Ethnic, national, and gender minorities in the U.S. have worse mental health, and are incarcerated at a disproportionately higher rate, than the white cisgender majority. Though we are coming to the end of July’s National Minority Mental Health Awareness Month, our work year round is devoted to awareness of factors that contribute to the disparities in mental health outcomes and justice involvement.
Compounded stigma, unconscious bias, and overt discrimination contribute to persisting inequalities in access to care and coverage, barriers to housing and employment, real access to justice, and the pursuit of happiness. Moreover, minority populations by gender, sexuality, and ability are more likely to be suspended or expelled from school, which triggers an increased likelihood of later incarceration. This phenomenon is referred to as the “School-to-Prison Pipeline.” Any one of these factors can reinforce the imbalances in mental health outcomes faced by a minority versus majority populations. By acknowledging the early and frequent, aggravating effects of systemic and overt racism, sexism, and other –isms on health, we can start to get at solutions.
The United States in 2017 is more segregated by race than at any time since the 1960s. On average, black and Latino households still earn far less than the average white household. The odds of emerging from poverty and achieving positive health outcomes are stacked against impoverished families. Poverty directly correlates with exposure to highly stressful life events called “Adverse Childhood Experiences” (ACEs). In youth, the effects of trauma and persistent stress may result in trouble regulating behavior and impulses, which is linked to increased risk of mental illness and involvement with the criminal justice system. LGBT people also have higher rates of mental health disorders due to a variety of added social stressors “as a result of leading marginalized lives.” This too, results in an increased likelihood of ensnarement in the School-to-Prison Pipeline for gay and transgender youth. This is all the more tragic, given that early intervention to treat children’s trauma can help mitigate its effects on long-term success – if only that treatment were available.
Gender and racial minorities, especially black and Latino people, are more likely to experience persistent disparities in health outcomes compared to white, heterosexual and cisgender people because of . This may lead to outcomes like those reported by the Greenburger Center for Social and Criminal Justice: “African Americans are 20% more likely to experience serious mental illness than the general population, yet only about 25% seek professional mental health care, as compared to 40% of whites in the United States.” Additionally, “only 5% of Hispanics surveyed reported using antidepressants, despite the fact that 27 percent suffered from depression.” According to NAMI, “LGBTQ youth are 4 times more likely and questioning youth are 3 times more likely to attempt suicide, experience suicidal thoughts or engage in self-harm than straight people. Between 38-65% of transgender individuals experience suicidal ideation.” These mental health discrepancies are indicators of broad systemic failures to deliver equitable health outcomes and prosperity to minority populations.
Unchecked unconscious bias causes us to make assumptions that conflict with our goals as a society striving for equality. People of color and gay and transgender people face greater barriers to accessing care and for being cared for instead of punished. Minority Mental Health Awareness Month reminds us that there is still a long road ahead to achieving health equity. When we recognize the barriers minorities face, mitigate our unconscious biases, and appropriately address behavioral health needs, we take a significant step toward equality, freedom, and increased prosperity.