Striving for mental health equity

Studies show that Black, indigenous and people of color, or BIPOC, Americans have less access to mental health care and are less likely to seek the care that they need. According to a report by the National Institute of Mental Health, of American adults with mental illness in 2020, 37.1% of Black, 35.1% of Hispanic and 20.8% of Asian American adults reported having received mental health services, compared to 51.8% of white Americans. 

At VCU School of Medicine, many faculty members are investigating and addressing mental health disparities through patient care and community-based research. 

Cheryl S. Al-Mateen, M.D.  
Department of Psychiatry

Cheryl S. Al-Mateen, M.D., a professor and pediatric psychiatrist in the Department of Psychiatry, works to improve the equity of mental health treatment for children and adolescent population. Al-Mateen noted that stigma, particularly in Black communities, can factor into a patient’s decision to turn to other support systems, such as religious leaders, their friends and family or a primary care provider, before seeking professional mental health care.  

“People from different cultures may be more likely to go to different places initially for help,” said Al-Mateen. “I try to incorporate the use of clergy, when possible, in the care of my patients.”  

Al-Mateen also serves as the co-chair of the Black Caucus for the American Academy of Child and Adolescent Psychiatry, a nonprofit professional organization that provides support for psychiatrists and resources for patients and their families. She is part of a pipeline program to recruit BIPOC medical students and psychiatry residents into child psychiatry. With more representation in the field, Al-Mateen said she hopes patients and their families will feel increasingly understood. 

In addition to treating patients and teaching students and residents, Al-Mateen has presented and written about cultural psychiatry topics in mental health, race and equity for underrepresented populations. Al-Mateen recently co-edited a journal issue that addresses systemic racism and disparate mental health outcomes for youth of color. 

Andrew J. Barnes  
Department of Health Behavior and Policy

Andrew J. Barnes, Ph.D., a professor in the Department of Health Behavior and Policy, evaluates several Medicaid coverage expansions and delivery system reforms underway in Virginia, including the Addiction and Recovery Treatment Services or ARTS, benefit, a program that provides enhanced treatment for Virginia Medicaid members experiencing substance use disorders. With an M.P.H. focusing on mental health and a Ph.D. concentrating on the economics of substance abuse, Barnes aligns his work researching addiction and health policy to investigate and address issues of equity in mental and public health. 

"I've lived at this intersection of policy and mental health for a long time,” Barnes said. 

Barnes and his team developed one of the first-ever statewide surveys to document the treatment experiences of Virginia Medicaid members who were diagnosed with an opioid use disorder and to investigate whether these member-reported experiences differed by their racial identity. In this survey, they found that Black Medicaid members with opioid use disorder were less likely to receive help with other health or personal needs, medical problems or mental health problems from their provider, compared to white members.  

He has also conducted research on the effects of Virginia’s recent Medicaid expansion for low-income adults, and found that Black Medicaid members reported a greater decrease in worries about the cost of health care compared to non-Hispanic white Medicaid members.  

“Financial distress is a huge predictor of all kinds of negative mental and physical health outcomes in your people’s lives,” Barnes said. “We are finding that Medicaid is not just health coverage for low-income families, but a social policy tool that can decrease poverty and improve equity.”