According to a Physicians for a National Health Program study that was published Aug. 12 in the International Journal of Health Services, minority children and young adults are only half as likely as their white counterparts to get mental health care, despite similar rates of need. According to the study findings, both black and hispanic children and young adults receive much less of virtually every type of mental health care, including both mental health and substance abuse counseling.
Dr. Lyndonna Marrast, a fellow at Harvard Medical School and Cambridge Health Alliance led the study. Co-authors Drs. David Himmelstein and Steffie Woolhandler write: “The under-provision of mental health care for minority children contrasts starkly with the high frequency of punitive sanctions that their behaviors elicit. Black children suffer excessive rates of school discipline such as suspensions and expulsions starting at preschool ages. Minority teens also have disproportionate contact with the juvenile justice system, with higher arrest rates for nonviolent, low-level offenses such as drug possession, as well as for non-criminal misbehaviors such as truancy and curfew violations. Youthful transgressions that might result in referral for treatment among non-minority children more often incur criminal sanctions for minorities.”
According to the study, black children made 37 percent fewer visits to psychiatrists and 47 percent fewer visits to any mental health professional than white children. Hispanic children were 49 percent less likely to see a psychiatrist and 58 percent less likely to see any mental health professional. The racial and ethnic disparities were even larger among minority young adults, with whites receiving about three times more outpatient mental health services than hispanics and blacks in the same age group. Substance abuse counseling for young black adults was only about one-seventh that of whites, even though that group has high rates of arrest for substance abuse. Differences in income and insurance did not account for the disparities in care between minorities and whites.
The study also found that girls received less mental health care than boys, although that difference was the opposite in young adults, with women receiving more mental health visits. Young black and hispanic men, the groups who are at the highest risk for incarceration, had the lowest rates of mental health visits, even though at least half of inmates suffer from mental illness, according to data from the Department of Justice, and most have been untreated at the time of their arrest.
Woolhandler says, “Minority kids don’t get help when they’re in trouble. Instead they get expelled or jailed. But punishing people for mental illness or addiction is both inhumane and ineffective. The lack of care for minority youth is the real crime.”