate housing instability or try to figure out where their next meal will come from.

In many such cases the focus is less on treatment than on removing a perceived problem or threat. Proper care, treatment and medication, when needed, should result in them, but the resources needed for such procedures are not there. However, with the proliferation of digital health services over the past few years, we as a healthcare ecosystem – and as a society – are becoming better equipped to address these issues at a systemic level rather than just paying lip service to them. lasting for decades.

A brilliant show of gap counting

We have a shared responsibility to design and implement programs that remove barriers for all patients, especially BIPOC patients, to ensure quality mental health care when needed. That responsibility extends to healthcare and digital health systems, politicians and government agencies, and our communities. With multiple stakeholders working together, we can create innovative solutions to help solve systemic problems and ultimately save lives.

Here’s how we can bridge the gap:

  • At community level: Addressing cultural stigma requires us to start conversations with patients as early as possible, at the lowest touchpoints. If a patient is not yet ready to see a therapist or take medication, consider hosting an event with a mental health organization at a barbershop or church, where people can feel safe and comfortable and more open to learning about their options. can . For homeless patients, conversations with shelters and food pantries should begin with a focus on helping them find a stable housing situation before discussing their mental health. These are fragile, sensitive conversations, but the sooner they happen, the sooner people are pressured to solve all their problems alone and at once.
  • In Healthcare and Digital Health Ecosystem: While digital health systems have greatly expanded access to care, not everyone has Internet access or owns a device, meaning telehealth and other digital solutions are out of reach. These companies need to start accounting for the challenges that all potential patients face when seeking help in their models of care. Consider implementing low-cash payment models or offering services that (literally) meet patients where they are — registered nurses visiting patients in their homes, for example, can help remove barriers.
  • Between governments and healthcare organizations: Snowballing mental health issues in the BIPOC community is always related to a lack of resources. Strong clinical programs and models within the health care system must be linked to food and housing assistance programs through local government funding. Creating a connected ecosystem will begin to address the challenges that impact high hospitalization and incarceration rates. Funding for mental health initiatives is how politicians and government agencies provide support. While funding has historically flowed to nonprofits at both the federal and state levels, it may be time to take a slightly different approach—one that helps for-profit or private organizations more seamlessly integrate and operate with nonprofits. program which will help well any Patients in need.

Addressing the mental health crisis is a long journey, but the first step is to address the lack of available resources and affordable access for BIPOC and underserved communities, as well as the long-term effects of lack of services on those patients.

People with mental illness have always been discriminated against. They are denied full participation in society and labeled as dangerous and criminal. Many are held in institutions that function more like prisons designed to punish than hospitals designed to treat them.

We must do better, and now is the time for action.

Photo: SIphotography, Getty Images

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