Mental health inequality

Lack of socioeconomic resources can lead to development of traumatic experiences that precipitate into mental health disorders.[4] For example, not having employment or having limited access to resources can influence the course of developing some of the most common mental health disorders, such as depression, anxiety, bipolar disorder, and psychological stress.[5] Living with a mental health disorder can also contribute to disparities in receiving mental health care. Living with a mental health disorder could affect an individual's economic status, which can additionally lead into their mental health quality as well as life expectancy.[6]

Another socioeconomic factor that can lead to barriers and inequalities in accessing mental health care services include financial restraints. There has a been a rise in cost for uninsured individuals in accessing mental health care services compared to individuals who have private or public insurance[7].

Educational disparities can be defined as unjust or unfair differences in educational outcomes that can be a result of difference in treatment of certain minority groups in schools, varying socioeconomic statuses, and varying educational needs.[8] These disparities in education can ultimately lead to issues of mental health. When this happens, less privileged groups get looped into the cascading effects of inequality.

Disparities in education, contributory to socioeconomic status, immigrant status, and ethnic/racial status can be another contributing factor to mental health inequality.[8] Socioeconomic status plays a large role in the difference in access to educational resources. School districts are split geographically. Because the current funding for public schools comes from local property taxes, there is more incentive for high-status individuals to narrow the boundaries to not include lower income families from their school districts.[9] Because each school district is then only encompassing one socioeconomic group, the programs and quality are affected. This is where we begin to see the dramatic differences between school districts. While some schools offer amazing guidance departments, advanced classes, and phenomenal facilities, other areas struggle to find qualified and motivated teachers to teach basic classes. Although public education is something that is supposed to be a right for all, an individual's socioeconomic status can greatly affect the quality of that education.

An individual's immigration status also affects the quality of education received. While there are some immigrant groups which do well after immigrating to the United States, many do not have the same level of success. There are many barriers that prevent the academic success of immigrant children. These barriers include but are not limited to the fact that most parents of immigrant children do not understand the United States educational system, inadequate English as a Second Language programs, and segregation. There are also differences in outcomes across immigrant generation, with first-generation immigrants performing better than subsequent generations. This is termed the immigrant paradox. These issues along with the psychological effects of acculturation (e.g., adapting to a whole new country, language, and culture) amplify educational inequality.[8]

Disparities in education are the insufficiency of resources that are included but limited. These disparities usually targets socially excluded communities with low income.[10] Statistics are used when measuring grades, GPA, test scores, and dropout rates to determine the success of students.[11] By creating a system in which a person could never succeed can perpetuate inequalities, especially those suffering from mental health.

Spatial disparities include, but are not limited to, where one lives, spends most of their time, where they receive most of their resources, and where they receive education. For example, minority races who live in higher poverty neighborhoods are at higher risk for additional stresses and mental health disorders. Yet this population has been shown to experience more difficulties in accessing mental health services. Considering this cycle of needing care but not being able to receive care, inequality due to spatial location will likely remain and continue to limit access to mental health care without additional intervention to increase access to mental health services.

Many minorities including African Americans, Hispanics, and Asian Americans inhabit these poverty filled neighborhoods due to factors being not in their favor in certain aspects of society. These neighborhoods lack resources such as offices with psychiatrists or health clinics with good doctors who are trained to help those in need of mental health care. It would also be beneficial to make specific services just for those in high-poverty neighborhoods who lack the resources so we can encourage those in need to get the help that they deserve. With adjustments made to meet these circumstances, the spatial disparities can be lowered and allow those who need the help to get it.

There is inequality in mental health care access for different races and ethnicities. Studies have shown that minorities with low-income have less access to mental health care than low-income non-Latino whites.[12] In addition to lack of access, minorities in the United States were more likely to receive poorer quality in mental health care and treatment compared to non-Latino whites individuals, leading to many minorities delaying or failing treatment.[13] Studies have shown the African Americans have decrease access to mental health services and mental health care compared non-Latino white Americans.[12] Many minorities have difficulty in finding care for mental health services.

After surveying individuals of different races, a study has shown that African Americans, Hispanics, and Asian Americans gain less access to the same type of mental services that non-minority whites get access to.[14] A possible reason that the author stated:

"This theory postulates that Whites have a greater propensity to avoid living in poverty communities because they are more likely to enjoy social and economic advantages. Only seriously mentally ill Whites suffer from steep downward mobility and come to reside in high-poverty neighborhoods"[14] (Julian Chun-Chung Chow, Kim Jaffee, and Lonnie Snowden).

This has been a problem for minority races that need the same services. It is an issue because African Americans, Hispanics, and Asian Americans need the services more in certain areas due to how biologically certain minority races are more likely to be diagnosed with a mental illness than whites.

Race is often difficult to acknowledge in mental health. Even when access to mental health therapies exists for minorities, oftentimes both the therapist and the patient can be reluctant to factor their own racial positioning into treatment or find it difficult to believe that some of their mental health stress is due to race. Both often favor explanations rooted in past experiences like family life, personal setbacks, and other potential barriers.[15]

Sexuality plays a large role in the prediction of mental illnesses and overall mental health. Those who identify as lesbian, gay, bisexual, transgender, and/or queer have a higher risk of having mental health issues, most likely as a result of the continued discrimination and victimization they receive at the hands of others. Members of this population are confronted with derogatory and hateful comments, whether through face-to-face communication or through social media, which affects their self-worth and confidence, leading to anxiety, depression, thoughts of suicide, suicide attempts, and suicide. These mental health effects are most commonly seen among adolescents, however, they are also prevalent among adults of all ages.[16][17] The sources of discrimination and victimization that the LGBTQ population suffers from can be both external and internal. While parts of society today are not accepting of the LGBTQ community and make public statements to advertise their discontent, an identifying LGBTQ can also have low confidence and a lack of self-worth that furthers these negative mental health effects.

The most notable predictor of mental health illnesses among the LGBTQ population is family acceptance.[16] Those of the LGBTQ population who receive little or no family support and acceptance are three times more likely to have thoughts of suicide than those who do have a strong family support system behind them. Oftentimes, the lack of familial support is more conducive of detrimental behaviors, such as drug and illegal substance abuse, which can cause further harm to the individual. Multiple aspects of lifestyles, including religion, can affect family support. Those who have strong family ties to religion may be less likely to seek support and help from family members due to fear of a lack of acceptance within the family, as well as within the religious community.[17]

While gender differences among those with mental health disorders are an underdeveloped field of study, there are gender specific aspects to life that cause disparities. Gender is often a determinant of the amount of power one has over factors in their life, such as socioeconomic status and social position, and the stressors that go along with these factors. The location of genders and sex within the social construct can be a great determinant of risks and predictors of mental health disorders. These disparities in gender can correlate to the disparities in the types of mental health disorders that individuals have. While all genders and sexes are at risk of a large variety of mental health illnesses, some illnesses and disorders are more common among one sex than another. Women are twice as likely as men to be diagnosed with forms of depression as depressive disorders account for close to 41.9% of the disability from neuropsychiatric disorders among women compared to 29.3% among men. On the other hand, men are three times more likely to be given a diagnosis of a social anxiety disorder than women.[18]

Sex can also be a determinant of other aspects of mental health as well. The time of onset of symptoms can be different dependent on one's sex. Women are more likely to show signs of mental illnesses, such as depression, earlier and at a younger age than men. Many believe this to be a correlation with the onset time of puberty. As a result of social stigmas and stereotypes within society, women are also more likely to be prescribed mood-altering medications, whereas men are more likely to be prescribed medications for addictions.[18] Further research on the mental health disparities among sex and gender is needed in order to gain a deeper knowledge of the predictors of mental health and the possible differences in treatments.