Mental Health and Minority Populations

Navigating Barriers, Bias, & the Road to Better Care

Insights by Jeremy Goshorn

Mental health struggles don't discriminate-but access to care often does. While society has made progress in talking about mental well-being, the reality is that many minority communities still face overwhelming obstacles when it comes to receiving quality, culturally sensitive mental health support. These challenges go far beyond personal willingness-they're embedded in the systems, structures, and stigmas that continue to disproportionately affect marginalized groups.

According to Jeremy Goshorn, Assistant Professor of Psychology and Clinical Mental Health Counseling at Lebanon Valley College, the barriers are layered and systemic. "Diversity is the existence of variety and uniqueness in human expression," Goshorn explains. "We too often equate diversity to race or ethnicity, but this is a limited view. Minority populations are any group of individuals who experience systemic inequalities, marginalization, and/or oppression due to a shared identity."
One of the most pressing issues is a lack of diversity among mental health providers. The counseling field remains predominantly white, female, and English-speaking-a mismatch that can leave clients from marginalized backgrounds feeling unseen or misunderstood. "Data suggests that diverse clients feel most understood, comfortable, and safe when their provider shares a similar background or experience as them," Goshorn says. "Language barriers can also significantly hinder effective treatment."

Beyond provider demographics, structural issues like cost and access loom large. Even for those with health insurance, mental health services are often categorized as specialty care, resulting in higher co-pays. For uninsured individuals, the out-of-pocket cost of therapy-often over $100 per session-can be prohibitive. "Cost of services and health insurance limitations are potential barriers for all clients," Goshorn notes, "but they tend to impact diverse clients at a disproportionate rate."

Geography further complicates the landscape. In rural areas, the shortage of specialized providers is particularly stark. Individuals may need to travel long distances, take time off work, or face social stigma in tight-knit communities where privacy is limited. "Rural communities tend to have a powerful rumor mill," Goshorn observes. "Providers in these areas are more likely to offer general services but may not have training in specialized areas like addiction counseling or working with minority groups."

Urban centers generally offer more diverse services, and the rise of telehealth has helped bridge some gaps. Still, digital access doesn't eliminate financial hurdles or replace the value of culturally attuned care.

Even when services are available, cultural perceptions often discourage individuals from seeking help. "Communities of color can hold cultural values that foster shame and stigma around mental illness," says Goshorn. "There can be a belief that mental health concerns should be handled spiritually or that they reflect personal failure."

This stigma is compounded by a historical mistrust of the medical system. "The history of healthcare in minority communities in the U.S., rightfully so, has sown distrust and skepticism," Goshorn explains. "Differences in treatment between White persons and Persons of Color continue today, leading to a reluctance to seek mental healthcare."

Socioeconomic status intersects with all of these challenges. Minority populations are disproportionately affected by poverty and unemployment, which compounds the difficulty of accessing care. "While some providers offer sliding scale services, these are often limited," Goshorn says. "High cost can be a deterrent, and rural areas often span large geographic zones, making service availability fragmented."

To address these issues, mental health professionals must practice cultural competence and humility. It's not just about understanding surface-level traits like food, language, or clothing-effective counselors must grasp the deeper values and beliefs that shape a person's worldview. "Culture frequently modulates or directly impacts a client's mental health concerns," Goshorn explains. "Culturally competent counselors explore how intersecting identities and values influence treatment. They must work to reduce their own stereotypes, watch for bias, and ensure that the theories and interventions they use are culturally congruent."

Trust is foundational to effective therapy, and for minority clients, it starts with respect and genuine engagement. "Culturally humble counselors approach clients with an openness to learning about their unique cultural identity," Goshorn emphasizes. "They show awareness of systemic biases, acknowledge traditional power imbalances, and strive to be social justice advocates." He adds that trust-building extends beyond the therapy room. "Clinicians who want to connect with communities of color should participate in community events, engage with local leaders, and advocate for community needs."

In a world growing more diverse by the day, mental health care must evolve to meet the needs of all communities. As Goshorn reminds us, "Culture is not static, and neither should our approach to mental health be. Every client deserves to feel seen, heard, and valued."