The Role of Afrocentric Features in Mental Healthcare Utilization and Counselor Preferences in Black College Students

Though mental health issues are prevalent in Black young adults, they underutilize mental healthcare services. This research examined the role of feature-based discrimination in mental healthcare (under)utilization. Study 1, a secondary analysis of the National Longitudinal Study of Adolescent to Adult Health, provided no evidence supporting a link between skin tone and mental healthcare utilization, when controlling for depression diagnosis. However, when controlling for depression symptoms, there was a trend such that Black young adults with darker, as opposed to lighter, skin tone utilized healthcare less. Study 2, an experimental study with 33 Black college students, showed 73% of the sample preferred a Black counselor. Additionally, they preferred counselors with darker skin, wider nose, and thicker lips, compared to counselors with lighter skin, narrower nose, and thinner lips. These findings suggest the importance of taking into account Afrocentric features and its social consequences when assessing health-related behaviors in Black Americans

“Is therapy for me?” Perceptions of Therapy Inclusivity and Willingness to Seek Help among Black Emerging Adults

Mental health issues are prevalent among Black emerging adults; however, they tend to underutilize mental healthcare services. The goals of the current study were to examine whether: (1) perceived therapy inclusivity would predict willingness to utilize mental healthcare services and (2) the relationship between perceived therapy inclusivity and willingness would be moderated by two indices of racial identity (i.e., centrality and private regard). Results provide evidence that greater perceptions of therapy inclusivity are associated with greater willingness to seek mental health services even after controlling for factors, such as gender, self-stigma, and previous mental healthcare utilization. Additionally, there was no evidence to suggest that racial identity moderates the relationship between perceived therapy inclusivity and willingness to use mental health services. These findings suggest that Black emerging adults may be more willing to utilize mental health services and engage with the mental healthcare system if they perceive that mental health services are for them. Findings from this dissertation project have implications for clinical practices to increase Black adults’ perceptions of therapy inclusivity. Recommendations include developing trainings about Black people’s experiences in the mental health system, building relationships with Black communities, and providing culturally responsive treatments. The findings also have policy implications. Specifically, structural changes (e.g., increasing Black adults’ representation in clinical staff and leadership) must be made to the mental healthcare system to increase Black adults’ perceptions of therapy inclusivity and willingness to seek care. Such intentional measures will help to create a better, more inclusive system for all Black adults

The Role of Feature-Based Discrimination In Driving Health Disparities Among Black Americans

Objective: A growing body of research finds that darker skin tone is often associated with poorer physical and mental health in Blacks. However, the psychosocial mechanisms underlying the skin tone-health link remain elusive. The present study seeks to address this knowledge gap by investigating the direct and indirect (through perceived discrimination, socioeconomic status, and self-esteem) effects of skin tone on self-reported physical and mental health. Design: An urban sample of 130 Blacks aged 35 and above completed a self-administered computerized survey as a part of larger cross-sectional study. Results: Self-esteem played a particularly important role in mediating the associations between skin tone and self-reported physical and mental health. This suggests that self-esteem could be a point of intervention to help Blacks with darker skin tone achieve better health. Conclusion: The present study highlights the important role feature-based discrimination plays in determining mental and physical health outcomes among Blacks

Addressing Structural Racism in the Health Workforce

One of the greatest challenges facing the United States are health inequities among racial/ethnic and other marginalized populations. The deep-rooted structural racism embedded in our social systems, including our health care system and health workforce, is a core cause of racial health inequities. 1 Among many definitions of institutionalized or structural racism, Dr Jones 2 best defines it as: “Differential access to goods, services and opportunities of society by race ... It is structural, having been codified in our institutions of custom, practice, and law, so there need not be an identifiable perpetrator.” Dr Jones further explains that to set things right in our country, we have to address this type of racism that is embedded in all of our systems. Historical and existing structural obstacles have significantly reduced access to health professions education among marginalized populations in the United States.3,4 This has rendered an underrepresentation of Black, Latino, and Native persons in health professions schools, practice, and leadership. 5,6 This commentary presents the evidence of and potential avenues for beginning to address structural racism in the health care workforce. We discuss how historical and present-day racism impacts recruitment and retention of historically excluded groups in the health professions (eg, Black, Latino, and Native people) and the investments needed to dis- mantle the impacts of structural racism on the diversity of our health workforce

Historic Redlining and Contemporary Behavioral Health Workforce Disparities

This cross-sectional study investigates the association between redlining and behavioral health specialist supply in 2 mental health professional shortage areas

Documenting a Decade of Exponential Growth in Employer Demand for Peer Support Providers

The past decade has seen peer support providers increasingly incorporated as part of a recovery-oriented approach to behavioral health (BH) services for mental illness and substance use disorder. Despite this, there are few data sources to track this sector of the BH workforce, and understanding of peer support provider supply, demand, distribution, and associated factors is limited. In this retrospective, observational study, the authors analyzed job postings from 2010 to 2020 to assess employer demand for peer support providers and the factors associated with its growth, using a labor market data set from Emsi Burning Glass. The authors identified peer support job postings using a three-pronged, stepwise approach. Then, bivariate regression analyses using robust standard errors were conducted to examine state-level relationships between the number of peer support job postings per 100,000 population and Medicaid policies and indicators of states\u27 BH infrastructure. The authors identified approximately 35,000 unique postings, finding the number increased 17-fold between 2010 and 2020. Bivariate analysis found significant state-level associations between peer support job postings and Medicaid expansion, as well as states\u27 mean number of mental health facilities. This analysis represents the first to quantify employer demand for peer support providers, clearly demonstrating robust growth over time. Findings underscore the importance of continuing to develop data on this workforce to better understand factors driving its growth