Several historically marginalized groups and populations face barriers to effective mental health treatment in the United States. These barriers are reasons or obstacles that prevent individuals from seeking, obtaining, or completing mental health treatment. Due to these barriers, these populations may often have negative mental health outcomes.
In the U.S., several historically marginalized groups experience significant mental health disparities. Health disparities are differences in health outcomes between groups of people.
Barriers that can reduce or prevent access to mental health care among these groups include:
- high costs
- lack of insurance or underinsurance
- lack of treatment services in the local area
- distrust in an inequitable healthcare system
- racism and discrimination
- language barriers
- stigma
These barriers often result in worse mental health care, leading to negative mental health outcomes.
In a 2020 research review, researchers referred to an older study that found people in racial-ethnic minority groups were 20% to 50% less likely to initiate mental health service use, and 40% to 80% more likely to prematurely drop out of treatment than other populations. They were also more likely to use psychiatric emergency services and to be involuntarily hospitalized. However, they were less likely to receive regular outpatient care after discharge, meaning their symptoms were more likely to last longer or recur. Research from 2023 states that several historically marginalized groups and under-resourced communities in the U.S. experience significant general health disparities due to racism in healthcare.
Researchers also reviewed mental health treatment barriers among underserved and disenfranchised populations in the U.S. in 2020. The review article notes growing evidence that the mental health services available to LGBTQIA+ individuals are often scarce and may offer inadequate and stigmatizing treatments. It states that negative and stigmatizing attitudes toward LGBTQIA+ people among doctors may stem from prejudice or, more commonly, a lack of knowledge.
Historically marginalized groups experience healthcare disparities that may lead to several barriers to mental health care. These barriers can also reduce the effectiveness of treatment, leading to negative mental health outcomes. Researchers have investigated several of these barriers, which include racism and discrimination in healthcare systems. Several other healthcare disparities may reduce access to the pathways to mental health care. However, research indicates that improving cultural competency can help improve access and outcomes of mental health care services among historically marginalized populations.
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