Historically marginalized communities can often experience disparities when it comes to accessing quality mental health care. Obstacles can include geographical limitations, stigma, and the cost of treatment.

Mental health includes our emotional, social, and psychological well-being. It allows us to manage daily stressors, maintain relationships, pursue our goals, and work and learn. In short, our mental health contributes to our overall quality of life.

Mental health care is a basic human right. But, systemic inequalities mean that not everyone is able to access care fairly. In 2020, only 46% of adults in the United States with a mental health condition received specialist support.

Several key limitations prevent individuals from accessing mental health care, including:

For people of color, accessing mental services can be made difficult by structural and systemic racism. This refers to racism that is deeply rooted in systems and policies, which in turn affect the way healthcare systems function, including medical education and care delivery.

Racism in mental health care can lead to:

  • Dismissal: People of color, and Black people especially, can experience medical dismissal and gaslighting. It can result in higher rates of illness and death from preventable conditions.
  • Stereotypes and misdiagnosis: Stereotypes about certain groups can have harmful effects on care. For example, a 2018 study found that African Americans who have severe depression are more likely to receive a misdiagnosis of schizophrenia.
  • Mistrust: Communities of color have historically experienced medical discrimination. This can often lead to deep-rooted mistrust in the healthcare system. It can cause some people to avoid seeking mental health support out of fear of harmful health outcomes.

Where you live can often affect the quality of mental health care you have access to. The Centers for Disease Control and Prevention (CDC) mentions that those who live in rural areas face more health disparities than their urban counterparts.

Around 60 million people in the United States reside in rural areas. Due to a lack of mental health professionals practicing in their area, they can face obstacles such as having to travel long distances to receive care.

They are more likely to experience inadequate broadband and internet coverage, which can also make it difficult to utilize telemedicine services.

The cost of mental health care can often be a major barrier to accessing treatment, especially for people without health insurance.

However, even with insurance, affordability can still remain a factor. A 2023 study found that 17% of U.S. adults with a mental health condition had an insurance plan that did not cover or pay enough toward treatment.

The cost of mental health services can often lead to people deprioritizing their needs and choosing to go without treatment or support from a mental health care professional.

Cultural competence refers to healthcare that considers an individual’s cultural and faith-based needs and values. It is vital to achieving effective care with positive outcomes.

However, research suggests that not all clinicians understand how to deliver culturally competent care. This can decrease the chances of an individual feeling understood and respected.

Culturally competent care should also consider linguistic needs and ensure translation services are available when needed. Language barriers can often prevent an individual from receiving quality care tailored to their needs. Studies have found that this can negatively affect care outcomes.

Individualist vs. collectivist values

For communities of color, an individualistic approach to mental health care may not align with their core values and may mean Western-centric treatment plans can be less effective.

Instead, effective treatment may include care that is rooted in community, tradition, and cultural practices.

This does not mean that individual needs must be sacrificed. Instead, it can allow for more autonomy over treatment plans that consider that ‘healthy’ can look different for everyone.

While we have made significant progress with how we speak about mental health, many people with mental health conditions still face stigma. This can lead to discrimination, which can worsen their health and reduce the chances of them seeking support.

In some cultures, the internalization of mental health stigma can lead people to feel as though:

  • asking for help is shameful
  • they need to be more emotionally resilient
  • they may be viewed as “attention seeking”

The World Health Organization (WHO) reports that stigma can also lead to mental health services being seen as “less prestigious than other health services” and receiving decreased funding.

We can create more accessible and effective mental health services in many ways, including:

  • Prioritizing culturally competent care: Healthcare professionals should consider a multifaceted approach when developing treatment plans to ensure that unique care needs can be met.
  • Improving access for underserved communities: When designing policy, the distribution of health services and technology needs should be considered to ensure equal access to care for all communities.
  • Working to reduce stigma: Community-driven resources may help close the gap in seeking care and reducing stigma.
  • Diversifying medical education: Prioritizing diverse medical training and reeducation for healthcare professionals can help improve health outcomes and ensure traditionally marginalized communities feel safe and respected when seeking care.

Historically marginalized communities can often experience systemic inequalities, which can make accessing effective and quality care difficult.

This can include structural obstacles like:

  • cost
  • stigma
  • racial discrimination
  • geographical limitations
  • a lack of internet access

While many of these barriers are deeply rooted in our healthcare systems, they are not impossible to remove. We can take steps to reduce these obstacles through policy change and the prioritization of person-centric care.