Minority Mental Health and Mental Health Disparities Research Program

Mental health disparities remain a persistent public health problem in the United States among populations such as those from minoritized racial and ethnic groups, people with lower socioeconomic status (SES), people from underserved rural communities, sexual and gender minority (SGM) groups, and people with disabilities.

Mental health disparities have been magnified by recent acts of racism and discrimination and converging public health crises (for example, COVID-19 and youth mental health) that disproportionately affect populations that experience health disparities. The NIMH Strategic Plan for Research prioritizes reducing disparities and promoting mental health equity by emphasizing research that addresses the needs of marginalized and minoritized populations.

The 2022 National Healthcare Quality & Disparities Report  underscores that social determinants of health, including social, economic, environmental, and community conditions, influence mental health outcomes. This report also demonstrates disparities in access to evidence-based mental health treatment, particularly among minoritized youth.

Social determinants of health represent potent, modifiable risk and protective factors for mental health status. It is essential to investigate how social determinants impact health and how they can be leveraged to reduce disparities and improve mental health outcomes and access to high-quality mental health care.

Today, many disparities persist or have worsened in key health outcomes, including suicidal thoughts and behaviors. Questions remain regarding individual-, community-, provider-, and health system-related mechanisms underlying disparities in mental health outcomes and mental health service use, as well as how to best leverage these multi-level mechanisms to inform mental health prevention and treatment development, optimization and implementation, and service delivery.

Questions also remain about how to increase the public health impact of the existing evidence base by bringing to scale effective mental health interventions and services by informing practices and policies that address the complex, multilevel factors that drive disparities in mental health outcomes (such as social determinants of health among marginalized and minoritized populations).

Additionally, data suggest current research practices have left some minoritized populations behind by treating groups as monoliths, ignoring the rich heterogeneity within health disparities populations. There is a crucial need for disaggregation of data, as well as within group studies of individual differences to fully understand disparate mental health outcomes among and within minoritized communities.

Minority Mental Health and Health Disparities Research Program Functions

The primary functions of the NIMH Minority Mental Health and Health Disparities Research Program are to:

• Oversee and coordinate NIMH efforts related to minoritized and marginalized populations' mental health and social determinants of mental health disparities.
• Identify opportunities and gaps in research related to minoritized and marginalized populations’ mental health and social determinants of mental health disparities.
• Work closely with other NIH Institutes and Centers and other Department of Health and Human Services offices and agencies to coordinate and promote high priority, high impact and timely research on minoritized and marginalized populations’ mental health and social determinants of mental health disparities.
• Establish and maintain research partnerships across federal agencies to increase the capacity and public health impact of scientific research to reduce mental health disparities.
• Provide subject matter expertise to partners and researchers about areas of minority mental health and mental health disparities research.

Program priorities

The goals of the Minority Mental Health and Health Disparities Research Programs are to:

• Foster inclusive research across the NIMH Strategic Objectives.
• Increase the understanding of mechanisms, at multiple levels (e.g., individual, community, systemic), underlying disparities in mental health.
• Encourage disaggregation of research data to understand the nuances of minoritized populations’ mental health needs and outcomes.
• Promote the scaling up of evidence-based interventions to ensure quality and equity in mental health care.
• Support the uptake of research that takes an intersectional lens to understand the complex interplay of race, ethnicity, sexuality, gender identity, geography, and disability status on mental health outcomes.
• Advance research on the social determinants of mental health disparities and multi-level interventions that can reduce or eliminate disparities.
• Catalyze, community engagement and coproduction of knowledge and discovery related to research on the mental health needs of marginalized and minoritized youth.

The minority mental health and health disparities research grant portfolios at NIMH are distributed across the NIMH Divisions and Offices according to their focus in the scientific areas of services and interventions research, translational research, neuroscience and behavioral research, HIV/AIDS research, global mental health research, and on populations of high need (e.g., youth, those with serious mental illness, pregnant people).

The Minority Mental Health and Health Disparities program is composed of two areas:

• Minoritized populations’ mental health research
• Social determinants of mental health disparities research

Minoritized Populations’ Mental Health Research

NIH designates people of racial or ethnically minoritized backgrounds, those who are socioeconomically disadvantaged, underserved rural populations, sexual and gender minority groups, and people living with disabilities as health disparities populations. Importantly, these identities and experiences do not occur in isolation. NIH emphasizes the importance of multilevel approaches  to understanding the phenomenology of mental health outcomes, treatment approaches, and etiology of mental illness for minoritized populations.

Intersectionality accounts for the multiple, interconnected social identities that individuals have and how the intersections of these identities and relevant inequitable systems shape their experiences and positionality in society. An intersectional approach can better predict variations in health outcomes, determine individual or population needs, and ultimately lead to more inclusive and multi-level research.

NIMH is interested in promoting impactful research that can inform ways to improve equity in access, engagement, utilization, and quality of care for people from minoritized and marginalized backgrounds. This is a priority that cuts across the entirety of the NIMH mission.

We have recently reaffirmed this commitment in the area of youth mental health disparities with the publication of a Strategic Framework for Addressing Youth Mental Health Disparities, which seeks "to provide a conceptual approach to help guide NIMH activities, including research funding, stakeholder engagement, and workforce development, related to research on the mental health needs of youth impacted by racial and ethnic health disparities.”

Social Determinants of Mental Health Disparities Research (SDoH-MHD)

The NIH defines social determinants of health  (SDoH) as the “conditions in which people are born, grow, learn, work, play, live, and age, and the wider set of structural factors shaping the conditions of daily life.” SDOH  encompasses social drivers of health, such as housing, nutrition security, transportation, geography, systemic and structural factors (for example, structural racism and health care systems), policy, and other conditions of daily life, as well as their intersections.

Disparities are defined as differences in health that are avoidable and due to social, economic , structural, and policy factors. The SDoH-MHD program promotes research that emphasizes SDoH as mechanisms of mental health outcomes and disparities among health disparities populations by working collaboratively within NIMH and across NIH Institutes, Centers, and Offices.