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RESEARCH WEEKLY: February Research Roundup, Black History Month
By Shanti Silver
(February 22, 2023) Research Roundup is a monthly public service of the Office of Research and Public Affairs. Each edition describes a striking new data point about severe mental illness and summarizes recently published research reports or developments.
This month’s roundup is in honor of Black History Month and highlights the experiences of Black people whose lives are impacted by mental illness.
DATAPOINT OF THE MONTH
1.6 times – Black patients are 1.6 times more likely to experience an involuntary psychiatric hospital admission than non-Black patients.
Black and multiracial patients are more likely to experience an involuntary admission, according to data collected over a six-year period from a psychiatric unit of a Boston medical center. This finding was true even when taking into account differences in housing status, psychiatric diagnosis, gender and insurance status. Across scientific literature, there is substantial evidence that Black patients are more likely to receive coercive psychiatric treatments compared to non-Black patients. While coercive treatment may be necessary in some cases, these racial disparities deserve further attention and need to be addressed.
Shea, T., et al. (December 2022). Racial and Ethnic Inequities in Inpatient Psychiatric Civil Commitment. Psychiatric Services, 73.
RESEARCH OF THE MONTH
Disparities in outpatient mental health care
Black and Hispanic people are less likely than white people to receive outpatient mental health care, even when differences in mental health need, income, education, age, gender, insurance and employment status are taken into account, according to nationally representative data from the Agency for Healthcare Research and Quality. Overall, Black patients who did receive care were more likely to receive psychotherapy and less likely to receive psychotropic medications than white patients. However, Black patients with mood disorders were more likely than white patients to receive both psychotherapy and psychotropic medications, according to the data.
The authors of the research note several potential reasons for these differences in receipt of care. One is that Black and Hispanic patients are more likely to have public health insurance. According to the authors, many mental health specialists and most psychiatrists do not accept patients insured by Medicaid, which disproportionately impacts mental health care access for Black and Hispanic patients. Another factor that may contribute to the disparity in receiving outpatient services is the national shortage of psychiatrists in areas of the U.S. that have high proportions of Black and Hispanic people.
Olfson, M., et al. (January 2023). Racial-ethnic disparities in outpatient mental health care in the United States. Psychiatric services.
Among people with serious mental illness in the U.S., being Black is associated with experiencing an increased number of arrests.
A recent study in Georgia looked at the arrest records of 240 people with a serious mental illness diagnosis. All people studied had at least two inpatient hospitalizations in the past year and impaired community functioning. The study authors found that 71% of people studied had previously been arrested in Georgia and of those who had been arrested, the average number of arrests was nine. Being a Black American, having lower educational attainment, being female and having a co-occurring substance use disorder were associated with a larger number of arrests. Researchers suggest that the comparatively higher number of arrests among Black Americans with serious mental illness is likely due to the impact of bias and historical inequalities in housing, employment, criminal justice and healthcare.
Compton, M. T., et al. (October 2022). Characterizing arrests and charges among individuals with serious mental illnesses in public-sector treatment settings. Psychiatric Services, 73.
Stigma presents a prominent barrier to mental health services for Black immigrants.
Black migrants are four to six times more likely to experience psychosis compared to people from the general population, according to some studies. However, Black immigrants are also comparatively less likely to use mental health services. In a recently published study from Women’s Health Reports, researchers interviewed 22 Black immigrant women to discuss their beliefs surrounding mental illness. The women’s responses revealed several barriers to treatment such as perceptions that mental health professionals may not understand their problems, beliefs that mental illness is caused by spiritual forces and fear of discrimination against those experiencing mental illness and their family members. To address these barriers to treatment, the researchers propose targeting interventions for this population to raise awareness about biological, psychological and social beliefs about mental illness. Through integrating cultural, spiritual and biopsychosocial beliefs about mental illness, it may be possible to increase treatment engagement for Black immigrant women.
Bamgbose Pederson, A., Waldron, E. M., & Fokuo, J. K. (December 2022). Perspectives of Black Immigrant Women on Mental Health: The Role of Stigma. Women's Health Reports, 3.
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