Understanding the Intersection of Race and Behavioral Health
The topic of Race and Behavioral Health Equity is not only timely but essential to the future of our healthcare system. While conversations about mental health have expanded dramatically in recent years, access to care is still not equal—especially for people of color. Clinical data underscores this disparity: 38% of white individuals with a mental health condition receive care, compared to only 25% of Black individuals and just 22% of Hispanic individuals.
These numbers represent far more than statistics. They reflect a deep-rooted, systemic issue that affects lives across generations. Behavioral health care is a right, not a privilege—and yet racial and ethnic minorities often face more barriers to access, diagnosis, and culturally competent treatment.
A Matter of Life and Death: Race and Youth Mental Health
A particularly devastating example of inequity can be found among adolescents. Nearly 9% of high school students have attempted suicide, with Black youth being twice as likely to die by suicide as their peers. These disparities are not driven solely by socioeconomic status or lack of insurance coverage. They are also rooted in awareness gaps and a shortage of culturally appropriate providers.
Families seeking care for their children often find themselves searching for providers who not only treat adolescents but who also understand the cultural contexts their children are growing up in. The need for Race and Behavioral Health Equity is especially urgent when young lives are at stake.
Structural Barriers to Equitable Care
Dr. Trent Haywood, former Deputy Chief Medical Officer for CMS, emphasized the importance of building transparency into the system through data and equality measures. While progress has been made in linking care quality with funding—especially through value-based payment models—the road to true Race and Behavioral Health Equity is still obstructed by significant systemic challenges.
One of the biggest concerns has been the unintended consequences of measuring quality without the necessary infrastructure. Clinicians in under-resourced communities often lack the tools—like electronic health records or sufficient staffing—to prove that they’re providing equitable care, even when they are. As a result, the equity gap can unintentionally widen.
Zip Code or Diagnosis? Where You Live Still Matters
In his work with Blue Cross Blue Shield, Dr. Haywood found that your zip code can often predict your behavioral health outcomes more accurately than your actual diagnosis. On the South Side of Chicago, where a large percentage of residents are Black or Latino, behavioral health conditions were drastically underdiagnosed—buried beneath more “urgent” physical comorbidities like diabetes or heart disease.
The lesson is clear: without addressing social determinants of health such as location, transportation, nutrition, and language barriers, Race and Behavioral Health Equity will remain elusive.
Maternal Mental Health: A Crisis Within a Crisis
According to Gabe Diop, maternal health is another urgent area where Race and Behavioral Health Equity must be prioritized. One in five moms will experience a mental health condition before or after giving birth. However, only 15% of these women will receive care.
The disparities are even more startling when broken down by race. Black mothers are 41% less likely, and Hispanic mothers are 57% less likely, to receive treatment than white mothers. These gaps cannot be dismissed as provider shortages alone. Only 20% of mothers are ever screened for behavioral health conditions during their perinatal care—a statistic that demands immediate action.
The impact of these disparities extends far beyond the mother. Poor maternal mental health affects children’s development, family stability, and even future health outcomes, making Race and Behavioral Health Equity not only a maternal issue but a generational one.
Bridging the Awareness Gap with Innovation
Awareness is often the first barrier. In a telling example, an OB-GYN recently shared that it could take her hours to find a behavioral health provider who is in-network and culturally competent for her patients. However, when shown the capabilities of platforms like Rula, which allow providers to find in-network behavioral health specialists in five clicks, she was stunned.
This example is hopeful. Solutions for advancing Race and Behavioral Health Equity already exist—but they need to be scaled and promoted. The challenge now lies in bridging the awareness gap so that both providers and patients can fully leverage these innovations.
The Role of Value-Based Care in Advancing Equity
Dr. Haywood noted that value-based care models can incentivize equitable treatment—if designed correctly. When payers build rewards for providers who serve complex populations or work in under-resourced areas, they begin to align incentives with outcomes. For instance, Medicare Advantage plans are now incorporating health equity indexes that reward care for historically underserved groups.
However, these programs must be structured thoughtfully. Poorly designed value-based programs can unintentionally penalize the very providers trying to do the right thing. A good program recognizes the structural barriers and gives providers the support they need to overcome them—not just additional burdens.
For Race and Behavioral Health Equity to become a reality, collaboration across sectors is necessary. Governments, health systems, schools, employers, transportation services, and community groups all play a role.
From Data to Action: Creating Community-Specific Solutions
One of the most promising approaches involves focusing on hyper-local data. While working with a prominent hospital system, Dr. Haywood’s team discovered that the majority of their employees were Spanish-speaking—a fact the hospital had completely overlooked. Despite having an “adequate” provider network, it wasn’t linguistically or culturally suited to their own staff.
This example illustrates how Race and Behavioral Health Equity depends on identifying the real needs of the population being served. A one-size-fits-all approach won’t work. Each community has different needs, and effective solutions must be designed accordingly.
Race and Behavioral Health Equity Is a Collective Responsibility
Both Gabe Diop and Dr. Trent Haywood agree that Race and Behavioral Health Equity must be integrated into the core of the healthcare system. Behavioral health cannot function in a silo; it must be woven into primary care, maternal care, pediatric care, and community services. We must build culturally competent networks, expand access through value-based models, and educate both providers and patients about available resources.
Most importantly, the work must be ongoing. Closing gaps in care is not a one-time initiative. It’s a commitment to ensuring that the quality of care a person receives is never determined by the color of their skin, their zip code, or their ability to navigate a fragmented system.
