What providers need to know about behavioral health equity

People from all backgrounds may struggle to access mental health care for a variety of reasons. The below list is not exhaustive, but rather highlights a few groups that are particularly likely to face obstacles in receiving behavioral health care.

Racial and ethnic disparities in mental health care

Federal data show that white Americans are significantly more likely to receive mental health care than people of color. As of 2020, more than 24 percent of white U.S. adults had recently received some form of mental health care, compared to roughly 15 percent of Black U.S. adults, 13 percent of Hispanic U.S. adults, and 8 percent of Asian U.S. adults. 

Why is that? Long-standing socioeconomic disparities can make it harder for people of color to afford — and, thus, access — behavioral health services. For example, studies show that average household incomes tend to be lower among most communities of color relative to white Americans. People of color in the U.S. are also more likely than their white peers to lack adequate health insurance, another barrier that stands in the way of access to medical care of all kinds. 

Cultural norms are a factor, too. Stigmas around mental health care persist in many communities of color, causing some people to fear that they will appear “weak” or “sick” if they seek treatment. Distrust in the medical system also tends to be more common within BIPOC groups, due to a long history of systemic racism in healthcare. A shortage of clinicians of color further exacerbates the problem, as many clients would prefer to see a therapist who understands their background and to whom they can relate deeply. More than 80 percent of psychologists practicing in the U.S. are white, data show, leaving limited options for patients of color. 

Economic disparities in mental healthcare

The high cost of mental healthcare prevents many people from getting the help they want and deserve. It’s hard to say exactly how much an average therapy appointment costs, because fees vary widely by geographic area and provider type. But many clinicians charge $100 or more per session — and many do not accept insurance, often leaving patients to foot the entire bill themselves.

Given that millions of Americans say they would struggle to pay off an unexpected $400 expense, it should be no surprise that many people cannot afford regular behavioral health appointments at these prices. Indeed, studies show that finances are among the most common reasons why people delay or avoid seeking treatment. Higher-income people tend to have the easiest time finding a behavioral health provider — not only because they likely have disposable income, but also because they are more likely to work in jobs that provide solid health benefits and allow enough scheduling flexibility to make regular appointments. 

Geographic disparities in mental healthcare

Demand for behavioral health care outpaces supply just about everywhere in the U.S. But mental health practitioners tend to be clustered in major urban areas, making it easier for city residents to find and use their services compared to people in less-populated areas. Federal statistics show that people in large metropolitan areas were significantly more likely than people in more rural areas to have recently received counseling or therapy as of 2020.

As of 2021, about 130 million Americans lived in one of almost 6,000 areas with a documented shortage of mental health providers. And in almost 600 counties across the country, there’s not a single practicing psychologist, psychiatrist, or counselor. These mental health deserts tend to be in rural areas, meaning people who live outside cities have a disproportionately difficult time finding care.