Missed Opportunity

For a minute it looked like real progress toward racial justice was possible.

The Black Lives Matter movement had many people who previously didn’t even consider racial disparities ponder their role in an unjust system. Ideas surfaced to explore ways we might work together to improve it. Among the disparities discussed were those found in healthcare.

Revealed for many was the gaping chasm between Whites and African Americans in mental healthcare.


Among adults with diagnosis-based need for mental health or substance abuse care, 37.6% of Whites, but only 25.0% of African Americans, receive treatment.

Overall spending for Blacks on outpatient mental health care is about 60 percent of White rates after taking into account need for care.

While overall rates of treatment for psychiatric disorders increased between 1990 and 2003, Blacks were only 50 percent as likely to receive psychiatric treatment as Whites for diseases of similar severity. This difference remains.

Fascinating facts were pondered. The general public discovered that rates of schizophrenia are higher in Blacks than in Whites, but rates of mood disorders are lower. An exploration of reasons for these differences, whether they have to do with diagnostic criteria, access to care, provider bias or cultural influence were nearly given new importance.

Then the discussion and the issues discussed changed.

The message about true racial disparities got lost in virulent debates over statues of Christopher Columbus. Focus changed from attention to the needs of economically disadvantaged communities to bias in textbooks in rich, primarily White schools. Consideration of budget priorities, including healthcare, disappeared as the movement was redirected toward symbolic, primarily political sloganeering.

Once again, the people who truly suffer from economic, social and healthcare disparities lose their seat at the table and their voice in the media. Once again, the poor who are truly disadvantaged, especially poor minorities facing mental health challenges, fade into the shadows of inner cities, not to be heard from again on key issues that affect them most.

We love our symbols and our debates on justice, but in the end we do little to truly help those left out of an unfair system. We argue about things that don’t matter at all to the people who cannot find treatment or education about treatment for psychiatric diseases that, for those to whom treatment is readily available, are most often successfully managed.

In the end we’re all likely to feel better about how we stood up for racial justice. And all of the racial disparities in mental healthcare will remain - unconsidered and undiscussed.

I fear the people who insist on change will win the battle of ideas and lose the war of practical racial disparity.


My new book Resilience: Handling Anxiety in a Time of Crisis is available wherever books are sold.