People of color are less likely to seek mental health services. Here are some reasons

LOS ANGELES (KABC) – The holidays can be a particularly stressful time. And for some, they can make mental health problems worse.

Studies show people of color may be less likely to use mental health services.

“Those who need it the most are most likely not to get it,” said Dr. Cheryl Grills, professor of psychology at Loyola Marymount University.

According to experts, there are several obstacles such as cost, stigma and even cultural history.

A pair of studies published this summer by UCLA and focused on the mental health needs of Latin American and Asian communities in California. Researchers found that the percentage of people reporting symptoms of depression and anxiety was significantly higher than those who said they really needed help.

“These differences between subjective and objective measures of the need for mental health services may indicate that there is a gap in mental health literacy, meaning that more work may be needed to reduce stigma and help. to normalize the conversation about mental health and the use of mental health services in these communities, ”said Dr Imelda Padilla-Frausto, one of the co-authors of the two studies and researcher at the Center for Policy Research UCLA Health Center.

But, even those who thought they needed help struggled to get it.

Almost half of Latinos and Asians in the study who said they needed mental health services did not receive care. Of those who have symptoms but may not know they need help, about two-thirds have not received care.

According to experts, not getting help can make problems worse.

Dr Cheryl Grills explained that for most people the stress breaking point can be high, but for historically oppressed communities of color the bar is much higher.

“But now that doesn’t mean that, because I have a higher level of stress and trauma tolerance, everything is fine. Having that higher threshold can actually still hurt and damage not just my skin. mental health, but also to my physical health, ”said Grills.

Barriers to care

Part of the barrier to mental health services is the cost.

Dr Grills said seeing a private psychotherapist can easily cost $ 200 or more per session without insurance. Even with insurance, coverage may vary.

“You can have an insurance policy that includes mental health, but it limits you to six brief psychotherapy sessions. Well, that may not be enough for what you need,” Grills said.

“This can restrict you to a particular set of providers, which can also be problematic if they don’t have a pool of providers to match your racial, ethnic, sexual orientation and gender identity realities,” she declared.

Communities of color are also more likely to live below the poverty line.

“In this reality, then, you are stuck with all publicly available sources of support. And the waiting list for that can be extremely long, your ability to qualify can sometimes be risky and difficult. of financial resources and not having Insurance that offers the kind of flexibility that one needs to find a therapist to work for them means that you have a lot of people who are out in the cold without having the ability to access the necessary services. “

It’s like going to buy shoes

Grills stressed the importance of finding a mental health professional who you can connect with.

She said most people might be able to get by with a doctor who might not have the best bedside manner, but who has the technical skills to treat their patients.

It does not work the same way with mental health care.

“It’s not such an easy thing when you’re talking therapy and sharing the more private and vulnerable parts of who you are,” Grills said.

She recounted the experience of shopping for a therapist with purchasing shoes.

“When you go to buy a pair of shoes and you try on the first pair you see, do you buy them immediately? No. A lot of people try four, five, six different pairs. They moderate the size of the shoe which they think they like the most. Well, you know, finding a therapist that you can actually identify with can take the same level of care and flexibility that comes with shopping for shoes, ”she said.

Lost in translation

The reluctance of people of color to seek mental health services may also stem from a historical distrust of the mental health community.

“We have seen abuse by the profession in terms of not getting, somehow, the same level of care their white counterparts can receive,” said Dr Erlanger Turner, psychologist at Pepperdine University and founder of Therapy for black children.

That’s why Turner said many prefer to work with someone from a similar community.

“They have more confidence in this person and can open up to them,” he said.

“When we see a client who is able to make that connection with the therapist, who comes from their own community, it strengthens that connection, that relationship, we see that clients are more likely to stay engaged in treatment,” continued Turner. .

In addition to trust, cultural and linguistic understanding is crucial, experts said.

“Things get lost in translation,” said Dr Grills.

“There are a number of concepts in different ethnic and cultural groups for which we do not have an equivalent understanding or recognition of how we view mental health,” she continued.

Grills said a lack of linguistic and cultural understanding on the part of mental health care providers can contribute to a misdiagnosis.

“Culture matters, worldview matters, life experience matters, words we know count, proverbs and analogies we have are important,” she said.

“There is nothing more exhausting, frustrating, distracting than having to repeatedly explain to a therapist what you mean by something,” Grills said.

A legacy of structural racism

Finding a mental health professional in your own community can be more difficult if you are a person of color.

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ABC7 analysis of census data shows white Southern Californians three times more likely to find a mental health professional who looks like them than Latinos and Asians, and one and a half times more likely than black Southern Californians .

“The root is the legacy of structural racism in education, income inequality and housing and, you know, in job creation,” Grills said.

Dr Turner of Pepperdine said that a lack of diversity in psychology curricula in schools can lead to a vicious cycle.

“Some students will get into these programs and then they won’t feel supported or represented, which makes them less likely to graduate,” he said.

Psychologists see the biggest gaps. Almost 70% of psychologists in Southern California are white, but only 30% of the population is.

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School psychologists have similar demographics. But it’s important for school psychologists to understand the different experiences students of color have, according to Dr. Turner, who studies child psychology.

“We often find that if children experience mental health issues, if they experience some type of trauma, if they witness stressful living environments, it can manifest itself in terms of academic and behavioral issues,” he said. Turner said.

Turner also said that if schools simply look at behaviors without understanding mental health and the underlying life experiences that lead to the behavior, they “will not be able to adequately address these concerns and address them. children will suffer the negative effects ”.

The importance of diversity in each specialization

Social workers and counselors, especially those working in the addiction field, are much more diverse. Experts said this was in part due to the differences in licensing and education required.

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“There may be a more diverse pool of them,” Dr. Cheryl Grills said.

“Who ends up being an addiction counselor? Sometimes it’s people who have been through the experience of substance abuse and addiction who, in their recovery and the stability of their recovery, determine that they want to serve,” a- she declared.

Grills emphasized that it is always important to have this diversity at all levels of the mental health profession, as different specializations meet different needs.

“If I have a BMW car, would I take it to a… Toyota dealership?” Where do they know the parts or not? With the machines? With fine adjustments? How does this particular type of car work? Grids asked.

“If we can understand the importance of specializing in all of these other areas of our life, why isn’t it so appropriate when it comes to our mental health? She continued.

Grills said there was a shortage of general mental health professionals, but community support groups, like those in the California Disparity Reduction Project, can help fill the void and provide a stepping stone to formal therapy.

Grills is part of the team that developed the model for these groups.

“The last one I observed, I’m not kidding, it rivaled the best group therapy I think I have ever seen in terms of level of sharing, self-disclosure, level of emotional vulnerability and level of community. and mutual support that people shared with each other in the group, ”she said.

Grills said the mental health field needs to “catch up” to the ways communities of color are already using culturally based strategies to manage their mental health, such as spirituality.

“We have to start building our intervention strategies out of that space, as opposed to some of those evidence-based practices that have never been fully tested on diverse ethnic and cultural communities. And so, they can be evidence for some people, but it “is not evidence for everyone,” she said.

His advice to people who might need help?

“Look inside your own culture and what does your culture provide as a tool to help support your well-being? Said Grills.

Mental health resources:

Addiction and Mental Health Administration Helpline: 1-800-662-HELP (4357)
Health, personal and social services number: 211
National Hotline for Suicide Prevention: 1-800-273-8255
Click here for more information on California Reducing Disparities Project community support groups

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About Evelyn C. Heim

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