Tele-Mental Health Equity: Possible but Unlikely?

Tele-Mental Health Equity: Possible but Unlikely?

As part of its “Coping Through COVID” series, The Cleveland Plain Dealer recently published an article underscoring the need for more Black mental health counselors. Of course, the well-recognized excess burden of the pandemic among Blacks, who are already facing multiple vulnerabilities, creates more demand for mental health services. And reluctance in the Black community to seek mental health care is something I’ve long known about. But some of the arguments for more Black therapists may be less well known:

–that Black patients may fear that disclosing sensitive information such as child sexual abuse to a White therapist would feed negative stereotypes about Blacks; and

–that disclosing race-related traumas and stresses can generate more trauma if the therapist doesn’t understand or perhaps believe such racism exists or is harmful.

–that the high cost of becoming a licensed social worker in Ohio contributes to a shortage of Black therapists.

The authors rightly pointed to telehealth as offering great potential for helping to bridge the Black Mental Health gap. In fact, we know from prior work I was involved with more than 30 years ago that people are more willing to disclose stigmatized behaviors to an interview mediated by a computer connection than directly to an interviewer (see my prior post on the topic). However, reports on telehealth use disparities suggest that this potential will not be realized without dramatic intervention. The Telehealth Equity Coalition (TEC) was recently established to call attention to and address such disparities. TEC recently published two stories that I co-wrote as their Research Director, highlighting telehealth use disparities and barriers to equitable telehealth adoption. Lack of digital skills and connectivity are significant barriers to equitable adoption. And no, this is not primarily a problem of rural areas lacking broadband. Watch for the launch next week of my new website, Public Health Innovators, to learn more about how digital health navigators can transform telehealth equity. And join the Telehealth Equity Coalition to add your voice to the conversation.