WHY ADDRESS MENTAL HEALTH DISPARITIES? Good mental health enables individuals from all racial and ethnic backgrounds to pursue healthy relationships, advance their education, succeed in the workplace and cope with adversity.34 These personal successes are important to society as they decrease juvenile justice, criminal justice, hospital, general physical health and other costs that affect everyone.35
In contrast, the consequences of inadequate and inappropriate mental health services result in access and utilization barriers that have significant human, societal and economic, and systemic costs. Lack of access and utilization of appropriate mental health services results in:
- Human costs: including decreased quality of life, including failing relationships, significant dysfunction and distress, suicide and suicidal ideation, and limited ability on the part of parents to care for their children.36
- Societal costs: including decreased productivity in the workplace, increased homelessness and increased physical health care costs as individuals with untreated mental illnesses access health services with greater frequency then the general population.37,38
- The impact of mental illness on both quality of life and economic productivity exceeds many physical illnesses, such as heart disease and diabetes.39
- The total yearly cost for mental illness in both the private and public sectors in the U.S. is $205 billion. Only $92 billion comes from direct treatment costs, with $105 billion due to lost productivity and $8 billion resulting from crime and welfare costs. The allocation for the cost of untreated and mistreated mental illness to American businesses, the government and families has grown to $113 billion annually.40
- Systemic costs: including overrepresentation of youth and adults from communities of color in more costly systems, including emergency rooms, which negatively impacts businesses and private health care costs through cost-shifting, and government systems like juvenile justice, criminal justice and child welfare.
- Similar prevalence, combined with lower utilization and poorer quality of care, results in a higher proportion of individuals with unmet mental health needs and an overrepresentation of people of color who are homeless and incarcerated.41 Communities of color often access mental health services through emergency rooms, which serve as an expensive and poor alternative for ongoing community based care.42,43 The evidence suggests that the disability burden from unmet mental health needs is disproportionately higher for communities of color.44
- Additionally, many ethnic youth receive their first exposure to mental health treatment in the juvenile justice system.45 African American adolescents with serious emotional disturbances are likely to end up in the juvenile justice system rather than receiving treatment in the mental health system, as would occur for their white counterparts.46 Native American youth face similar negative consequences when they have serious emotional disturbances, including being legally removed from their families by child welfare and potentially geographically removed from their tribes.47 Overall, racial and ethnic youth are disproportionately served in child welfare, juvenile justice and special education systems; public systems that have high case loads and find it difficult to meet service needs. Much of this overrepresentation, in addition to being caused by a lack of early intervention and mental health services, can be attributed to such things as differential treatment and placement decisions for these youth.48
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