Disparities in Mental Health Care

by DR. LEKESHA DAVIS

For as long as I can remember I have wanted to help others. I didn’t always know what that would look like, I just knew, on some level, that it was always my calling.

I lived in a bubble of “we are all the same” until about the age of 12. I remember it so clearly; I was walking in the neighborhood with some of my friends. I was the only black kid in the group, but at the time it never dawned on me that it mattered. We were having a fun time just laughing and talking. A car full of white teenage males drove past us and in my mind, I thought, “Oh, cute boys,” until they screamed out the window, “Hey fat N-!” In that moment, the weight of the world I lived in came crashing down on me. My bubble was forever popped as I realized that I would always be seen differently. No matter what I did, there would be people who saw me as less than without knowing a single thing about who I was as a person.

That incident was a defining moment in my life. I wanted to make sure that I could do something to help people not have to live their lives feeling how I felt in that moment. My favorite Bible verse is, “I can do all things through Him who gives me strength” (Philippians 4:13). When faced with difficulties and adversities, I find comfort and strength in knowing that God is with me.

I have had my personal experiences with racial disparities, but I had no idea how deep those disparities permeated until I became older. The history of mental health treatment in this country is steeped in racial disparities. In an effort to understand how far we have come, it is important to understand where we started, and where we have yet to go. There has been much progress that has been made. And I am aware that there was a time that I would not have been able to work at an institution of higher learning such as Missouri Baptist University, but I am thankful that I am here to learn and grow with so many people who have experiences very different than my own.

Although there have been efforts made to decrease the gap in access to care, disparities in mental healthcare remains more significant than other areas of healthcare (Le Cook et al., 2017). Many people may not be aware that there was a time in this country when being Black was considered a disorder. It is hard to believe, I know. Benjamin Rush, often touted as the “father of American psychiatry” stated that Blacks suffered a disorder called “Negritude” and the cure was to become White (Perichilli, 2020).

Another influential American physician by the name of Samuel Cartwright described the term “drapetomania” as a mental illness that led to slaves attempting to flee captivity (Perichilli, 2020). The only way to treat this mental illness was to keep slaves submissive by whipping them and removing toes to ensure that slaves were no longer capable of running away (Perichilli, 2020). Even the U.S. Census made the claim that freed slaves suffered mental illness at a higher rate than those who remained slaves (Perichilli, 2020). At the turn of the 20th century, prominent psychiatrists noted that “negroes” were “psychologically unfit” to be free, and the disorder, “drapetomania,” remained in the Practical Medical Dictionary as late as 1914 (Perichilli, 2020).

As difficult as it may be to learn about some to the historical practices that occurred in our country, it helps provide a better understanding of why these disparities continue to exist. There are several ongoing factors that contribute to poor mental health outcomes experienced by racial/ethnic and other minorities: discrimination, stigma surrounding mental health treatment and care, access to high-quality care, and lack of awareness are a few of those factors (Le Cook et al., 2017). There are also disparities in misdiagnosing mental health disorders. For example, black men are four times more likely to be overdiagnosed with schizophrenia than white men, but underdiagnosed with post-traumatic stress disorder and mood disorders (Le Cook et al., 2017).

Understanding the past enables new ways of addressing current implications and identifying barriers. For almost four decades, the mental health field has been called to focus on increasing cultural competency training, which has focused on the examination of provider attitudes/beliefs and increasing cultural awareness, knowledge and skills. In addition to emphasizing culturally competent services, other recommendations to bridging the gaps and addressing barriers include diversifying workforces and reducing the stigma prevalent in communities of color (Perichilli, 2020).

As Christians we must stand firm on God’s promises and remember that if we want to fulfill God’s command to be the salt and the light, we cannot neglect social justice and advocacy. The Bible teaches us to “learn to do good; seek justice, rescue the oppressed, defend the orphan, plead for the widow” (Isaiah 1:17). And when we have the opportunity “let us do good to everyone…” (Galatians 6:10).

There has been so much growth and change in how disparaged groups are provided healthcare services. And while being black may no longer be considered a disorder, there are significant areas of growth still needed to support and uplift marginalized groups. Dr. Martin Luther King Jr. stated, “Life’s most urgent question is, ‘What are you doing for others?” When we trust in God to meet our needs, it gives us the freedom to support and help others.

We are on the cusp of great change in our society. The mental health needs of marginalized groups continue to grow and it is up to us, as Christians, to meet those needs as God meets ours needs daily. I want to leave you with the words of Rosa Parks: “To bring about change, you must not be afraid to take the first step. We will fail when we fail to try.”

REFERENCES

Le Cook, B., Trinh, N., Li, Z., Hou, S. S., Progovac, A. (2017). Trends in racial-ethnic disparities in access to mental health care, 2004–2012. Psychiatric Services, 68(1), 9–16. doi:10.1176/appi.ps.201500453.

Perichilli, T. (2020). The historical roots of racial disparities in the mental health system. Counseling Today, Retrieved from https://ct.counseling.org/2020/05/the-historical-roots-of- racial-disparities-in-the-mental-health-system/

AUTHOR’S BIO Dr. Lekesha Davis is an assistant professor of counseling education at Missouri Baptist University. She is a licensed professional counselor in Missouri and has more than 20 years of experience. Before coming to MBU, she served as vice president of behavioral health services for the Amanda Luckett Murphy Hopewell Center, a Federally Qualified Health Center serving the central and north regions of St. Louis City.

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