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The Inequality of Access to Mental Health Care

The mission of the American Counseling Association is to enhance the quality of life in society by promoting the development of professional counselors, advancing the counseling profession, and using the profession and practice of counseling to promote respect for human dignity and diversity. Statistics show that millions of individuals in the United States are impacted by mental illness annually. According to NAMI (2019) 20.6% of U.S. adults (51.5 million people) along with 7.7 million youth ages 6-17 experienced mental illness in 2019. For a clearer understanding, this represents one in five adults and one in six children in the U.S. being impacted by mental illness on a yearly basis. This data is astounding and is expected to increase with time. Mental illness is a common occurrence that has become increasingly prevalent, and does not discriminate based upon age, race, religion, sexual orientation or social status. With that being stated, it has become evident that mental illness is diverse and can impact anyone, at any moment and stage of their life. Regrettably, not all individuals are offered an equal level of treatment options as they seek support in navigating their mental health.

The month of July has been focused around increasing awareness of the distinctive struggles that underrepresented groups face regarding mental illness in the United States. This in turn has led me to provide insight, along with my personal experience with witnessing the struggles that many clients face firsthand.

As an individual who has had the opportunity to not only shadow mental health professionals, but provide direct care in a variety of settings, and with a host of populations, it became evident that not all individuals were suitably represented as it related to mental illness, and treatment options offered. Based on my experience in providing services to include therapeutic day treatment, intensive in-home therapy, mental health skill building, crisis stabilization, substance abuse, case management, outpatient therapy and within the therapeutic group home and residential facilities, I have gained insight into some of the problematic areas these populations have faced.

One may ask what does an underrepresented group consist of? This simply means a group of individuals that are less represented than in a general population. From my experience, race, ethnicity, gender, education, social status, as well as religious and sexual orientation have at some point presented as barriers when mental health treatment is considered. Most of my career has been providing treatment to underprivileged or underrepresented populations as well as those with unique circumstances, to consist of individuals residing in low-income areas, children growing up in single family homes, grandparents raising their grandchildren due to the absence of the biological parent, children of incarcerated parents, clients who identify as homosexual, individuals residing in rural areas, and those battling substance abuse and homelessness. The common consensus amongst each of the above-mentioned groups was the fact that the quality of services, resources and treatment options were not accessible, and many were oblivious as to how to gain access, although there was a significant need. Unfortunately, for these reasons, many of those individuals have been set up for failure and continue to battle the inequalities associated with the limited treatment that is available to them. From firsthand experience, poor mental health outcomes were significantly elevated and ultimately the mental health and symptoms of these individuals in many cases was left untreated.

Additionally, there has been a lack of support for those who have been diagnosed with a mental illness due to family, peers and even providers at times, being unaware of how to combat or respond to the behaviors/symptoms that these clients are presenting with. As I reflect, I recall providing services to clients in several local rural counties and the first statement and question that I would be presented with, following the introductory meeting would be “There is no help for me in my area and what can I do”? This was my opportunity to link the clients with resources and treatment options. However, in many cases, although options were explored, there were countless barriers that the clients would run into and this ultimately would deter them from pursuing treatment altogether. Many of the clients lacked insurance which hindered their ability to obtain services, lacked the funds needed to pay for services if insurance was not in place, did not possess a method of transportation to transition to and from scheduled appointments, lacked education and support as well as encountered a limited quantity of providers whom they identified with in their locality. Unfortunately, all the barriers I have mentioned, have placed a strained on their ability to receive adequate support. As a result, many people are left suffering and feeling neglected.

The question now becomes what can be done to reduce the disparities present to produce a greater level of equality when treatment is considered. The following strategies come to mind from the common complaints of the populations I have engaged with: Improving health care access, quality of services received, offering diverse mental health providers, and increased education on mental illness and local resources. As a Licensed Professional Counselor, it became essential for me as a services provider, that when providing treatment to the clients I encountered, that I not only provided education, but strived to bring awareness to the resources and tools that were available to promote success.

It is pertinent that as mental health professionals, we strive to raise awareness of those living with mental health issues and assist with minimizing the stigma so many have and continue to experience. With a collaborative approach, this can be obtained to achieve a higher level of positive outcomes amongst the clients who are receiving services. It is imperative that we come together to rectify this issue by increasing the client’s ability to access services in their locality, increase the diversity of providers to enhance the clients comfort levels or provider preferences, offering affordable treatment options, and most importantly providing education on mental illness as a whole.

In conclusion, I wanted to provide several resources that could be utilized to not only promote awareness but aid clients with gaining support in areas that they can identify with. These resources are as follows: Innocence Project, Equal Justice Initiative, Equality Now, Trevor Project and Although the above-mentioned resources are provided, there are a host of resources that are available to all populations and groups. It is my hope that we continue to put forth efforts to build a society in which individuals have equal access to resources and receive equitable treatment regardless of their race, gender, religion, sexuality, social status, disability or mental health.


American Counseling Association. (2014). ACA code of

National Alliance on Mental Illness. (2021, March). Mental Health By the Numbers.


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