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Unmet Needs: Addressing Barriers to Mental Healthcare

The numbers speak for themselves– Over 50 million Americans or 1 in every 5 Americans were experiencing a mental illness in 2019-2020 [1,4]. In 2021, over 5.4 million Americans took a mental health screen, a 103% increase from the previous year and a slightly below 500% increase from 2019 [2]. About 12.1 million people reported experiencing serious thoughts of suicide, and over 1 in 10 American youth are experiencing life-impairing depression [1]. Simply put, it is apparent that the state of mental health in our country is alarming. While mental health conditions were becoming increasingly prevalent to begin with, the pandemic’s effects on people’s health, financial situations, and social interactions only accelerated this growth. As the pandemic continues, people report heightened mental distress and seek mental health care at unprecedented rates. The situation regarding mental health in our nation is only worsening, but this is not where the issue stops. Mental health disorders disproportionately affect minority populations, and treatment is harder than ever to utilize due to a number of barriers.


Not only is the nation’s state of mental health declining, but also there is not an adequate infrastructure of mental health providers put into place. Over one-third of people in the US live in Mental Health Professional Shortage Areas, places with less mental health providers than is needed to meet the needs of the population [5]. It is predicted that the US “will be short between 14,280 and 31,109 psychiatrists in a few years [4]. Because of this shortage of providers, people in the US often find themselves having to wait for a couple months for an appointment. This has led to nearly 40% of Americans suffering from anxiety, depression, substance use disorder, or other mental illnesses to not receive any treatment forms [6]. The lack of accessibility to adequate mental health care is not exclusive to the US. The World Health Organization estimates that 75-85% of serious mental disorders in developing countries were untreated [3]. To address the shortage of treatment providers, many have called for the opening of new psychiatry residency slots to increase the number of trained physicians, but funding for these programs is difficult to allocate on a state and government level. Insurance companies also contribute to the disaster, as most plans cover little to no mental health services, causing this treatment to be more expensive for the patient and also more difficult for providers to offer a comprehensive care plan [7].


These issues, amongst many others, are amplified for minority populations, as cultural and socioeconomic barriers prevent them from accessing sufficient treatment options. In general, ethnic and racial minority groups are less likely to seek mental health care than whites [8]. With respect to cultural barriers for minority populations, the primary concerns are stigmas surrounding mental health disorders, care providers, and treatment methods. Stigmas can lead to potential patients declining or avoiding treatment, worsening the symptoms of their conditions, as they can lead them to feel more isolated and hopeless [8]. In some Asian and Hispanic cultures, having a diagnosed mental illness is thought to look bad upon families and is often considered embarrassing or weak. Only 4% of Asian Americans, compared to 26% of whites, would seek help for a mental illness from a psychiatrist or specialist [8]. While it is clear that stigma contributes to the inequalities in mental health, mistrust and overall health status are other major barriers to mental healthcare for minority populations. A few studies have shown that African Americans and Latinos reported a significantly higher rate of mistrust in physicians and care providers than their white counterparts, citing prior experiences where they believe they were mistreated by a physician [8]. Furthermore, the burden of illness is higher for minority populations, and they are more likely to suffer from chronic illnesses. While this in itself is a major issue, chronic illness is recognized as a risk factor for mental health disorders, contributing to the gap in mental health care in our nation.


Many entrepreneurs have taken on the challenge of combating these serious issues in mental healthcare through various projects, startups, and businesses. Startups such as Meditopia ($18.3M Series A funding), NUE Life Health ($26.3M Series A), and Lyra Health ($910.1M Series F funding), increase accessibility to services through a mediation app, offer ketamine therapy through a subscription service, and increase mental health service utilization by employer-provided mental health coverage, respectively [10]. These are few of the many rapidly growing startups in the mental health space that are critical in addressing the various barriers to mental health treatment. While these companies will help to improve the overall situation, some entrepreneurs have taken a more specific approach in targeting minority mental health issues. To address the distrust in care, Kevin Dedner founded Hurdle and, in 2021, raised a $5 million series seed to accelerate his project [9]. Hurdle is a technology service that measures cultural responsiveness and provides appropriate training for therapists [9]. In other words, the company is designed to create a system in which all people can receive treatment from therapists who understand their backgrounds. Another startup project working to combat mental health issues within minority populations is Shine, an app founded by Marah Lidey and Naoimi Hirabayashi, which provides content specifically geared towards Black, LGBTQ+, and women’s mental health. Lidey, Hirabayashi, and their team, which is over 80% people of color, have raised $1 million in venture capital funding [9]. These ideas are just the beginnings to a force of heavily needed solutions to the mental health crisis in the US. Americans must continue on the path to developing an innovative mental healthcare system that addresses the various barriers preventing the receipt of adequate mental healthcare for all.


References

  1. “The State of Mental Health in America.” Mental Health America, https://www.mhanational.org/issues/state-mental-health-america.

  2. “Mental Health and Covid-19: Two Years after the Pandemic, Mental Health Concerns Continue to Increase.” Mental Health America, https://mhanational.org/mental-health-and-covid-19-two-years-after-pandemic.

  3. Ngui, Emmanuel M et al. “Mental disorders, health inequalities and ethics: A global perspective.” International review of psychiatry (Abingdon, England) vol. 22,3 (2010): 235-44. doi:10.3109/09540261.2010.485273.

  4. Weiner, Stacy. “A Growing Psychiatrist Shortage and an Enormous Demand for Mental Health Services.” AAMC, 9 Aug. 2022, https://www.aamc.org/news-insights/growing-psychiatrist-shortage-enormous-demand-mental-health-services.

  5. “Fact Sheet: President Biden to Announce Strategy to Address Our National Mental Health Crisis, as Part of Unity Agenda in His First State of the Union.” The White House, The United States Government, 15 July 2022, https://www.whitehouse.gov/briefing-room/statements-releases/2022/03/01/fact-sheet-president-biden-to-announce-strategy-to-address-our-national-mental-health-crisis-as-part-of-unity-agenda-in-his-first-state-of-the-union/.

  6. “Addressing the Behavioral Health Workforce Shortage .” Behavioral Health + Economics Network, BHECON, https://www.bhecon.org/wp-content/uploads/2016/09/BHECON-Behavioral-Health-Workforce-Fact-Sheet-2018.pdf.

  7. Boyd, J. Wesley. “Why Is It so Hard to See a Psychiatrist?” Psychology Today, Sussex Publishers, https://www.psychologytoday.com/us/blog/almost-addicted/201411/why-is-it-so-hard-see-psychiatrist.

  8. Office of the Surgeon General (US); Center for Mental Health Services (US); National Institute of Mental Health (US). Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2001 Aug. Chapter 2 Culture Counts: The Influence of Culture and Society on Mental Health. Available from: https://www.ncbi.nlm.nih.gov/books/NBK44249/

  9. Morant, Keisha. “The Black Founders Advocating for Better Mental Health.” POCIT. Telling the Stories and Thoughts of People of Color in Tech., 21 Nov. 2022, https://peopleofcolorintech.com/founders/the-black-founders-tackling-mental-health/.

  10. Howarth, Josh. “20 Growing Mental Health Startups in 2022.” Exploding Topics, Exploding Topics, 29 July 2022, https://explodingtopics.com/blog/mental-health-startups.


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