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RESEARCH WEEKLY: Double Jeopardy- The Intersection of Ethnicity and SMI in America
By Shanti Silver
(October 19, 2022) People from ethnic minority groups who have serious mental illness can face double discrimination due to the combination of their race and their illness. In a recent study from The Journal of Racial and Ethnic Health Disparities, researchers called this intersection of identities “Double Jeopardy,” referring to the idea that racial discrimination and serious mental illness combine to have a negative impact on a person’s life that is greater than the impact of either of these alone. To explore this Double Jeopardy, researchers used data from over 65,000 people from The National Survey of Drug Use and Health to compare the outcomes of ethnic minorities and whites who had untreated serious mental illness.
The National Survey of Drug Use and Health is an annual research survey conducted by the Substance Abuse and Mental Health Services Administration that produces data about people with mental illness and substance use disorders, including their treatment history, housing status and other variables. Using this data, researchers compared the likelihood of negative outcomes such as poverty and unemployment between people of different ethnicities who had a serious mental illness. Through doing this, researchers identified several areas where minorities with serious mental illness had worse outcomes than whites with serious mental illness.
Racial Disparities in Outcomes for People with Serious Mental Illness
The results of the study indicate that, compared to whites with serious mental illness, African Americans with serious mental illness were:
- 2.8 times more likely to live in poverty,
- 1.6 times more likely to be unemployed,
- 1.6 times more likely to self-report their health as ‘poor’ or ‘fair,’ and
- 2.1 times more likely to have been arrested in the past year.
Additionally, compared to whites with serious mental illness, Latinx Americans with serious mental illness were:
- 1.7 times more likely to live in poverty and
- 1.9 times more likely to report their health as ‘poor’ or ‘fair.’
Decreasing Disparities for Ethnic Minorities with Serious Mental Illness
This study found several disparities between ethnic minorities and whites who had serious mental illness. The researchers chose to compare those with untreated serious mental illness to account for the fact that white Americans are more likely to receive treatment than ethnic minorities. If those who receive treatment were included, it is possible these disparities could be even more severe.
These disparities point back to the idea of a “Double Jeopardy” faced by minorities with serious mental illness whose ethnicity and diagnoses can combine to negatively impact life outcomes. The researchers suggest that this Double Jeopardy may be caused by minority groups’ social and economic disadvantages (e.g., exposure to violence, immigration status, English language skills, lack of access to healthy food, etc.) becoming even more pronounced when individuals have a serious mental illness.
The researchers recommended several actionable steps to decrease racial disparities for people with serious mental illness including:
- Increased outreach to minority communities to identify people with mental illness and connect them to appropriate, culturally sensitive resources.
- Careful examination of antidiscrimination policies in employment and housing to limit the possibility of double discrimination for this population.
- Encouragement of policies that require language assistance for people with lower English proficiency, especially in mental health settings.
- Utilization of the Americans with Disabilities Act to prevent discrimination against ethnic minorities with serious mental illness.
References
Snowden, L. R., Cordell, K., & Bui, J. (September 2022). Racial and Ethnic Disparities in Health Status and Community Functioning Among Persons with Untreated Mental Illness. Journal of Racial and Ethnic Health Disparities.
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