Minority Mental Health Worsened During the COVID-19 Pandemic

Cost of treatment is major barrier to accessing care, with Asian adults least likely to receive mental health care and Native Americans least likely to seek care for substance use challenges

WASHINGTON, D.C. (July 21, 2021) – Nearly half of all Black, Hispanic, Asian, Native American and LGBTQ+ individuals say they have personally experienced increased mental health challenges over the past 12 months, but few received treatment, according to a new poll by the National Council for Mental Wellbeing.

Minorities and LGBTQ+ also say they have thought more about their own substance use challenges during the COVID-19 pandemic, though barriers to access prevented many from receiving needed care.

The poll, conducted by Morning Consult and released today by the National Council to raise awareness about Minority Mental Health Awareness Month, underscores the toll the COVID-19 pandemic has taken on minority and LGBTQ+ individuals and the urgent need to improve health equity among minorities through Certified Community Behavioral Health Clinics (CCBHCs) and other programs that dramatically boost access in underserved communities.

“The COVID-pandemic has spared no one, and now we’re facing a second public health crisis – a mental health and substance use crisis – and the impact on Black, Hispanic, Asian, Native American and LGBTQ+ individuals represents an immediate concern,” National Council President and CEO Chuck Ingoglia said. “Eliminating barriers to access for mental health and substance use treatment will help reverse long-standing inequities and improve wellbeing among people of color and the LGBTQ+ communities.”

With respect to mental health and treatment for mental health challenges, the survey found that over the past 12 months, many people have neglected seeking treatment. According to the findings:

• 49% of LGBTQ+ adults have experienced more stress and mental health challenges, but just 41% say they have received treatment or care of any kind for their mental health.
• 46% of Black adults say they are experiencing more stress and mental health challenges, but just 21% say they have received treatment or care of any kind for their mental health.
• 45% of Native American adults have experienced more stress and mental health challenges, but only 24% have received treatment for mental health.
• 42% of Hispanic adults report experiencing more stress and mental health challenges, but just 26% say they have received mental health treatment.
• 40% of Asian adults say they are experiencing more stress and mental health challenges, but just 11% say they have received treatment or care of any kind.

Half or more of adults surveyed said they have frequently experienced feeling tired or having less energy (63%); had difficulty sleeping (58%); felt nervous, anxious or on edge (51%); and had trouble relaxing (50%) over the past 12 months.

With respect to substance use, 13% of adults surveyed say they are more aware of their substance use during the COVID-19 pandemic, but just 9% said they are receiving treatment for substance use challenges. New data from the Centers for Disease Control and Prevention (CDC) released July 14 shows overdose deaths soared to 93,000 in 2020. According to the survey, over the past 12 months:

• 10% of Native American adults have thought more about their own substance use, but just 3% have received treatment for a substance use challenge.
• 14% of Black adults have thought more about their own substance use, but just 5% have received treatment for a substance use challenge.
• 12% of Asian adults have thought more about their own substance use, but just 7% have received treatment for a substance use challenge.
• 17% of those in the LGBTQ+ communities have thought more about their own substance use, but just 10% have received treatment for a substance use challenge.
• 17% of Hispanic adults have thought more about their own substance use, but just 12% have received treatment for a substance use challenge.

Many barriers to access prevent people from seeking treatment. Almost half (47%) of all adults surveyed agreed that the cost of help/treatment is an obstacle in seeking treatment for their mental health and 40% of adults agreed that cost is an obstacle to seeking treatment for a substance use challenge.

The impact of cost on seeking treatment for mental health varied, but represented the biggest obstacle for LGBTQ+ individuals (65%) and Native Americans (63%). The cost of treatment for a substance use challenge was viewed as the greatest obstacle to treatment by Asians (47%), Native Americans (46%) and LGBTQ+ (46%).

Cost is not the only barrier; access to care also represents a significant hurdle. Nearly one in five (18%) of those surveyed found it difficult to access a therapist or counselor for mental health treatment and one in six (15%) reported difficulties securing treatment to address a substance use challenge.

“The urgent need to address mental health and substance use challenges among the nation’s minority and LGBTQ+ populations existed well before the COVID-19 pandemic. The public health crisis has exacerbated the problem and heightened the importance of addressing disparities in health and health care,” Ingoglia said. “One way we can expand access and help people of color and LGBTQ+ individuals is through CCBHCs.”

Adopting the CCBHC model allows mental health and substance use treatment organizations to expand their services and increase access to treatment. Designed to expand access to care for underserved populations, CCBHCs are proving to help address health disparities and promote equity for an estimated 1.5 million people across the country. A recent survey of active CCBHCs found:

• 100% of responding clinics indicated that CCBHC status has helped them to serve people of color, improve access to care and reduce health disparities in their communities.
• 75% reported increased screening for unmet social needs that affect health, like housing, income, insurance status, transportation and more.
• 60% were able to hire staff who are demographically similar to the populations their clinics serve.
• 53% initiated or expanded translation services as a result of adopting the model.

“As an organization committed to the mental wellbeing of all people, we will continue to focus efforts on social determinants of health to ensure health equity and better outcomes for vulnerable populations,” Ingoglia said.

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Morning Consult conducted the poll June 21-June 28, 2021, among a total of 3,600 adults, including a national sample of 2,200 adults and oversamples of 300 Asian American adults, 300 Black adults, 300 Hispanic adults, 200 Native American adults and 300 LGBTQ+ adults. The interviews were conducted online and each sample was weighted to approximate a target sample of the surveyed audience based on gender, educational attainment, age, race and region. Results from the full survey have a margin of error of plus or minus 2 percentage points, results among Asian American, Black, Hispanic and LGBTQ+ adults have a margin of error of plus or minus 6 percentage points and results among Native American adults have a margin of error of plus or minus 7 percentage points.