As we all have learned over the past 2½ years, the Covid-19 pandemic has taken a steep toll on the mental health of many people, who continue to struggle with loss and despair. These losses – of income, social connections, good health and the lives of loved ones – have struck hardest at communities of color.

But even before the pandemic, disparities based on race and ethnicity were significant – and had been growing for at least a decade. A new analysis by the Kaiser Family Foundation offers a look at how mental health burdens were shifting in the run-up to the pandemic and after it began, with rates of suicide and drug overdose deaths rising faster among people of color than among whites.

“The findings show larger increases in deaths due to drug overdose and suicide among people of color, particularly among Black and American Indian and Alaska Native people,” said Nirmita Panchal, a senior policy analyst for the foundation and the lead author of the new report. “Our analysis highlights the importance of addressing barriers to mental health services among people of color.”

The report also found a steep increase in the number of parents feeling their mental health has been impacted by the stresses of the pandemic, with Black and Hispanic parents being nearly twice as likely to express those sentiments.

Here’s a summary of the report’s findings.

SUICIDES

Suicide death rates have long been higher among whites – roughly three times as high – compared with those of most other racial and ethnic groups. But while white people continue to take their own lives in far greater numbers, suicide rates from 2010 to 2020 grew far more quickly among most communities of color.

During the 2010 to 2020 period, the suicide rate rose 43% among Blacks, 41% among American Indians and Alaska Natives, 27% among Hispanics, 12% among whites and 10% among Asians or Pacific Islanders. Among adolescents, suicide rates more than doubled for Asians and nearly doubled for Blacks and Hispanics. While the rate of increase was lower than among other groups, young American Indians and Native Alaskans continue to take their own lives at a shockingly high rate – more than three times that of whites and more than four times that of all other groups. The high suicide rate among indigenous youth – and adults – is the result of complex factors including the history of genocide and displacement, discrimination, unemployment, loss of ethnic identity, high rates of substance use and minimal access to mental health treatment. The deaths of friends or family members due to suicide or other causes is also a factor, research suggests.


DRUG OVERDOSE DEATHS

The same pattern is apparent in overdose fatality rates. For nearly two decades, whites had the highest overdose death rate until the Black rate rocketed up with a huge jump in 2020. Two years earlier, overdose rates among American Indian and Alaska Natives also passed that of whites, and then surged further upward in 2020.

Overdose deaths skyrocketed among all groups during the pandemic. But the disparity, along with the size, of the increases over just two years – from 2018 to 2020 – is what’s shocking: While overdose fatalities rose 28% among whites, they rose 68% among Blacks, 60% among Hispanics, 55% among American Indians and Alaska Natives, and 49% among Asians.

The distribution of overdose fatalities among the total population also shifted dramatically: From 2015 to 2018, whites’ proportion plummeted while the contribution by Blacks and Hispanics rose. This trend was most striking among Hispanic adolescents, who make up about a quarter of the adolescent population. In 2015, they accounted for 18% of overdose deaths and in 2020, the figure had jumped to 30%.


MENTAL ILLNESS AND ADDICTION

White adults aged 18 to 64 were more likely to report having a mental illness or substance use disorder (36% combined) compared to Blacks (28%) and Hispanics (27%) in a national survey published in 2020. But many researchers believe that these conditions are underdiagnosed in people of color due to structural barriers and a lack of culturally sensitive screening tools to detect mental illness.

Symptoms of mental illness or addiction among people of color are more likely to be labeled as disruptive or even criminal compared to whites, according to the KFF brief. The practice can start in childhood, where behaviors characterized as mental disorders among white kids are considered disruptive and penalized among children of color. This process may discourage them from seeking help and lead to them being sent to criminal
justice settings instead of treatment centers.


PANDEMIC-DRIVEN WORSENING OF MENTAL HEALTH

People of color experienced higher rates of Covid-19 infection and death and greater financial challenges compared to whites. More than six in 10 Black and Hispanic parents – but less than half of white parents – said in a survey that pandemic-related stress negatively impacted their mental health. Both Blacks and Asians have reported that increased racism and violence worsened their mental health.

DISPROPORTIONATE BARRIERS

While white, Black and Hispanic adults are equally likely to report having moderate to severe anxiety and/or depression in 2019, a majority of Black adults with these symptoms said they weren’t receiving care, while nearly two-third of whites were.

What could make a difference in addressing these disparities? A more diverse behavioral health workforce, culturally sensitive screening tools, culturally competent care and a reduction of structural barriers to care could help, according to the authors of the Kaiser report. So could broader recognition of the ways that racism, discrimination and adverse childhood experiences impact both physical and mental health.

Don Sapatkin

Don Sapatkin is an independent journalist who reports on science and health care. His primary focus for nearly two decades has been public health, especially policy, access to care, health disparities...