Countering Health Disparities in Black & Latinx Communities: What Counselors and Other Mental Health Professionals Can Do

When considering behavioral health disparities, the current health pandemic is of critical importance and instructive. Although the information about COVID-19 is constantly shifting, it is clear that certain segments of the U.S. population are disproportionately impacted. Those particularly vulnerable are:

• African Americans, especially those in low income neighborhoods,
• Some members of Latinx communities, particularly immigrants and undocumented workers,
• Native American Indian communities, specifically those residing on reservations,
• The elderly, veterans, incarcerated, and other people in dense residential settings, and
• Anyone with pre-existing health conditions.

These disparities follow familiar patterns of racial and economic bias in healthcare delivery for African American, Latinx, and indigenous communities. For instance, in the current healthcare crisis, doctors are less likely to refer African Americas and Latinx patients for testing and there is evidence of subjectivity in assessment of coronavirus symptoms. Also, research has shown that delays in diagnosis and treatment can be especially harmful for members of racially and ethnically minoritized groups who often have higher rates of diabetes, high blood pressure, and kidney disease, leading to more severe cases of COVID-19. Moreover, the distribution of testing sites shows a disparity in access to medical care and an inequitable distribution of medical resources for people of color and LGBTQ+ individuals. To further complicate matters, during the initial months of the COVID19 outbreak, the Centers for Disease Control (CDC) had not reported any data on race and only a few states had released demographic data until public outcries demanded more transparency. 

Of significance, members of African American and Latinx communities have historically tended to mistrust mainstream healthcare systems, both physical and behavioral health, for a number of reasons. Unfortunately, behavioral healthcare professionals have been the agents of structural racism, either aggravating existing conditions or causing them, serving as catalysts for generations of historical trauma. Mental health professionals must come to terms with their complicity in this matter. Racism in behavioral health was evident early in U.S. history with diagnostic terms, such as drapetomania (flight from home madness of runaway Africans enslaved on plantations) and Dysaesthesia Aethiopica (refers to the mental affliction of enslaved Africans who resisted the forcible labor imposed upon them). These foundling diagnoses were intended to support and reproduce cultural dominance by labeling acts and thoughts of self-preservation as dysfunctional. Instead, effective interventions designed for African American, Latinx, and indigenous communities need to focus on strength-based, culture-centered interventions using a psycho-social approach, engaging community stakeholders in service provision.

Culture-centered interventions have been discussed within educational settings to highlight cultural discontinuity between home and school for culturally diverse students. However, mental health professionals have been slow to incorporate culturally situated conceptualizations, assessment tools, and interventions. Over a half a century ago, the Rev. Dr. Martin Luther King, Jr. wrote about “why we can’t wait,” the sense of frustration felt by many African Americans about the slow progress toward equality. That frustration is felt today. Our clients can’t wait and neither should we. 

Community-based, Culture-centered Interventions

• Historical Trauma Conversations
  • Healing Discourse Therapy - to address the legacy of Native American historical trauma (See Gone, 2009; A community-based treatment for Native American historical trauma: Prospects for Evidence-based practice)
  • Association of Black Psychology’s Emotional Emancipation Circles- designed to deepen understanding of the impact of historical forces on Black people’s emotional lives, and learn essential emotional wellness skills
• Rite of Passage Programs (youth) – are culturally-specific and focus on improving self?-concept, ethnic identity development, and self?-sufficiency among African & Latinx youth.

Culture-centered Resources

• Black, Indigenous People of Color (BIPOC) Mental Health Month 2020 Outreach Toolkit
• Culture-centered Disaster Mental Health Counseling (C-DMHC) Credentialing Program
• National Queer & Trans Therapists of Color Network