Minorities' Access to Mental Health Care Services Bias in Mental Health Assessments References Minorities' Access to Mental Health Care Services Minorities in America face severe economic, cultural, linguistic and physical barriers for treatment of mental illness, difficulties that prevent thousands from being properly treated.  Mental health was identified as the top health problem by 10 of 12 Indian Health Service areas and the Urban Indian Health Programs in 2001.(1)  As noted by Surgeon General Satcher, epidemiological research consistently reveals that African, Asian, Native, and Hispanic Americans needing outpatient care are unlikely to receive it.(1)  African Americans and Hispanics are also less likely than whites to receive guideline-adherent treatment when suffering from from serious mental illness .(3,4) Other factors that affect access to mental health services include ability to pay for those services. African Americans and Hispanics are less likely to have health insurance and more likely to have lower incomes than whites. When sought, assistance for mental health problems is especially likely to come from providers in the general medical sector, rather than by a mental health specialist.(5)   Bias in Mental Health Assessments Determining the role of bias in mental health assessments is important in establishing a comprehensive explanation of disparities and, ultimately, efforts to effectively address them.(6) Differences between African Americans and whites in how they present symptoms of mental illness to clinicians play a crucial role in the way they are diagnosed.(4) Provider expectations and culturally-specific attitudes towards drug treatment and mental health treatment may influence diagnosis. Alvidrez and Havassy report, in a 2005 paper, on racial distribution of dual-diagnosis clients in mental health and drug treatment settings. (Dual-diagnosis clients are individuals with co-occurring mental health and substance use disorders.) African Americans in the sample were just as likely as whites to have severe mental health disorders and whites had just as frequent illicit substance use as African Americans. HOWEVER, whites were more likely to have used mental health services than African Americans and African Americans were more likely to have used detoxification services.(7) For more on access to health care and barriers to receiving health care, please visit the Access to Health area of this website, or look up articles in the PubMed and Google search.  Back to Top References 1. Johnson JL, Cameron MC. Barriers to providing effective mental health services to American Indians. Ment Health Serv Res 2001;3(4):215-23. 2. Culture, race and ethnicity: disparities in mental health. Public Health Rep 2001;116(6):626. 3. Wang PS, Demler O, Kessler RC. Adequacy of treatment for serious mental illness in the United States. Am J Public Health 2002;92(1):92-8. 4. Young AS, Klap R, Sherbourne CD, Wells KB. The quality of care for depressive and anxiety disorders in the United States. Arch Gen Psychiatry 2001;58(1):55-61. 5. Vega WA, Kolody B, Aguilar-Gaxiola S, Catalano R. Gaps in service utilization by Mexican Americans with mental health problems. Am J Psychiatry 1999;156(6):928-34. 6. Snowden LR. Bias in mental health assessment and intervention: theory and evidence. Am J Public Health 2003;93(2):239-43. 7. Alvidrez J and B Havassy. Racial distribution of dual-diagnosis clients in public sector mental health and drug treatment settings. J Health Poor Underserved 2005;16(1):53-62. This research was supported by a National Library of Medicine (NLM) Publication Grant #5G08 LM07653-02 in support of the creation of a web site titled Factline: Tracking Health in Underserved Communities, www.factline.org. Saqi S. Maleque, MSPH, Researcher, Principal Investigator: Virginia Brennan, PhD.