DEI Strategy: Closing the BIPOC Mental Health Treatment Gap

As mental health professionals, it is our responsibility to treat everyone we serve equally. Yet even in 2022, there is still a large treatment gap.

With National Minority Mental Health Awareness Month coming up in July we wanted to shed light on BIPOC mental health treatment gap.

In this article, we will discuss:

  • What is BIPOC
  • The history of BIPOC mental health treatment gap
  • The importance of creating a DEI strategy for your organization and treatment
  • Tips for closing the treatment gap

What is BIPOC?

Before getting into the history of the BIPOC treatment gap we first need to explain what BIPOC means.

For those that do not already know, BIPOC stands for Black, Indigenous, and People of Color (BIPOC). While you may have heard this referred to with the term ‘minority’, many people are replacing it with BIPOC because non-white individuals are becoming the majority in the U.S.

History of BIPOC Mental Health Treatment Gap

Starting after the Civil War mental health facilities would make the people they serve perform chores. Black patients were often tasked worth more laborious work than White patients.

Until 1950, some Indigenous children in Canada were sent to boarding schools where they experienced abuse, resulting in generational trauma leading to a rise in alcohol and substance abuse, depression, and suicide.

In 1851 a racist, pro-slavery physician developed the diagnosis of drapetomania for Black individuals who escaped slavery.

In 1968, the Archives of General Psychiatry released an article stating that Black men developed “hostile and aggressive feelings and delusional anti-whiteness”. They also defined schizophrenia as a ‘protest psychosis.’

In the 1980s penal institutions began taking the place of mental health facilities. During this time those with mental health issues and people of color were disproportionately incarcerated instead of being treated.

In 2016, with government and policy changes Hispanics, Asian Americans, immigrants, Indigenous people, and other BIPOC began to experience more hate and discrimination. This led to increased mental health issues and distrust in the systems that were supposed to be helping them.

In 2020, Daniel Prude’s death at the hands of police shined a light on the still present gap between the mental health care of White people and BIPOC.

In 2021 the American Psychological Association issued an apology for its role and complicity in contributing to the systemic inequalities in the mental health industry.

As you can see there is a long and sad history of systemic racism in mental health treatment, and it is still present.

Importance of Creating a DEI Strategy

Nearly 1 in 5 Americans experience mental illness and it does not discriminate. In fact, Black Americans are 20% more likely to experience mental health problems.

Indigenous people are 2.5 times more likely to experience psychological distress and those between the ages of 15 and 19 are twice as likely to commit suicide.

The number of Latinx/Hispanic people ages 18-25 with serious mental illness (SMI) rose from 4% to 6.4% and those ages 26-49 went from 2.2% to 3.9% between 2008 and 2018.

Additionally, for AAPI youth aged 12-17 major depressive episodes increased from 10%-13.6%, 8.9% to 10.1% in young adults 18-25, and 3.2% to 5% in the 26-49 age range between 2015 and 2018.

Yet there is still a disparity when it comes to the availability of treatment.

According to research BIPOC individuals are:

  • More likely to receive poor quality care
  • Less likely to have access to treatment
  • More likely to stop seeking treatment early
  • Less likely to look for treatment

This can be due to a wide range of factors such as:

  • Cultural stigma
  • Systemic racism
  • Lack of insurance
  • Language barriers
  • Mistrust in healthcare providers
  • Lack of cultural competency from providers

So what can your organization do to help?

6 Ways to Improve Your DEI Strategy & Close the BIPOC Mental Health Treatment Gap

Creating a DEI strategy goes hand-in-hand with closing the treatment gap for BIPOC. But what factors should you consider when creating your strategy?

Our Behavioral Health DEI consultants compiled a list of ways your organization can close the gap and improve your quality of care.

1. Increase Awareness of Biases

Whether we choose to admit it or not, we all have biases. When working in healthcare these biases can lead to misdiagnosis and can greatly affect someone’s life.

For example, in a recent study conducted by Rutgers University, they found that people of color who experience severe depression are more likely to be misdiagnosed as schizophrenic. This is because the physicians’ biases caused them to poorly assess mood symptoms and other factors when diagnosing.

This is just one of many examples where a healthcare professional misdiagnoses and mistreats a person of color due to their inherent biases. But by making sure your staff is aware of these biases they may have they can actively work on fixing them.

Speaking of biases, providers’ biases can impact the way they communicate with the people they serve.

2. Optimize Communication

Researchers at Harvard University’s “Project Implicit,” did a study where they utilized the Implicit Association Test. In their research, they found that BIPOC reported negatively towards providers who exhibited low explicit biases and high implicit bias.

Providers who had high implicit bias scores tended to talk more and not listen. They also use first-person plural pronouns like “we” or “us”. This caused the people served to not trust or have confidence in their providers.

Additionally, providers with higher implicit biases spent less time with the people they served per visit and were not seen as being supportive. By understanding how you may be perceived by the people you serve you can equip your team with the knowledge on how to build trust and confidence.

Learning Languages

Another factor to consider when discussing optimizing communication is diversity in languages. There are over 50 million individuals in the US that speak a language besides English.

In a study conducted with Asian American participants, half reported language difficulties when seeking mental health treatment. Additionally, many Hispanics and Indigenous people speak languages besides English and experience poor communication with their healthcare providers.

Therefore, it is important to have people and resources that are able to communicate in a wide range of languages. Being able to effectively communicate with the demographics you serve as well as having language support is crucial to quality mental health treatment.

3. Break Down Barriers

In BIPOC communities there is a lot of mistrust and stigma surrounding mental health treatment. These barriers make it less likely for individuals in these communities to seek help.

Due to the stigma surrounding seeking help in some cultures, among Asian American and Pacific Islanders with mental health conditions, more than 70% do not receive treatment.

By spreading awareness on the types of mental health illnesses and treatments, you can help to make people feel more comfortable. Education is the best tool for stopping misinformation in its tracks and easing any worry.

You can share stories and testimonials of those who have gone through recovery to help people understand that they are not alone.

4. Conduct Cultural Responsiveness Training

Your team needs to learn about the importance of culture and intersectionality of LBGTQIA+ and persons of color.

It is important to be able to consider a number of factors when treating people. This is a component of whole-person behavioral health care.

The Importance of Understanding Intersectionality

When treating the people you serve it is important to recognize cultures are not monoliths. Culture and race are not synonymous and people can often check off “multiple boxes” in our multicultural world.

Culture is not always a fixed and rigid construct and there are cultures within cultures. It is important to understand that people do not fit into boxes and can’t be defined by stereotypes. Additionally, it is crucial to understand how this intersectionality between identities can impact the people you serve.

For example, in a study conducted by the National Asian Women’s Health Organization, they found that Asian American women were heavily impacted by conflicting cultural values causing a reduced sense of control over their life decisions.

Training Employees to Be Culturally Aware

You can train employees to be aware of their biases and different types of microaggressions.

Some things to teach your staff to improve cultural responsiveness include:

  • Respecting the individual experiences of the people they serve
  • Partnering and engaging with your community
  • Showing humility and listening to others
  • Learning about your blind spots

Additionally, you can teach your HR about techniques to recruit more diverse staff, which brings us to our next point.

5. Increase Diversity in Staff

It is important that your staff looks like the people they serve. According to the American Psychological Association (APA) in 2019, 83% of psychologists were white.

As mentioned previously BIPOC individuals are more likely to experience mental health problems and yet the people treating them are disproportionately white. Creating an environment where your staff looks like the people you serve is a great way to decrease distrust.

Being diverse is not only beneficial for the people you serve and your staff but according to Mckinsey, diverse companies are more profitable.

6. Hire DEI Consultants

No matter if you think you already have an amazing DEI strategy for your treatment center there is always more you can learn about racism and the role it can play. A DEI Consultant can help analyze your current strategy and assess your organization as a whole.

From there you can learn about a wide range of DEI and cultural responsiveness topics and define your DEI vision. Then a consultant can help develop your strategy that fosters a culture of belonging for both the people your serve and your staff.

Future Considerations

  1. Develop short and long-term goals – when creating a DEI strategy it is important to view your DEI as a journey, not just a one-and-done.
  2. Perform cultural audits – conduct a culturally responsive analysis of your environment of care.
  3. Attend DEI workshops – There is always something new you can learn and ways for your business to improve.
  4. Go above and beyond – “Check the box initiatives” are not enough to make systemic change.
  5. Plan next steps – Plan ways you can incorporate your DEI strategy into Physical Plant, P&Ps, HR Communications, Clinical Documentation, Website, and Marketing Communications.

Work With C4 Consulting, the Best in Behavioral Health & DEI Consulting

Zina Rodriguez, our Senior Consultant and Diversity Equity Inclusion & Belonging Specialist, uses her dynamic experience in the behavioral health industry and depth of expertise to approach DEI work with cultural humility and integrity.

Rodriguez works internally and with our clients to create inviting, intentional, and inclusive healing spaces for individuals to achieve mental wellness while creating pathways for success for individuals from underrepresented communities.

Ensure your behavioral health organization is an inclusive and safe space for all with the help of our DEI consultants.