Unmet need for mental healthcare among African Americans: Taking the racism bull by the horns

• In Event: 3463 - Social Marginalization and Its Consequences on Mental Health

Abstract

Most of the research examining inequities in mental health care employs race-comparative approaches; comparing gaps in mental health status, access to services, utilization and quality of care across marginalized and dominant racial groups. However, identifying and addressing mechanisms that underlie inequities require more in-depth analyses of the contexts in which people who belong to racial minority groups experience poor health outcomes. This study describes reasons for unmet need for mental health care specifically among Blacks, identifies factors that are associated with causes of unmet need, examines the racial context of unmet need and constructs ways to improve service use. Data from the 2011-2015 National Survey on Drug Use and Health were pooled to create an analytic sample of black adults with unmet mental health need (N=1,237). Qualitative data came from focus groups (N=30) recruited through purposive sampling. Using sequential mixed methods, reasons for unmet need were regressed on sociodemographic, economic, and health characteristics of respondents and findings were further explored in focus groups. Higher education was associated with greater odds of reporting stigma and minimization of symptoms as reasons for unmet need. The fear of discrimination based on race and on mental illness was exacerbated among college-educated Blacks. Racism causes mistrust in mental health service systems. Anti-racism education and community-driven research, policy and practice will reduce unmet need by fostering critical self-reflection at the individual level, and racial equity analysis at the organizational level. Mental health systems must confront racism and engage the historical and contemporary racial contexts within which black people experience mental health problems.

Author

• Sirry Alang, Lehigh University