Inequalities in Diagnosis and Therapy for Bipolar Disorder Across Different Races
Bipolar disorder, a mental health condition characterized by dramatic shifts in mood, affects people of different races at the same rate. However, research indicates that racial and ethnic minorities, particularly Black and Hispanic individuals, face significant barriers in receiving proper diagnosis and treatment.
A study by Dr. McMaster and co-authors in 2014 revealed that Hispanic people were less likely than non-Hispanic white people to seek healthcare professional help for a manic episode. In the same study, it was found that 17% of white people with bipolar disorder had received mood stabilizers in the past year, whereas none of the Black people had. A more recent study in 2017 showed a similar trend, with 21% of non-Hispanic white people taking mood stabilizers, while none of the Hispanic people were.
Misdiagnosis is a common issue, particularly for Black people who are more likely to be misdiagnosed with schizophrenia. Unconscious bias and systemic racism in healthcare have persisted, leading to misdiagnosis or underdiagnosis. Black Americans face more barriers than white Americans when it comes to getting proper treatment for bipolar disorder.
Research suggests that other historically marginalized groups may also face barriers to diagnosis. Some people with bipolar disorder may experience psychotic symptoms, such as delusions or hallucinations, which can further complicate the diagnostic process.
Strategies to reduce racial disparities in the diagnosis and treatment of bipolar disorder include increasing cultural competence and bias training for healthcare providers, improving provider-patient racial concordance, enhancing awareness and education about bipolar disorder symptoms in these communities, and addressing access and systemic barriers to equitable care.
Promoting ongoing culturally competent and anti-racism training for healthcare providers can help reduce unconscious bias that leads to misdiagnosis or underdiagnosis. Research indicates that when patients and physicians share racial or ethnic backgrounds, health outcomes often improve, suggesting efforts to diversify the mental health workforce or improve provider cultural sensitivity could be beneficial.
Increasing community awareness about the symptoms and nature of bipolar disorder may encourage earlier recognition and help-seeking behavior, addressing underdiagnosis due to misconceptions or stigma. Addressing systemic disparities such as lack of access to quality mental healthcare and reducing the tendency to mislabel symptoms is critical. Using standardized diagnostic scales alongside thorough clinical interviews can also help mitigate subjective bias in diagnosis.
In summary, strategies combine provider-focused interventions, patient/community education, and systemic reforms to improve access and diagnostic accuracy, thereby reducing racial disparities in bipolar disorder care. It is crucial to continue efforts to address these disparities and ensure equitable treatment for all individuals affected by bipolar disorder.
- The study in 2017 demonstrated a similar trend as the one in 2014, showing that Hispanic people were less likely to receive mood stabilizers for bipolar disorder compared to non-Hispanic white people.
- Misdiagnosis, particularly with schizophrenia, is more common in Black individuals, a discrepancy that can be attributed to unconscious bias and systemic racism in healthcare.
- To address racial disparities in the diagnosis and treatment of bipolar disorder, it's essential to increase cultural competence and bias training for healthcare providers, and to improve provider-patient racial concordance.
- By promoting ongoing culturally competent and anti-racism training for healthcare providers, and increasing community awareness about bipolar disorder symptoms, we can encourage earlier recognition and help-seeking behavior, and reduce misconceptions or stigma.
