Addressing racial, ethnic disparities in availablility of mental health care for kids

A new study shows that white children access mental health care services at a higher rate than black or Latino children.

The authors of the study in the International Journal of Health Services were interested in why kids of color are more likely to be incarcerated or suspended from school. Many incarcerated young people  have mental illness, so the researchers looked at inequalities in mental health care delivery.

Examining six years of national data from The Medical Expenditure Panel Survey, they found that white kids accessed services at a higher rate than children of color.

“What we found was that for black and Hispanic children, much fewer visits were made to psychiatrists and other mental health professionals,” said Dr. Lyndonna Marrast, lead author. “This was not because they needed less care, because black and white children have similar rates of mental health problems.”

The why behind that statistic is complicated, she said. It ranges from a lack of providers in some communities, to stigma and insurance issues. But doctors can take some steps now to address the disparity.

“Health professionals on one hand have a role that they can play,” said Marrast of Hofstra University. It’s important that they try to get “patients into mental health services as opposed to having certain behaviors attributed to misbehavior.”

“Youthful transgressions that might result in referral for treatment among nonminority children more often incur criminal sanctions for minorities,” according to the study.

To be clear, the data doesn’t provide a definitive link between the scarcity of access to mental health care and incarceration, but Marrast said she and her team are making an inference.

For Flossie Ierardi, who heads the music therapy master’s program at Drexel University, that resonates with patterns she’s seen in her own 20-year practice. She’s worked at a juvenile detention facility where most of the kids are African-American or Latino, even though the larger suburb where it’s located is mostly white.

Music therapy made a noticeable difference for some kids there, she said.

“And there were some kids who just took to music therapy very well. And you could see their strengths come out,” said Ierardi. “Their affect just really changed, and you could see a spring in their step as they were walking out of the room.”

That may have to do with the fact that in trauma-informed music therapy, the focus is not so much “what did you do?” as it is in a law-enforcement context but more “what happened to you?”

Marrast said providing more training to mental health professionals, recruiting more providers of color and adopting what she calls a “less punitive attitude” toward youthful misbehavior could all make a difference.