New research lays out how decades of systemic inequities in mental health care have yielded significantly worse outcomes for racial and ethnic minorities, marginalized and under-resourced populations.
A report released Wednesday by Satcher Health Leadership Institute (SHLI) at Morehouse School of Medicine examined four years (2016-2020) and found that, at minimum, nearly 117,000 lives and approximately $278 billion could have been saved.
The report — the Economic Burden of Mental Health Equities in the United States Report — was led by Daniel Dawes, executive director of the SHLI and a nationally recognized leader in the health equity movement.
Officials said the first-of-its-kind report, supported by Otsuka America Pharmaceutical Inc., also shows national estimates chronically underrepresent the burden of mental health care inequities, which has crippling implications on policies, funding, access to care, and resources.
For perspective, the researchers wrote that nearly six million Americans are not accounted for in national reporting estimates regarding mental health care.
The Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey cited earlier this year by Blue Cross Blue Shield found that Black and Hispanic respondents had equal or higher rates of depression than whites.
Similarly, the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health found that more Black and Hispanic individuals reported a moderate to severe impact from depression on their lives, including their ability to manage at home, work and within close relationships compared to white respondents.
Blue Cross officials wrote that stigma may influence the decision to seek care, and a response to a Blue Cross Blue Shield Association survey of 2,700 adults suggest greater social stigma around mental health issues in Black and Hispanic communities may influence a person’s likelihood to seek care.
Fifty-four percent of Black and 47% of Hispanic respondents in the Blue Cross survey reported that individuals with mental health conditions in their communities “are looked down upon.”
That was the perception of only 38% of white respondents.
“Such perceived stigma, combined with the structural racism that may prevent historically marginalized communities from receiving equitable treatment, may compound the difficulty of asking for help,” Blue Cross researchers discovered.
The SHLI study found that in the United States, the decline of the overall population’s general health and life expectancy “is evidenced by increased morbidity and mortality rates.”
“In addition to this decline in the nation’s systemic health is the alarming deterioration of mental and behavioral health across the country, which has been exacerbated by the deleterious impact of the COVID-19 pandemic and ongoing syndemic,” the researchers wrote.
They wrote that those mental and behavioral health outcomes are significantly more adverse and unparalleled when visualized through the lens of indigenous populations and racial and ethnic minoritized, marginalized, and medically underserved populations.
Previous studies have attempted to highlight how health disparities affect economic and lifespan outcomes for indigenous populations and racial and ethnic minoritized groups. Still, none have specifically analyzed the financial burden of mental and behavioral health inequities, researchers at SHLI wrote.
They said the report is designed to inform all stakeholders about the ramifications of a chronically underfunded and siloed mental health care system, with a particular focus on underserved and under-represented communities.
“We are at a tipping point within the United States of a broader acknowledgment that this statement is not only true but our decadeslong lack of focus and resources on mental health has had a significant and negative impact on overall health outcomes in the U.S,” SHLI researchers asserted.
“We are also at a long overdue awakening of how decades of systemic health inequities have yielded significantly worse outcomes for indigenous, racial and ethnic minoritized, marginalized, and medically under-resourced populations, which has led to generations of poor outcomes and reduced value of every life.”