In recognition of Minority Mental Health Month, Christina Zavalza, PsyD, Pediatric Psychologist and Clinical Supervisor at The Guidance Center, sheds light on the unique challenges faced by minority communities and advocates for inclusive mental healthcare.

The mental health and wellbeing of children and adolescents continues to be a growing concern that demands attention and intervention. However, minority youth experience significantly more barriers that impact access to appropriate mental health care, including the access to psychotropic medications (Leslie et al., 2003).

Although it greatly depends on the specific mental health needs of the child or adolescent, psychotropic medication has been shown to be effective in treating mental health symptoms in youth, particularly when combined with individual and family therapy (AACP, 2015). However, the literature has shown that Black and Latinx children and adolescents are less likely to use psychotropic medications compared to White children and adolescents (Leslie et al., 2003).

Why do minority youth tend to utilize this resource less than their White counterparts to manage mental health symptoms? In this blog, I hope to address these disparities, discuss potential reasons behind them, and highlight ways in which we can promote equity in minority youth’s access and use of psychotropic medication when indicated.

There are several factors that contribute to the disparities in the access and use of psychotropic medications in minority youth including cultural stigma and mistrust, lack of cultural competency and language barriers, limited education and awareness, and socioeconomic factors (Alegria et al., 2010).

The first factor that can lead to the disparities in the access and use of psychotropic medication is the youth or family’s disinterest or refusal to go this route in treatment. In my experience, there have been several occasions in which I have recommended a psychiatry evaluation to determine whether an anti-depressant might help improve the severity of a client’s depressive symptoms or a stimulant might help manage ADHD, and caregivers either immediately refuse the referral or express discomfort with the idea of their child being on medication for symptoms of mental health. This is completely understandable. Minority communities may have different cultural beliefs and attitudes towards mental health, which can lead to stigma around using medication to address mental health symptoms. Part of this can be due to historical experiences of discrimination and mistrust of healthcare systems, and part might be due to the preference to treat health with alternative or holistic approaches that feel more in line with their cultural practices. It is important for healthcare professionals to respect and express understanding of these beliefs and practices in order to better support the youth and families in their decision-making process.

This leads me to the second factor leading to disparities in mental healthcare which is lack of cultural competency among mental health providers. When therapists and psychiatrists lack cultural awareness and competency in working with people who may hold different values or worldviews, minority youth and families may find it difficult to feel seen or understood. This also has the potential to lead to mistrust of healthcare providers. Furthermore, language barriers can hinder effective communication, which impacts the ability to gather relevant information or provide psychoeducation to the youth and family. In both cases, barriers in communication negatively impact the ability to accurately diagnose or to support the youth and family in making the best decision for themselves.

When youth and families experience difficulty trusting healthcare providers and the healthcare system, it makes it difficult to be able to provide education that has the potential to challenge unfounded fears or myths. Lack of education around the potential benefits of this resource may result in delayed or inadequate treatment, and an increased reliance on alternative remedies. Although alternative or holistic remedies can be effective, ultimately a lack of education and awareness can lead to a premature rejection of a resource that may have the potential to improve their child’s functioning.

The last factor that contributes to disparities is socioeconomic status. This can include financial constraints for the youth and families, limited healthcare coverage, as well as limited healthcare resources in underserved communities overall (Kataoka et al., 2002). For example, it is difficult to find psychiatrists that specialize in treating children and adolescents, much less child and adolescent psychiatrists who work in underserved communities where the majority of minority youth reside (Thomas et al., 2006). All of these factors combined can ultimately lead to significantly less minority youth with access or use of psychotropic medications that may help improve the youth’s functioning.

So how do we overcome these barriers?

I believe that it starts with enhancing cultural competency as mental health providers. Training mental health professionals can lead to understanding and respect of cultural norms, beliefs, and traditions. It can help us to connect with youth and families, validate their concerns, and stand by them in exploring ALL of the options available to treat and support their child. This does not mean we are convincing or imploring that minority youth and families use psychotropic medications. Instead, it means that we are able to sort through the pros and cons of all potential interventions, alongside youth and families, and determine a treatment plan collaboratively.

In addition, collaborating with community organizations and schools to disperse education around mental health treatment can help increase awareness, overcome stigma and reduce misinformation. By providing accurate information about psychotropic medications, addressing myths, and promoting early intervention we can help ensure timely and appropriate treatment for minority youth. We must also continue to advocate for increased funding to expand mental health services in underserved areas. This means increasing minority youth’s access to bilingual healthcare providers, as well as cost effective mental health programs that include access to psychiatry services (Kataoka et al., 2002).

Overall, by enhancing cultural competence among healthcare providers, engaging families and communities, and improving access to care, we can ensure that more youth have accurate information and access to all resources available to support their mental health needs, regardless of ethnicity or background.  Together we can create more equitable and inclusive mental health systems for all youth.


The American Academy of Child and Adolescent Psychiatry—

U.S. Department of Health and Human Services (2001) Mental Health Culture, Race, and Ethnicity–A Supplement to Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.


Alegria M., Vallas M., Pumareiga A.J. (2010). Racial and ethnic disparities in pediatric mental health. Child and Adolescent Psychiatric Clinics of North America, 19(4). doi: 10.1016/j.chc.2010.07.001.

American Academy of Child and Adolescent Psychiatry (AACP). (2015). Recommendations about the Use of Psychotropic Medications for Children and Adolescents Involved in Child-Serving Systems.

Kataoka, S. H., Zhang, L., & Wells, K. B. (2002). Unmet need for mental health care among U.S. children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159.

Leslie L.K., Weckerly J., Landsverk J., Hough R.L., Hurlburt M.S., Wood PA. (2003). Racial/ethnic differences in the use of psychotropic medication in high-risk children and adolescents. Journal of American Academy Child Adolescent Psychiatry, 42(12). doi: 10.1097/00004583-200312000-00010

Thomas, C. R., & Holzer, C. E. (2006). The continuing shortage of child and adolescent psychiatrists. Journal of the American Academy of Child Adolescent Psychiatry, 45. doi: 10.1097/01.chi.0000225353.16831.5d