Focusing on the Symptoms: Why Ignoring Systemic Inequities Won’t Cure this Mental Health crisis

The Covid-19 pandemic not only harmed our physical health, it also created a mental health crisis. Many people felt nervous,isolated, and anxious during that time. However it was even more challenging if you were part of a group that was being excluded.No matter how helpful private therapists and community groups are, they just couldn’t handle the demand. The pandemic awoke people  and made one thing  very clear, the government needs to do more to make sure that everyone can get and have confidence about their mental health care.

Not everyone agrees with this. For example, Dr. Sally Satel believes that community-based solutions and personal responsibility should be the focus of mental health care, not government programs((Klick & Satel, 2011) . While efforts from both individuals and groups do matter it is important to realize that systemic problems need systemic answers. To make sure that mental health care is accessible and works , the government needs to step in. Not as a replacement, but as the backbone of these systems.

Klick and Satel argue that many health disparities are the result of factors like income, education, and employment, rather than race or ethnicity itself. While it may be true that economic status has a significant impact on health outcomes, the authors overlook how deeply structural racism and discrimination can amplify these issues. Black Americans, particularly those living in urban areas, face systemic barriers like racial profiling and housing segregation challenges that make it harder to access basic needs which includes healthcare. The effects of these inequities are deep and impact people both financially and in quality of life. In fact, research highlights the staggering toll of this inequality: “The overall economic burden of failing to achieve health equity goals was $1.03 trillion, including $421.1 billion for racial and ethnic minorities, with two-thirds attributable to premature death” (JAMA, 2023). This reality makes it clear that focusing solely on income disparities without taking into consideration is counterproductive. 

Furthermore, there’s  significant evidence showing that healthcare providers often carry implicit racial biases.This in turn makes it harder for patients especially from marginalized communities to receive proper care and diagnosis. Unfortunately, Klick and Satel’s argument doesn’t fully address this issue.While it’s easy to assume that this is a personal choice in reality it’s a deeply ingrained bias in the system that directly affects the quality of care people receive. For instance, one study found that African American patients diagnosed with schizophrenia were much more likely than their white counterparts to also screen positive for major depression—yet these mood symptoms were often ignored due to racial biases in diagnosis (Strakowski et al., 2019). These biases have real word consequences leading to inappropriate treatment.What this shows is that these problems go beyond individual choices and point to systemic issues that negatively impact patient care, as providers may unknowingly interpret symptoms through the lens of racial stereotypes.

While Klick and Satel made important points about personal responsibility and solutions within the community they fail to address the much larger issues that contribute to these factors.The reality is that these health disparities need much larger responses especially when it comes to mental health care. The pandemic exposed the problems that are within our healthcare systems when trying to access valuable resources. To address these issues, we need the government to step not to replace local solutions but to support them.This means going beyond just recognizing the economic factors that influence health and directly confronting the structural racism and discrimination that make these problems worse. Focusing only on personal responsibility without addressing the systemic barriers that cause these issues completely misses the bigger picture. 

Citations

Klick, J., & Satel, S. (2011). The health disparities myth: Diagnosing the treatment gap. The AEI Press.

LaVeist, T. A., Pérez-Stable, E. J., Richard, P., et al. (2023). The economic burden of racial, ethnic, and educational health inequities in the US. JAMA: The Journal of the American Medical Association, 329(19), 1683–1691. https://doi.org/10.1001/jama.2023.5965

Gara, M. A., Minsky, S., Silverstein, S. M., Miskimen, T., & Strakowski, S. M. (2019). A Naturalistic Study of Racial Disparities in Diagnoses at an Outpatient Behavioral Health Clinic. Psychiatric Services, 70(2), 130–134. https://doi.org/10.1176/appi.ps.201800223