Panel Paper:
Gender Identity, Race, and Ethnicity Discrimination in Access to Mental Health Care: Evidence from an Audit Field Experiment
*Names in bold indicate Presenter
We hypothesize that minorities face discriminatory barriers in access to MHPs. MHPs could discriminate by selectively responding to inquiries or restricting access to appointments. There is significant evidence of this discrimination in access to primary care, but little work on discrimination in mental health care.
To test if trans/nonbinary people and racial and ethnic minorities face discrimination in access to appointments with MHPs, we email MHPs requesting appointments from fictitious prospective patients who vary based on race or ethnicity (white, Hispanic, and African-American names) and based on gender identity. In the email, prospective patients introduce themselves, mention their mental health concern (anxiety, stress, or depression), request an appointment, and, for trans/nonbinary people, mention they are seeking a therapist who is “trans-friendly.” We measure discrimination primarily by comparing the appointment offer rates by race, ethnicity, and gender identity.
Understanding the role of discrimination in access to mental health care is especially important given the mental health disparities that minorities face: higher rates of anxiety, depression, substance abuse, PTSD, and suicidality. Discrimination not only exacerbates these conditions through "minority stress", but discrimination poses a barrier to the ability for minorities to use mental health care to treat these conditions that they disproportionately face.
