Magellan Healthcare is a proud supporter of BIPOC Mental Health Awareness Month in July. BIPOC is an acronym for Black, Indigenous and People of Color that aims to empower groups formerly identified as “minority” or “marginalized.”

In this post, we’ll discuss BIPOC mental health and barriers to care. You can learn more by watching a recording of our webinar, “Navigating mental healthcare: Unique challenges faced by the BIPOC community,” here.

Prevalence of mental health conditions among BIPOC communities

BIPOC face unique stressors that increase mental health vulnerability. Racism and discrimination are consistently found to be associated with poorer mental health.[1]

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports the prevalence of mental health conditions among BIPOC:[2]

BIPOC adults (prevalence of any mental health condition)

• 32% Two or more races
• 19% American Indian and Alaska Native
• 18% Hispanic or Latinx
• 17% Black or African American
• 17% Native Hawaiian and Other Pacific Islanders
• 14% Asian American

BIPOC youth (prevalence of depression)

• 21% Two or more races
• 17% Hispanic or Latinx
• 15% Asian American
• 12% American Indian and Alaska Native
• 11% Black or African American
• (data not available) Native Hawaiian and Other Pacific Islanders

Barriers for BIPOC in accessing mental healthcare

BIPOC are less likely to receive treatment for mental health or substance use conditions.[2] In 2020, 5.7% of Asian Americans, 9.4% of Black people or African Americans, and 10.7% of Hispanic or Latinx people received mental health services, compared to 21% of White people.[2]

Research indicates, compared with people who are White, people in BIPOC communities are:[3]

• Less likely to have access to mental health services
• Less likely to seek out treatment
• More likely to receive low or poor quality of care
• More likely to end services early

Several factors contribute to BIPOC being less likely to receive treatment for mental health or substance use conditions, including a lack of insurance or underinsurance, mental illness stigma, a lack of diversity and cultural competence among mental healthcare providers, language barriers and distrust in the healthcare system.[4]

Increasing awareness of the issues people of color and those in marginalized communities face helps reduce stigma so those with mental health concerns can get the help they need to thrive in their lives.

On July 20 Magellan Healthcare hosted a webinar, “Navigating mental healthcare: Unique challenges faced by the BIPOC community,” for BIPOC Mental Health Awareness Month. Watch a recording of the webinar as we explore different roles in behavioral healthcare and overcoming stigma to help BIPOC feel more knowledgeable and comfortable about reaching out for help: https://www.magellanhealthcare.com/event/navigating-mental-healthcare/.

[1] “Racism as a Determinant of Health: A Systematic Review and Meta-Analysis”, “Self-Reported Experiences of Discrimination and Health: Scientific Advances, Ongoing Controversies, and Emerging Issues”, “Discrimination and Subsequent Mental Health, Substance Use, and Well-being in Young Adults”

[2] SAMHSA 2020 National Survey of Drug Use and Health Adult and Youth Mental Health Tables

[3] Counseling Today, “The historical roots of racial disparities in the mental health system”

[4] American Psychiatric Association, “Mental Health Disparities: Diverse Populations”

Magellan Health Insights: Dr. Ghani, thank you for chatting with us today. Why do you think it’s important to be aware of minority mental health?

 Dr. Shareh Ghani: Many psychological conditions have a connection to the individual’s perception of themselves. How comfortable do we feel in our environment? How well do we fit into what is seen as the norm? It’s human nature to want to fit in. Being a minority myself as an immigrant to the U.S. from Pakistan, I can see that there is extra pressure when you may be uncertain about fitting in or what is expected.

Seeking treatment for mental health unfortunately carries a degree of stigma for everyone and minorities are much less likely to seek or receive treatment for mental health conditions. For those who don’t speak the primary language or do not speak fluently, it can be even more difficult to seek these services and treatment. In addition, there may not be bilingual providers available or covered in the network, if the patient has insurance coverage – which is less likely for minority members. We are starting to see improvements, but for immigrants and members of other minority groups, it can be even more difficult to ask for help.

Magellan Health Insights: Why wouldn’t a minority member seek out care for mental health?

 Dr. Shareh Ghani: There are many reasons. Fundamentally, these members are often challenged by the complications of poverty and social determinants of health (SDOH). Language, i.e. communication and or comprehension, can be a barrier. Beyond language, it may not be culturally acceptable to ask for help. It may seem embarrassing. Which leads us to stigma. The person’s community at large, the clinicians and physicians providing care, and even the patients themselves may see it as stigma. People openly discuss their diabetes but not their depression.

 In addition, these patients are less likely to be routinely screened. They also may not be able to specify that their symptoms are symptoms of a behavioral health condition. In the U.S., patients come to me and say they think they may be depressed. In India, my patients would describe physical symptoms – like gastrointestinal problems. This means they may go through a battery of tests to eliminate physical diseases before behavioral health is addressed.

Magellan Health Insights: How can providers best support minority mental health?

Dr. Shareh Ghani: Paying extra attention and being aware of the cultural needs of every individual is key. In order to come up with a successful treatment plan, providers need to be knowledgeable about cultural factors. And they need to ask about what their patients preferences are related to care. Unless and until we talk to each person about their comfort level working with a provider of a particular gender, someone from their own culture or sexual orientation, or even age group, we can’t provide the best treatment. We, as patients, are most likely to speak openly when we feel comfortable. Being able to speak openly with a therapist or provider will make it more likely that the member will be accurately diagnosed and that treatment will be more successful.

Providing culturally competent care is critical – all care must be culturally competent care. What does that mean? We must be able to provide care to patients with diverse values, beliefs and behaviors and meet patients’ social, cultural and linguistic needs. We must acknowledge the importance of culture, recognize the potential impact of cultural differences, and adapt services to meet culturally unique needs. By taking training and educating ourselves on cultural competence we can reduce the racial and ethnic disparities in healthcare and give all of our members the best care. 

Magellan Health Insights: We couldn’t agree more! Thank you, Dr. Ghani!

Read more about Minority Mental Health Here

As we observe National Minority Mental Health Awareness Month, we sat down with Dr. Rakel Beall-Wilkins, a former Magellan Healthcare medical director.

 Magellan Health Insights: Dr. Beall-Wilkins, thank you for speaking with us today. Of course, everyone’s mental health is critical, but why is it important to pay particular attention to the mental health of Black, Indigenous and People of Color (BIPOC)?

Dr. Rakel Beall-Wilkins: We know that mental health conditions can be successfully treated. However, BIPOC are significantly less likely to receive treatment for mental health conditions, including substance use. And it’s reaching crisis levels, especially among our young people. For example, suicide is now the third leading cause of death among African American males who are 15-24 years old.

Magellan Health Insights: What are the barriers to BIPOC receiving high quality mental health treatment?

Dr. Rakel Beall-Wilkins: BIPOC are less likely to seek treatment, both for their physical and mental health. However, when they do reach out for assistance, they are less likely to receive consistent, high-quality treatment.

There are many contributing factors to these barriers. The high costs of care can be a deterrent. Most BIPOC in the U.S. (with the exception of Asians) have higher than average rates of poverty. BIPOC are more likely to lack insurance coverage, and may only seek emergency care, which costs more and is less effective than sustained treatment. Medications or diagnostic procedures may be viewed as too expensive. Or reliable transportation for follow-up care may not be available.

There are also what are called the social determinants of health (SDoH). These include factors such as consistent transportation, the availability of healthy food, safe and affordable housing, access to education, public safety and working conditions. BIPOC are more frequently negatively impacted by the SDoH. For example, these members are more likely to be homeless or move frequently, which interferes with maintaining consistent treatment. They may lack adequate nutrition and are at greater risk for having associated medical conditions like hypertension or diabetes.

Further, the stigma around mental health conditions, while improving, is still a deterrent to seeking treatment—for everyone. Some cultures may see it as taboo to request help or be seen as someone who needs help.

When BIPOC patients do seek treatment, there may be no one available who speaks their language. In some clinical settings I’ve been in, it could take a week to arrange for an interpreter or a therapist who was proficient in the patient’s language. They may not have a primary care physician (PCP) to help with screening for mental health conditions or provide follow-up care. In addition, the community clinics where BIPOC are more likely to receive care may be understaffed, overcrowded and have long wait times. Understaffing may lead to inadequate screening or even misdiagnosis. And, frankly, the clinic also may not be in a place where the member feels safe traveling so, they may hesitate to go in the first place or return for continued treatment.

Magellan Health Insights: How can everyone, including healthcare professionals, best support minority mental health?

Dr. Rakel Beall-Wilkins: Everyone can help eliminate stigma. Be open to talking and hearing about mental health conditions, and make it clear that you know that having a mental health condition is nothing to be ashamed of. When someone you care about is going through a difficult time, encourage them to get help, and learn ways you can support someone who coping with a mental health challenge.

As healthcare providers, we personally can help by:

• Ensuring we are taking into account each person’s wishes when referring them to other providers: We should ask every patient whether they prefer to see someone of a specific race, ethnicity, gender or sexual orientation.
• Educating ourselves to be more culturally competent and making cultural training a priority for our staff.
• Expanding our workforces with staff from various backgrounds, sexual orientations, cultures and with varied linguistic skills particularly for the unique cultures that are most prevalent in the community.
• Screening for psychiatric conditions during routine visits. Many patients will report physical symptoms instead of talking about the underlying mental health concerns. PCPs and others see many cases of mild or moderate depression during routine care, and screening every patient can help prevent costly emergency visits and admissions. Self-screening tools can also help.

Beyond what we can personally do to educate and equip ourselves and our staff, I believe that the best solutions come from an integrated, collaborative approach. Everyone can help eliminate the disparities. If we work with leaders in the community, for example in churches and schools, we can raise awareness of mental health conditions, destigmatize treatment seeking, help address the social determinants, and improve the lives of everyone in our communities.