Race-based biases in psychological distress and treatment judgments

Abstract

Racism creates and sustains mental health disparities between Black and White Americans and the COVID-19 pandemic and ongoing harassment directed at Black Americans has exacerbated these inequities. Yet, as the mental health needs of Black Americans rise, there is reason to believe the public paradoxically believes that psychopathology hurts Black individuals less than White individuals and these biased distress judgments affect beliefs about treatment needs. Four studies (two pre-registered) with participants from the American public and the field of mental health support this hypothesis. When presented with identical mental illnesses (e.g., depression, anxiety, schizophrenia), both laypeople and clinicians believed that psychopathology would be less distressing to Black relative to White individuals. These distress biases mediate downstream treatment judgments. Across numerous contexts, racially-biased judgments of psychological distress may negatively affect mental healthcare and social support for Black Americans.