Bias, cultural barriers impede mental health diagnosis, treatment

Roughly 53 million Americans live with a mental, emotional or behavioral health disorder, but not all are diagnosed and treated at the same rate, according to a press release from AmeriHealth Caritas.

AmeriHealth cited the American Psychiatric Association, which stated Black adults are less likely to be offered either evidence-based medication therapy or psychotherapy compared to the general population. They are also less likely to receive guideline-consistent care and less frequently included in mental health research, compared with whites.

“The mental health care system was not designed with everyone in mind,” Yavar Moghimi, MD, a behavioral health medical officer for AmeriHealth Caritas, said in the release. “Provider bias and systemic barriers cause many Black people to feel that treatment will not be helpful for them.”

Challenges to proper diagnosis and treatment for underrepresented populations include a need for a more diverse behavioral health care workforce as well as a lack of cultural competency or the necessary skills, behaviors and attitudes to work effectively with different cultural groups, AmeriHealth said in the release. This can lead to misdiagnosis and inadequate treatment and cause mistrust in the patient. Such barriers can have significant consequences, especially in marginalized communities.

In 2019, suicide became the second leading cause of death for Black teens and young adults aged 15 to 24 years, and Black women remain one of the most undertreated U.S. populations for depression, per the release.

Moghimi recommends patients consider the following to best evaluate whether a mental health provider is the right fit and can provide culturally competent care:

• if the provider inquires about issues in the context of your social network, such as family, friends or others in your community;
• if the provider asks what you think the causes of your problems are;
• if the provider asks about the most important aspects of your background or identity and whether they make a difference to a particular issue;
• if the provider asks about barriers that may or have prevented you from getting the help you need, including any stigmas or social determinants of health;
• and if the provider seeks out your concerns about differences in culture or background and what your expectations of diagnosis and treatment are.

According to AmeriHealth, culturally competent mental health providers should consider these issues when trying to provide responsive care in the context of culture and inequities.

“Finding a mental health care provider who can [incorporate] an individual’s unique culture, beliefs and values into their care is important for treatment to be successful,” Moghimi said in the release.