Mental Health Equity

On Juneteenth, our nation commemorates a significant milestone in our history: June 19, 1865, when enslaved people in Texas learned of their freedom—more than two years after President Abraham Lincoln signed the Emancipation Proclamation on January 1, 1863.

Today, even as we celebrate freedom and the triumphs of enslaved African Americans, we also reflect on the enduring legacy of slavery and the consequential challenges faced by Black Americans. Among those challenges are persistent mental health disparities.

Mental illnesses are common in the United States, affecting tens of millions of people each year. Striking disparities exist in the prevalence, course, and outcomes of mental illnesses in the U.S. People from under-resourced and minoritized communities, including many Black Americans, are less likely to receive mental health care, and when they do receive care, they are less likely to receive high-quality, evidence-based mental health services.

Mental health outcomes worsen with the degree of exposure to racism, exacerbating these disparities. Public health crises compound disparities even further, as Black Americans and other individuals from under-resourced communities have been most severely affected by the COVID-19, HIV, and opioid epidemics, as well as by natural disasters like Hurricane Katrina.

Research to address mental health disparities is necessary to ensure that the mental health care needs of all Americans are met equitably. Accordingly, NIMH prioritizes research to advance practices that aim to reduce mental health disparities, promote equity, and address the needs of people and communities who are underserved by, and underrepresented in, health research. For instance, we’re supporting research projects that address mental health disparities by aggregating existing data sources to find out what areas need more research (RFA-MH-22-200 ). We’re funding studies that improve how we measure and study important factors related to the health of minority groups and the differences in their health outcomes (PAR-22-072 ).  And we’re supporting research into health care technology that could help increase access to mental health care (PAR-22-145 ).

NIMH also recognizes that properly addressing the mental health needs of Black Americans and other minoritized people requires a culture change within the scientific enterprise. Supporting a diverse and inclusive scientific workforce is a key component of such culture change. Through listening, outreach, and other efforts, we are working to diversify our reviewer pools and advisory bodies, increase the number of Black investigators applying for NIMH grants, and decrease the gap in eventual award rates between Black and White investigators.

Yet much remains to be done. Across NIH, we’re focused on building an inclusive workforce that supports researchers from underrepresented backgrounds and is committed to a culture of equity. We intend for these efforts, along with the NIH-Wide Strategic Plan for Diversity, Equity, Inclusion, and Accessibility  and the UNITE initiative , to lead to lasting change.

We have also revamped the NIMH Strategic Plan, adding greater emphasis on the importance of inclusion in research and our approach to disparities research. Our website further outlines five priority research areas to address mental health disparities, and the NIMH Strategic Framework for Addressing Youth Mental Health Disparities articulates our approach to addressing issues affecting minoritized and underserved youth.

All these efforts have as their goal true mental health equity, in which all people have a fair and just opportunity for mental health and well-being. This Juneteenth, NIMH recognizes the dual nature of this important holiday, marking the celebration and unrealized potential of emancipation. Mental health equity remains an unmet goal; hopefully, NIMH research will help us move steadily toward that goal.