Addressing Mental Health Disparities Among Oppressed Communities
Katherine [Katu] Medina-Pineda, MHC-LP
Despite decades of research and growing awareness, disparities in mental health remain stark and persistent across marginalized populations. Oppressed groups—including racially and ethnically minoritized individuals, people living in poverty, LGBTQ+ individuals, and those in rural or carceral settings—continue to face significant barriers to care. These inequities not only worsen mental health outcomes but also perpetuate cycles of disadvantage across education, employment, and physical health. To move toward equity, it is essential to understand the structural, cultural, and personal factors that shape access to and effectiveness of care.
The Scope of the Problem
Mental health disparities have been recognized as a national research priority. In 2011, the Federal Collaborative for Health Disparities Research identified mental health as one of the top four areas requiring immediate attention. Populations such as Native Americans and Alaska Natives, African Americans, Latinx individuals, and sexual and gender minorities face unique burdens. For example, suicide rates among American Indian/Alaska Native youth are more than three times higher than among other racial groups, while Black and Hispanic youth are more likely to be misdiagnosed with disruptive behavior disorders rather than mood disorders.
These disparities are not only present in diagnosis or misdiagnosis—they extend to access and quality of care. According to a study published on the Federal Collaboration on Health Disparities Research by Safran et al (2011), roughly one in four Americans lack adequate access to mental health services, but for oppressed groups, barriers are compounded by systemic discrimination, socioeconomic challenges, and cultural mismatches between providers and patients.
Why Traditional Approaches Fall Short
Evidence-based treatments (EBTs), such as cognitive-behavioral therapy (CBT), are widely considered the gold standard of care. Yet, they often fail to engage BIPOC. According to a study published in The American Psychologist Journal in 2021, a meta-analysis found that African Americans, Asian Americans, and Latinx Americans are significantly less likely than White Americans to use mental health services, even when they have a diagnosable disorder.
Part of the problem lies in cultural and structural barriers. Diagnostic tools and therapeutic approaches have historically been rooted in Eurocentric perspectives that may not align with the lived experiences of marginalized groups. For example, for many ethnicities within the Asian American population, priority is given to the way the individual is perceived by the collective, which can make self-disclosure in therapy feel shameful. Conventional CBT, which emphasizes self-reflection and internal change, may therefore seem less relevant or even alienating. Cultural adaptations of therapies (CATs) have attempted to address this gap, but progress has been slow. While culturally adapted interventions show moderate effectiveness, they are often inconsistently implemented, lack systematic frameworks, and fail to capture the diversity within cultural groups.
Addressing Structural Inequities
Beyond tailoring interventions, tackling structural barriers is critical. Oppressed groups face systemic challenges such as racism, anti-Blackness, transphobia, misogyny, poverty, housing insecurity, and discriminatory health systems that exacerbate mental health disparities. For example, a study by Barksdale et al (2021) found that minoritized individuals are more likely to receive emergency department-based mental health care rather than ongoing outpatient treatment, perpetuating crisis-driven care rather than preventive or sustained support. Intersectionality must also guide intervention design. Ignoring these intersecting oppressions risks overlooking the complexity of people’s lived experiences in favor of continuing to center and emphasize one-size-fits-all frameworks, which are essentially designed to ensure oppressed people assimilate to and continue to perpetuate white supremacy.
Promising approaches include community-centered mental health models that partner with local organizations to reduce stigma, build trust, and deliver care in accessible, culturally resonant ways. Structural interventions, such as policies addressing provider shortages in rural areas or expanding insurance coverage, are equally essential to reducing disparities.
Addressing mental health disparities requires a multi-level approach:
Individual level: Personalize therapy to make it relevant, credible, and engaging.
Community level: Involve trusted networks and culturally grounded practices.
System level: Reform health care policies to ensure equitable access and quality.
Structural level: Address racism, discrimination, and poverty as root causes of inequity.
As researchers have emphasized, disparities in mental health are not inevitable—they are the product of social, cultural, and systemic inequities. With innovative, inclusive, and equity-focused strategies, we can move toward a future where all individuals, regardless of background or circumstance, have access to the mental health support they need and deserve.
Conclusion
There are many evident disparities in the Mental Health Industrial Complex that adversely impact minoritized individuals by keeping us from accessing mental health services or gaslight us into assimilation. In addition to much needed systemic changes and a re-imagination of what it means to live in societies, we must turn to decolonized exploration- not just within mental health, but also within our communities. White supremacy requires hyper-individualism in order to sustain itself, thus, turning toward community healing and being curious of the systemic elements that adversely impact your communities’ mental health (resource insecurity, safety, accessibility, mobility) are ways in which we can resist oppression and engage in a collective imagination of something different, and better, for oppressed communities.
Sources:
Safran, M. A., Mays, R. A., Huang, L. N., McCuan, R., Pham, P. K., Fisher, S. K., McDuffie, K. Y., & Trachtenberg, A. (2009). Mental health disparities. American Journal of Public Health, 99(11), 1962–1966. https://doi.org/10.2105/AJPH.2009.167346
Hall, G. C. N., Berkman, E. T., Zane, N. W., Leong, F. T. L., Hwang, W.-C., Nezu, A. M., Nezu, C. M., Hong, J. J., Chu, J. P., & Huang, E. R. (2021). Reducing mental health disparities by increasing the personal relevance of interventions. American Psychologist, 76(1), 91–103. https://doi.org/10.1037/amp0000616
Barksdale, C. L., Pérez-Stable, E. J., & Gordon, J. (2022). Innovative directions to advance mental health disparities research. American Journal of Psychiatry, 179(6), 397–401. https://doi.org/10.1176/appi.ajp.21100972