Waymark Clinical Pharmacist Lead Silu Zuo has seen firsthand the impact mental health stigma has on patients who identify as Black, Indigenous, or people of color (often referred to as members of BIPOC communities). In many cases, she says, it’s a taboo topic: if you struggle with your mental health, you simply don’t talk about it. As a result, patients often grapple with untreated behavioral health symptoms that have a negative impact on their physical health as well.
“Mental health challenges in some BIPOC communities are often not openly discussed,” she added. “This could be perceived as a ‘taboo’ topic, and communities with a mistrust of Western medicine may perceive medication negatively.”
That’s exactly why Mental Health America founded BIPOC Mental Health Awareness Month. Observed every July, this month-long initiative endeavors to address the stigma around mental and behavioral health struggles within BIPOC communities. This stigma is often the reason why BIPOC patients don’t seek out the resources and care they need to manage their mental health, understand behavioral health symptoms and, ultimately, lead well-rounded and satisfying lives.
An Essential Investment
“There’s a lot of stigma in the BIPOC community about the idea of having a therapist or being seen as weak,” said Waymark Therapist Lead Joseph Melendez. “Frankly, there are a lot of people in communities of color who still don’t believe that therapy works. It’s also seen as dangerous to seek mental health care because then you’re vulnerable.”
Unfortunately, these concerns Melendez mentioned BIPOC patients often have around being seen as vulnerable can be backed by data. Compared to white counterparts, BIPOC patients are statistically more likely to encounter challenges while pursuing mental healthcare–such as an absence of cultural competency in available mental health practitioners and subconscious biases impacting how they are treated. Recent estimates found that over 50 percent of white adults with any mental illness were treated, but that percentage dropped to 39 percent of Black adults, 36 percent of Hispanic/Latinx adults, and 25 percent of Asian adults.
Furthermore, a 2023 study by the Centers for Disease Control and Prevention (CDC) found that Black adults visited emergency departments (EDs) for mental health-related care almost twice as often as white adults, underscoring the need to address mental health concerns for this community. But often, that’s easier said than done; systemic racism and discrimination practices have a long history in the United States, and a profound impact on BIPOC communities – meaning that it’s all the more vital that healthcare professionals focus on providing mental health support that is truly equitable.
For patients receiving Medicaid, the challenges may be even greater, as insufficient payment for behavioral health services compared to physical health is a huge barrier to many seeking to access mental health treatment. And even if these patients do seek out mental health care, a lack of cultural competency among providers can make seeking out those resources an insurmountable challenge.
“I’ve seen patients that aren’t even aware of the help available to them for their mental health,” said Lisa Harper, a Waymark Care Coordinator serving patients in Virginia. “They don’t even know how to ask for help.”
What Can Be Done?
While stigma manifests itself differently within BIPOC communities – for example, through a lack of community support to discuss mental health, language barriers that prevent those not proficient in English from being screened for mental health concerns, or mistrust of medications used to treat mental health conditions – there is one commonality: the care providers who serve these patients have the ability and opportunity to address stigma and connect patients with the care they need.
Community Health Worker (CHW) Lead Prisila Velazquez Cordova has found that BIPOC patients struggling to access mental health care often benefit from two things: education and empowerment.
“Some are not aware of resources or how to utilize them,” she said. “And when they’re referred to a therapist, we should always ensure they know they can decline meeting with [the therapist] after the first meeting if they’re not a good fit.”
To further patient education, CHWs, primary care providers (PCPs), and community organizations must remain aware of the mental health resources that are available to, and accepting of, BIPOC patients. This means being culturally and socially aware of existing barriers such as insurance or lack thereof; as Melendez notes, some primary care practices employing mental health professionals will not accept patients receiving Medicaid, which in and of itself is a barrier.
Instead, Melendez suggests that members of care teams serving BIPOC patients understand which behavioral health providers in their community do accept Medicaid, and connect patients with them. This includes Federally Qualified Health Centers (FQHCs), or clinics that receive federal funds to provide healthcare services to underserved communities. These clinics typically accept Medicaid and are equipped to offer services to members of marginalized communities. Additionally, some of these clinics have made telehealth options for mental and behavioral health services part of their permanent patient offerings, which removes access barriers for patients without transportation.
“This is why national and local organizations supporting the health of specific BIPOC populations should increase their awareness within their communities so they can make those connections at the right time,” added Zuo. “I also encourage patients to continue seeking care through a PCP they trust so that, with time, mental health can be addressed as a routine part of overall health.”
In that same vein, members of care teams should also make themselves aware of and familiar with in- and out-patient therapeutic resources for patients living with a serious mental illness (such as obsessive-compulsive disorder, bipolar disorder, or schizophrenia) and patients dealing with substance use. Rehab centers in several states accept Medicaid (depending on the program) and can ensure patients have the hands-on and specialized care they need.
While there is no simple answer to the ongoing mental health struggles many members of BIPOC communities face, the end goal for those serving these patients is simple: ensuring they have the support they need while feeling empowered to take ownership of their mental health and their overall health care.
“It’s our responsibility to listen to them and ask open-ended questions to understand what they need,” said Harper. “Make them aware of crisis centers. Bring up the topic of therapy to them. This is how we greatly reduce stigma.”
