The COVID-19 pandemic has exacerbated disparities in mental health care access for communities of color. The care gaps in mental health are further accentuated as more health care services, such as mental health, begin to be delivered virtually through telehealth services. As much as 60 percent of mental health care is being delivered by telehealth. Mental health-related telehealth visits reached a massive uptake between March to August 2020 and remained high in 2023. However, only 68 to 70 percent of communities of color have access to reliable and affordable internet services. Therefore, the gap in mental health care access is further exacerbated because of the compounding limitations of low access in the first place and limited access to affordable and reliable internet services.
In 2020, the Centers for Disease Control and Prevention (CDC) reported a higher prevalence of serious considerations of suicide and adverse mental or behavioral health symptoms among Black, non-Hispanic individuals compared to whites and the overall population. Given the gap in access to treatment, even more troubling is the rate of suicidal ideation among communities of color. 15 percent of Black, non-Hispanic respondents seriously thought about suicide in the past 30 days, compared to 8 percent of white individuals and 10.7 percent of all other respondents. If we want to begin dismantling the inequities within our healthcare system, particularly for communities of color, we need to improve access to affordable internet services.
The Affordable Connectivity Program (ACP) is a new and little-known federal benefit. It provides individuals with connectable devices and up to $30 percent per month they can use towards their internet bill. The ACP was created under the Bipartisan Infrastructure Law to provide internet subsidies to lower-income households. While 51.6 million households are eligible, only 25 percent have enrolled, potentially missing out on savings that households could allocate toward other necessary expenses. Medicaid patients are automatically eligible for the ACP, yet over 86 percent remain unenrolled in the program. One way to spread the word and increase enrollment into the program is through an already trusted source: health care workers and facilities.
Communities of color often experience a disproportionate burden of disability due to a mental health disorder or diagnosis. To address these disparities, we need to begin to look upstream. Instead of focusing on solutions within the health system, we must look beyond and acknowledge that health and well-being are embedded within broader contexts. The barrier to telehealth is the lack of affordable internet access. The ACP is an excellent opportunity to reduce this barrier. However, creative strategies are needed to enroll more eligible patients in the program. Ultimately, with access to affordable internet, timely and crucial mental health services will become more tangible for communities of color and ultimately improve mental health disparities.
Megan Amarbayan is a medical student. Sammer Marzouk is an undergraduate student. Alister Martin is an emergency physician.
