Ruiz-Yu Bernalyn, Ni H Wenwen, He Emily
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, 90095, USA.
J Clin Psychol Med Settings. 2025 Jun;32(2):239-252. doi: 10.1007/s10880-024-10025-5. Epub 2024 Aug 26.
Mental health disparities between racial/ethnic minority groups and non-Latinx Whites in the United States persist despite significant efforts aimed at decreasing these disparities. Efforts to address mental health disparities have largely focused on individual (e.g., stigma, help-seeking, health behaviors) and structural (e.g., public policy, interventions, addressing poverty) level factors. In contrast, this paper considers how processes at the interactional level (i.e., interactions between patients and providers) are also an important contributor to racial/ethnic disparities in mental health. Specifically, social psychological research has demonstrated how biases, including stereotypes, prejudice, and discrimination, can affect patient-provider interactions and contribute to mental health disparities. This narrative review of empirical studies that examine interactional processes between patients and mental health providers identified eleven studies to be included. Concepts represented in the studies are summarized and additional frameworks that can help explain how disparities are maintained are proposed. Last of all, practical suggestions for mitigating provider bias during patient-provider interactions are provided based on the findings from the narrative review.
尽管美国为减少种族/族裔少数群体与非拉丁裔白人之间的心理健康差距付出了巨大努力,但这些差距依然存在。解决心理健康差距的努力主要集中在个体层面(如耻辱感、寻求帮助、健康行为)和结构层面(如公共政策、干预措施、解决贫困问题)的因素上。相比之下,本文探讨了互动层面的过程(即患者与医疗服务提供者之间的互动)如何也是心理健康方面种族/族裔差距的一个重要促成因素。具体而言,社会心理学研究已经证明了包括刻板印象、偏见和歧视在内的偏见如何能够影响患者与医疗服务提供者之间的互动,并导致心理健康差距。这篇对实证研究的叙述性综述考察了患者与心理健康服务提供者之间的互动过程,确定了11项研究纳入其中。总结了研究中所体现的概念,并提出了有助于解释差距如何持续存在的其他框架。最后,根据叙述性综述的结果,提供了在患者与医疗服务提供者互动期间减轻医疗服务提供者偏见的实用建议。