Health Disparities in Black Patients with Severe Mental Illness and the Role of Structural Racism

Black patients with severe mental illness (SMI) experience health disparities when compared to White patients. These disparities include differences in the availability of culturally appropriate, affordable care; a disproportionate diagnosis of psychotic illnesses; differential and inequitable access to certain medications and treatments; and a decreased likelihood of being referred to higher-quality, evidence-based aftercare programming. These disparities are not due to Black people being "sicker," but instead are due to implicit bias and structural racism. In this article, we describe the health disparities that Black patients with SMI suffer in access to mental health care, diagnosis, treatment, and aftercare. We discuss the origins of these disparities and some ways that each of us can combat them in our day-to-day practice.