Racial Disparities in Mental Healthcare Hurt My Family and Many Others

The stark reality of America’s mental health crisis never hits so hard as when it affects someone close to us. One moment my mother was active, healthy and independent. The next, she was found unresponsive on a flight of stairs, exposed to the elements late on a frigid night in February 2019.

“Traumatized” doesn’t adequately articulate the reality of your world imploding. Without question, the experience changed me forever.

As my mother’s mental health condition became apparent in the days following that event, the stress fractures in my own psyche cracked along their usual fault lines. I unfortunately neglected to check in with a mental health professional.

If I had one wish for how people respond to this article, it would be that they take stock of their situation and seek help when they need it. Day-to-day life is hard enough; why make it more so by trying to fight through things alone?

My personal struggles with my mind intensified through my mother’s illness. Minor things seemed to be inflated. Despair and anger always seemed to rear their destructive heads at the most inopportune moments. Isolation seemed better than worrying about what I perceived at the time as my shameful behavior. This formula plunged me deeper into an abyss of self-loathing and rage.

A Severe and Disproportionate Shortfall

Sadly, in America, mental health provision is simply not a priority, be it on the local, state or national level. MentalIllnessPolicy.org estimates that almost half of all Americans with mental illness are not getting treatment, and notes that hundreds of thousands of people with serious mental illness experience incarceration, homelessness or family separation.

Nor are the severe harms of this shortfall equally distributed. Black and Brown people are disproportionately affected by the woeful inaccessibility of vital mental health services.

While implementation of the Affordable Care Act helped to reduce the proportion of uninsured individuals, particularly between 2014 and 2016, the proportion began rising again after 2016. As of 2018, according to the Census Bureau, 5.4 percent of non-Hispanic white Americans, 6.8 percent of Asian Americans, 9.7 percent of Black Americans and 17.8 percent of Hispanic Americans had no health coverage.

Amid all this, Black Americans have far worse mental healthcare access than white Americans. In 2018, just 8.7 percent of adult non-Hispanic Black Americans received mental health services, according to the US Department of Health and Human Services Office of Minority Health, compared with 18.6 percent of white Americans. The equivalent disparity for receiving prescribed mental health medications was 6.2 percent versus 15.3 percent. And among adults with past-year major depressive episodes,  68.5 percent of non-Hispanic white Americans were treated for it, compared with only 61.2 percent of non-Hispanic Black Americans.

The disproportionate dearth of services, without question, is rooted in the sordid legacy of white supremacy.

As well as the structural factors that lead to higher uninsured rates for Brown and Black people, conscious or unconscious bias from providers and lack of cultural competency, leading to misdiagnosis and poorer quality of care, further rig the system. As such, there is a strong argument that priority should be given to making up this shortfall in care, when and if expanded funding is directed towards the current treatment crisis.

The disproportionate dearth of services, without question, is rooted in the sordid legacy of white supremacy. Its many manifestations include deep-rooted wealth disparities, systemic bias within the medical field and the fact that, as the Health and Human Services Office of Minority Health notes, “African Americans are … more likely to be exposed to factors that increase the risk for developing a mental health condition, such as homelessness and exposure to violence.”

In this context, African Americans seek medical treatment considerably less often than their European American counterparts. And if they do attend, they are more likely to discontinue treatment due to various societal factors.

Sadly, when confronted with the difficult task of dealing with challenging and disturbing symptoms, many people of all demographics are simply overwhelmed and choose to ignore the problem.

The average hospital cost for a patient readmitted for a mood disorder is $7,100. The National Alliance on Mental Health estimates that untreated mental illness costs the country up to $193.2 billion every year due to losses in productivity. Suicide is the second leading cause of death among people aged 10 to 34. And mental illness and substance use disorders often co-occur, increasing the risk of death from overdose.

If this country is to begin investing in all of its citizens, that has to start with the most vulnerable. Those who suffer through systemic bias against communities of color and people living in poverty must be our priority. The true litmus test of our society should be how it treats those who are most in need.

My Family’s Ordeal

As a testament to those failures, I witnessed firsthand the utter uselessness of the many options presented to me while pursuing care within the American system.

Although my mother had good health insurance, the hospital that first admitted her was unprofessional and provided misleading information.

It was obvious that my mother was treated differently from the other patients.

The next place was even worse. It was supposed to be a rehab facility but personally, I felt it was a place for people to be broken, not healed. The staff was very rude and unprofessional, and it was obvious that my mother was treated differently from the other patients.

We had to complain so much that several nurses were prohibited from providing “care” to my mom. She also received undiagnosed infections due to negligence. This was discovered after she was transferred to another under-staffed, under-funded facility.

Throughout this ordeal, my brother and I had to maintain constant vigilance and sleep with her because the facilities were so inattentive.

Unfortunately such experiences seem to be the norm for my demographic, as many studies affirm. People who overcome the major barriers to seeking care in the first place must then navigate a system that too often doesn’t see the humanity of those in need. Is it any wonder that a marginalized person might see this as a hopeless path to invest in their recovery or well-being?

As Black and Brown people, we should especially embrace mental health needs as a path to our wellness and empowerment. We are in desperate need of it after being subjected to white supremacist terror for centuries, with ongoing, intergenerational ramifications today. Lynchings, rapes, murders, thefts, redlining, gaslighting, the drug war, mass incarceration, medical bias, and so it goes on.

Black people’s post-traumatic stress often goes undiagnosed for years. Until systems of oppression change, it is up to us not only to seek aid, but to follow through with treatment and advocate for ourselveseven if it means fighting through a hostile medical system that seems intent on undermining our access.

Until we achieve systemic transformation, self-care and intra-community care will continue to be the only help many of us can reach.

Regarding my own mental health, I fortunately had two important people in my life who didn’t give up on me when I had already done so. With a lot of reading, support and hard work, I am proud to say that I am finally doing better.

I started writing to help me get through things, and in a perfect world my articles will play some part in helping people in dire straits. I was blessed, but many who look like me are not so fortunate.

I am still trying to deal with my new normal as best I can. Whatever the trigger, I’ve come to realize how critical mental stability or the lack thereof is, and how little most of us prioritize it.

So please, check in with each otherbe it with friends, family, neighbors, or whatever other form of support is available to you. Until we can achieve systemic transformation, self-care and intra-community care will continue to be the only forms of help many of us can reach.


Photo by Anaya Katlego on Unsplash

Erving Jean-Jacques

Erving is a Boston native and cannabis advocate. Incarceration led to a transmutation of his consciousness and a pivot toward writing and other forms of media.

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