Why do some people get put in therapy, and others get put in jail?

This week in our series exploring health and social inequality, we’ll explore mental health. When exploring inequalities in the mental health systems set in place in the USA and UK. I looked at who is most likely to have mental health issues, who are least likely to receive help and who is most likely to suffer consequences because of their mental health issues.

The evidence led me to a surprising conclusion about the prison systems of nations with the lowest crime rate like Singapore, Sweden and Iceland.

Who is most likely to have mental health issues?

People in poverty (the lowest 20% of earners) are about two to three times as likely to develop mental health disorders than the rest of the population. We know that racially diverse populations and the LGBTQ+ community and women experience higher rates of poverty than men and this echoes the data I found on who is most likely to have mental health issues. Older people are more likely to be wealthy than younger people.

Trauma is more likely to affect diverse populations and immigrants with one study reporting 70% of Southeast Asian refugees receiving mental health treatment were diagnosed with PTSD. LGBTQ people are twice as likely to have a mental health disorder in their lifetime when compared to heterosexual men and women and 50% of mental health problems are established by age 14 and 75% by age 24.

Surprisingly, Black men and White men experience similar rates of mental health problems (with the exception of psychosis), however, Black women experience significantly higher rates of mental health issues than White women.

Who is least likely to receive mental health treatment?

Despite the earlier statistics that most people will have an established mental health problem by 24, young people aged 16-24 were found to be less likely to receive mental health treatment than any other age group.

Despite the earlier statistic that Black and White men experience the same rates of mental health disorders and the population of Black women experiencing significantly more mental health issues than White women, White British people are more likely to receive mental health treatment, although Women are more likely than men to receive treatment for all mental health conditions (15 per cent vs. 9 per cent).

Despite having the highest number of diagnosable trauma rates, populations of Asian/ Pacific Islanders are the least likely to access mental health services. Overall, people from racial and ethnic minority groups are less likely to receive mental health care. In 2015, among adults with any mental illness, 48% of whites received mental health services, compared with 31% of blacks and Hispanics, and 22% of Asians, but having access isn’t the only issue, because not only are diverse people more likely suffer from mental health issues, they’re more likely to be punished for it- especially if they’re Black or part of the LGBTQ+ community.

What happens to Black and LGBTQ+ people with mental health issues?

Black people with mental health conditions; especially those with schizophrenia, bipolar disorders, and other psychoses; are more likely to be incarcerated than people of other races.

Compared with the rest of the population, African Americans are less likely to be offered either evidence-based medication therapy or psychotherapy and are 40% more likely to get treatment through a police or criminal justice route.

LGBTQ+ people are overrepresented at every stage of the criminal justice system starting from youth. Especially trans people and queer women. While incarcerated, LGBTQ individuals are subject to more inhumane conditions and treatment than cisgender people.

Why does this happen?

The best explanation I could come up with as to why diverse people are overrepresented in prisons is because we are less likely to empathise with people who don’t look or act like us (funnily enough though, we’re most likely to be critical of people who are almost exactly like us, because we believe there must be something wrong with them and suspending this belief means that it could happen to us An example is a car crash of someone who is just like you. They must be a bad driver, because if it wasn’t them, it could have been you, and that is terrifying).

Even in countries like Singapore, Sweden and Iceland where crime rates are low, the populations are mostly one race (for example 75% of Singapore is Chinese) and in these countries, racial minorities make up the majority of the prison populations.

This research led me to believe their low crime rates could be due to their understanding and empathising with each other better because a majority of the people look and act similarly, and is not merely explained by the fact these countries are “happier” like the articles I’ve personally read previously have stated.

Is diversity a bad thing?

If you remember we started this blog post looking for differences in mental health between social classes, but these differences led us to inequalities in the mental health system leading to unequal incarceration. It’s clear that people who mirror what the majority of a population looks like will receive benefits and positive attitudes towards them that some people won’t get, and that those who don’t fit this mould are suffering unfair consequences.

Is the solution for a happy society to make everyone look the same? Besides the fact it’s not possible, and for so many reasons that it could be its own university major, absolutely not. Plus, even if we all looked the same, an “us” and a “them” would eventually rise anyways looking at historical conflicts. People would eventually distinguish themselves physically in other ways, for example, using religious clothing/ styles or gender as separators instead.

Plus, although homogenous groups may be happier, their performance is worse. Diversity is key to moving society forward and solving complex issues.

What can we learn from this information about mental health and unequal incarceration?

1. Early intervention is key.

If 50% of mental health disorders are prevalent by age 14, we should be having conversations about how to process emotions earlier. Mind has a great article for parents with children who have mental illnesses.

2. Ask questions.

Knowing we’re hardwired to empathise more with people who look and act like us (i.e. people we are familiar with and understand), can help us take a step back and have compassion when making snap judgements about people who we don’t understand and ask questions without judgement to better understand them. Turning to them with open ears and a "How are you?" is a good place to start.

3. Don't use negative labels or steotypes.

This goes for "Asians who can't drive", for "Angry Black women", "Karens" and yes, even "Rich White men in board rooms." People live up to the labels we give them. Avoid calling a group of people angry or troublesome, and remember everyone can change with the right incentives or treatment. Our identity is formed by our behaviours over time. If you can convince someone to do things a productive member of society would do, eventually they might become one.

Mental health is an issue that affects all races, genders and sexualities, but we recognise and treat some people more than others based on who we are. Before you judge or feel guilty about how unfair it is, remember it is human instinct to be afraid of what we don’t know. You can't control how other people act, however, now that you know why you might be afraid, you have the power to understand people before jumping to conclusions.

Enjoyed this post?

Thanks for reading. Hope you learned something new you can use to get you closer to happiness. Next week we’ll be exploring class differences in digital literacy.

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