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Study shows racial, class discrimination among psychotherapists

Individuals who were white or middle class were more likely to receive mental health appointment offers from psychotherapists than blacks or those of working class, according to recent findings.

“It is striking that discrimination toward black and working-class therapy seekers occurred even though all therapy seekers had the same health insurance and were contacting in-network providers,” Heather Kugelmass, MA, a doctoral student in sociology at Princeton University, said in a press release. “This evidence points to bias rather than financial considerations. It is possible that if insurance coverage had not been held constant, inferences based on racial and class stereotypes would have augmented discrimination even beyond that which was observed.”

To assess the effect of race, class and gender on accessibility of psychotherapists, Kugelmass conducted a phone-based field experiment. New York-based psychotherapists (n = 320) received voicemail messages requesting appointments from one black middle-class individual, one white middle-class individual, one black working class individual and one white working class individual.

Analysis indicated middle-class individuals were three times as likely to receive an appointment offer than working class individuals.

Race differences occurred only among middle-class individuals. Blacks were significantly less likely to be offered an appointment compared with whites.

Average appointment offer rates were comparable between genders, though women were more likely to receive an appointment offer in their preferred time range.

“Access to health insurance may not be sufficient to ensure equal access to therapy. In fact, psychotherapists may unintentionally stymie efforts to promote equal access when they have discretion over their clientele,” Kugelmass said in the release. “Macro-level barriers to accessing care are incredibly important, but the influence of interactions between therapists and prospective patients should not be overlooked.” – by Amanda Oldt

Disclosure: Please see the full study for a list of all authors’ relevant financial disclosures.