Microaggressions and the Enduring Mental Health Disparity

Abstract

Despite federal focus on reducing mental health disparities for Black Americans, mental health disparities persist, resulting in reduced access to and benefit from mental health care. Amid calls for deeper examination of etiology, the current literature review introduces discrimination in the form of microaggressions at the institutional level as one changeable systemic cause for mental health disparities. In combining the mental health disparity and microaggression literatures, I first review the evidence regarding prevalence and contributing factors for current mental health disparities and microaggressions. Next, I examine the potential contributing role that microaggressions as a form of institutional betrayal within mental health care may play in perpetuating these disparities. Finally, I review implications regarding the particular role of mental health care systems, the field of psychology in general, and Black American psychologists specifically in systematically reducing mental health disparities for Black Americans.

Black American Men's Treatment Experiences in Mental Health Court: A Phenomenological Analysis

“…Hughes and Peak (2013) argued that because of the harmful nature and inconclusive effectiveness of many psychotropic medications, as well as the longer lasting benefits of alternative interventions, MHC funders and providers should consider researching and implementing more alternative interventions. Participants' mistrust of medical practices was also consistent with literature on institutional betrayal, which indicates that many Black Americans find it difficult to trust interventions provided by the dominant culture given their experiences of historical and continuing trauma (Gómez, 2015;Suite, La Bril, Primm, & Harrison-Ross, 2007). Although medication may be helpful for initial stabilization of some disorders, implementation of individual and group counseling modalities has consistently been found to be effective in facilitating lasting emotional, cognitive, and behavioral change in clients, thus reducing the chances of harmful side effects and expenses caused by long-term psychiatric medication dependence (Hughes & Peak, 2013).…”

“…He and other participants described feeling supported, seen, and invested in authentic relationships with individual and group counselors. We believe that increased individual counseling may provide counselors an opportunity to broach issues of race and systemic injustice in building rapport for trauma work and could benefit clients by providing them validation, social support, and effective treatments as well as reducing stigmatization (Corrigan, 2007;Gómez, 2015;Hughes & Peak, 2013).…”

“…of poverty and low access to resources (CDC, 2011). Although they report psychological distress more frequently than other races, they have less access to treatment and are less likely to seek treatment, citing mistrust of culturally insensitive treatment providers (Alvidrez, Snowden, & Kaiser, 2008;Dirks-Linhorst, Kondrat, Linhorst, & Morani, 2011;Gómez, 2015). Their mistrust is well founded given that Black American clients regularly encounter institutional oppression in the form of cultural misunderstanding, misdiagnoses, and racism when seeking treatment from a profession of predominantly White American providers (Gómez, 2015).…”

Impact of ableist microaggressions on university students with self-identified disabilities

“…Similar effects of institutional betrayal have been found in other systems, such as the medical system and the military (Monteith, Bahraini, Matarazzo, Soberay, & Smith, 2016;Tamaian & Klest, 2017). Gómez (2015) Ableist microaggressions. Ableism refers to negative attitudes and prejudice targeted towards an individual based on his or her disability status (Fierros, 2006).…”

“…Racial microaggressions have been studied the most, particularly with respect to the classification of these experiences and their impact on individual targets (Gómez, 2015;Hughey, Rees, Goss, Rosino, & Lesser, 2017;Sue et al, 2007;Wong, Derthick, David, Saw, & Okazaki, 2014). Sue et al (2007) identified three specific types of microaggressions that can be perpetrated against racial minorities: microassaults, microinsults, and microinvalidations.…”