In her years as a mental health practitioner, Kyaien Conner saw a system that fell short for people of color.
Most of her clients were white, even though she worked at mental health agencies in communities of color. And the tools used for diagnosis had been fine-tuned for predominantly white communities, leading to care that was insufficient for people of other races.
Today, as an assistant professor in the University of South Florida’s Department of Mental Health Law and Policy, Conner uses research to drive change in her profession.
But the disparities she saw on the front lines are still very much in place, as evidenced by a report released early Wednesday by the Centers for Disease Control and Prevention that takes a snapshot of the nation’s pre-pandemic mental health.
In the past year, according to the report, non-Hispanic white adults were more likely to have received mental health treatment than any other race or Hispanic-origin group. The percentage of Black and Hispanic adults who received mental health treatment was about 10 points lower. Hispanic adults were the least likely to have received any mental health treatment.
And while Black adults were as likely as White adults to experience symptoms of depression in the two weeks before being surveyed, they were less likely to have received mental health treatment over the previous year.
Disparities also exist across gender, according to the data. Women were more likely than men to receive counseling or therapy or take prescription medication in the past year.
The data is based on a nationally representative sample of nearly 32,000 adults and 6,800 children aged five to 17. The individuals span more than 33,000 households.
The Florida Department of Health’s most recent State Health Assessment in 2017 echoes the national results.
That year, among adults with a serious mental illness, more than 70 percent of white women received mental health care, compared to 50 percent of Hispanic women and just over 60 percent of Black women, the state data showed. Similarly, about 60 percent of white men received care, compared to about 50 percent of Hispanic and Black men.
Aside from those disparities, Florida is one of the most difficult places in the nation to find mental health care, according to a 2020 ranking by Mental Health America, a national nonprofit. The ranking, which placed Florida at 40th for access, measured the availability of treatment, insurance and special education, among other factors.
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At NAMI Pinellas County, a group serving people with mental health conditions and their families, the number of Black and Hispanic people participating in support groups and other services is low, said executive director Denise Whitfield.
Whitfield said the disparities are in part due to barriers in access to care as well as lack of mental health providers from communities of color.
However, to address those barriers, “it might be easier for us to go into those communities,” she said. “Sometimes we need to go to them."
While physical health disparities tend to focus on illness and disease disparities, “in behavioral health or mental health, the biggest health disparity is really access to care,” said Conner, the USF professor, who focuses her research on African American mental health.
Black and Hispanic people “are more likely to experience barriers when they want to seek mental health services," Conner said. "And even when those initial barriers have been overcome and they do happen to make an appointment or see a therapist, they’re more likely to terminate treatment prematurely.”
She said those barriers include increased likelihood of living in poverty or areas where quality mental health services are not readily available, limited access to insurance, the stigma within minority communities surrounding mental illness, and a deep-rooted mistrust of the American health care system driven in part by experiencing implicit bias on the part of health care providers.
“Racial and ethnic minorities often have reasons to be mistrustful of our health care system," Conner said. African Americans in particular are experiencing significant race-based trauma, which many of the systems in place are not designed to assess and treat adequately, she said.
The pandemic is also shining a light on disparities, local crisis workers say.
The number of suicide calls from those who identify as Black have increased 19 percent this year, according to data from the Crisis Center of Tampa Bay. Calls for mental health issues in general went up 25 percent among the same group.
The increases were similar for Hispanic callers.
“It’s the pandemic. It’s the hurt that’s been experienced within minority communities. It’s the election causing stress," said Ken Gibson, the center’s senior director of marketing and public relations.
“It’s a soup that’s kind of brewing together," he said. "Frankly, it’s almost a tsunami that’s brewing.”
This story was funded in part through a grant from the Foundation for a Healthy St. Petersburg. Donors are not involved in the reporting or editing process.