Does Mental Illness See in Color?

Millions of people all over the United States have some form of depression, an illness that shows symptoms of extreme sadness, apathy, or frustration. These symptoms can affect individuals every single second for their entire lives. Yet, even though so many people are trying to cope with depression, not everyone has equal access to medicines used to combat the effects of the illness. According to the results of a study conducted by Wolters Kluwer Health Adis International, whites are prescribed antidepressants in far greater numbers than blacks, Hispanics, and Asians.

These results are disturbing; for a country that prides itself on equality for all, it simply doesn’t make sense that one race or ethnic group benefits over another. Many people would be tempted to argue that doctors are racist, but that notion is based in emotion, rather than logic. One of the underlying causes of this phenomenon has less to do with doctors and more to do with the individuals that are, or are not, seeking medical treatment for their depression.

Critics of the Kluwer study easily forget that depressed individuals only get prescribed antidepressant medication if they make an appointment with a doctor, and qualify for a prescription. Many people don’t even bother to talk about their depression, let alone make appointments to treat it. Often, cultural barriers prevent a lot of minorities from seeking any kind of treatment for any illness.

Overall, there is a stigma surrounding mental illness that is present in all cultures; mental illness makes an individual weak, cowardly, and unfit to function normally in any society. It is quite an embarrassing topic for many people. This attitude leads to people of all races and cultures, some more than others, not being comfortable with addressing and accepting their mental illness, and in turn, not seeking professional treatment.

Examples of these cultural barriers are generally different in each culture. According to many mental health information websites, blacks tend to not trust doctors in the treatment of any illness. This stems from inhumane studies undertaken in the earlier half of the 20th century on blacks, such as the infamous Tuskegee Syphilis Study. The long and disturbing history of unethical medical testing on blacks is critical in discussing why the distrust of medical professional is so rooted in their culture.

According to the American Psychiatric Association, Latinos have strong family bonds and ties to religion, and many latinos rely heavily on these two factors when any problems arise. This at-home care explains why thousands of latinos with mental illness never seek professional treatment. Asian americans tend to have extremely negative attitudes regarding mental illness because it is a viewed as something that can be overcome, or that should not even exist in the first place. This pressure discourages the mentally ill from seeking professional treatment.

Upon closer inspection of these studies, it is revealed that people with private health insurance are more likely to receive antidepressant prescriptions than those with Medicaid or Medicare. In addition, those with Medicaid are even less likely to be prescribed antidepressants because Medicaid is based on income, while Medicare is accessible to elder people. Because income varies by race statistically, the affordability of health insurance is what causes the racial discrepancy in antidepressant prescriptions.

In 2008, 30% of Hispanics, 17% of blacks, and 10% of whites did not have any form of health insurance, according to the Centers for Disease Control and Prevention.* Without health insurance, prescriptions are fully priced. Brand name antidepressants such as Prozac can cost up to $257 per month for the smallest dosage available, which is unaffordable for too many people. It makes sense that the uninsured don’t get prescriptions with these rates, but since more minorities are uninsured, it misleads the public into thinking that doctors favor white patients.

In addition to the high cost of brand name prescriptions, the generic prescriptions are not as widely advertised. The allure of brand names can lead some people to not consider the generic form, which is immensely cheaper; generic Prozac, known as Fluoxetine, costs up to $28 per month for the same dosage level. Those desperately in need of cheaper prescriptions often don’t even know that generics exist. Some argue that generic prescriptions are not as effective, even though the ingredients in the brand name are exactly the same as the generic.

If the 2008 Centers for Disease Control statistic is reversed, 70% of Hispanics, 83% of blacks, and 90% of whites had health insurance in some form. Respectively, 45%, 53% , and 70% had private health insurance, while the other 55% , 47% , and 30% had government health insurance. Even though having health insurance makes it easier to afford prescriptions, the affordability and availability of the medication still depends on which insurance plan you have.

Traditionally, private health insurance plans are the most expensive because they cover a lot more services, doctors, and medications than Medicare or Medicaid. The high cost of being able to have access to any doctor at any care center for any treatment is too much for many people, so they have cheaper plans that restrict where they can go and who their doctors are and what types of prescriptions are covered. Medicaid provides low income individuals and families with many medical services, such as midwives and vaccines, without charge. But services like prescriptions might not be available, depending on state laws. Medicare provides the elderly with hospital stay coverage, but a lot of additional services require a premium, and not all medications are covered. If an individual’s plan does not cover the cost of prescription antidepressants, then they are less likely to get them, which in turn affects the statistics.

The racial gap in the prescribing of antidepressants is not because of racist doctors. Overall, the presence and type of health insurance is what determines who can afford antidepressant prescriptions. If this gap is to be fixed, then the racial gaps in health care need to be accounted for as well.

*It is not known why Asians are not included in this study.

Works Cited

“Using Antidepressants to Treat Depression” Consumer Reports. September 2013. Web. 25 April 2014.

“Income, Poverty, and Health Insurance Coverage in the United States: 2012” U.S. Department of Commerce. US Census Bureau. September 2013. Web. 25 April 2014.

“Mental Health: Hispanic-Latino” American Psychiatric Association. Web. 25 April 2014.

“Mental Health: Asian American-Pacific Islander” American Psychiatric Association. Web. 25 April 2014.

“Diagnosis of Depression and Use of Antidepressant Pharmacotherapy Among Adults in the United States” Sclar, David A; Robison, Linda M; Schmidt, Jennifer M; Bowen, Kurt A; Castillo, Leigh V; Oganov, Ambartsum M. Wolters Kluwer Health Adis International. February 2012. Web. 25 April 2014.

 “What Is Medicare? What Is Medicaid?” Medical News Today. MediLexicon International Ltd. Web. 25 April 2014.

“What Is Private Medical Insurance?” Easey, Cameron. eHow. Web. 25 April 2014.

“About the USPHS Syphilis Study” Tuskegee University. Web. 25 April 2014.

“People Without Health Insurance Coverage, by Race and Ethnicity” Centers for Disease Control and Prevention. 3 December 2008. Web. 25 April 2014.