Centering Culture in Mental Health: Differences in Diagnosis, Treatment, and Access to Care Among Older People of Color

Am J Geriatr Psychiatry. 2022 Nov;30(11):1234-1251. doi: 10.1016/j.jagp.2022.07.001. Epub 2022 Jul 8.

Abstract

Mental healthcare disparities are routinely documented, yet they remain wider than in most other areas of healthcare services and common mental disorders (depression and anxiety) continue to be one of the highest health burdens for older people of color. To address disparities in mental health services for older people of color, the narrative must move beyond simply documenting these inequities and attain a better understanding of the internalized, interpersonal, systemic, and medical racism that have harmed these communities and excluded them from its services in the first place. It is imperative that researchers, clinicians, and policymakers acknowledge the realities of racism and discrimination as leading causes of mental healthcare disparities. Therefore, this review is a call-to-action. Authors adopt an antiracist and health equity lens in evaluating the differing needs of Blacks/African-Americans, Asian Americans, and Latinos by exploring psychiatric comorbidity, experiences with seeking, accessing, and engaging in treatment, and the unique cultural and psychosocial factors that affect treatment outcomes for these diverse groups. Further, authors offer researchers and practitioners tangible tools for developing and implementing culturally-sensitive, mental health focused interventions for older people of color with special attention placed on cultural adaptations, models of care, prevention, and practical strategies that can be implemented to reduce disparities and increase equity in mental healthcare.

Keywords: Disparities; Health beliefs; Late life mental health; Older people of color; Prevention; Stigma.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Health Services Accessibility
  • Healthcare Disparities
  • Humans
  • Mental Health Services*
  • Mental Health*
  • Skin Pigmentation