UVM Study Finds Racial Bias In Mental Health Services

Nov 18, 2016

A new study conducted by researchers at the University of Vermont shows a disturbing prevalence of racial bias in mental health services.

The study involved looking at the responses provided by therapists to a voicemail message. In the message, an actor called requesting counseling services. For about half of the randomly-chosen recipients, the actor said her name was Allison. The other half of the time, she said her name was Lakisha. The names were chosen because of their perceived association with people of specific races.

What researchers found was that in instances where the caller gave the name Allison, she was more likely to get a response that offered a path toward accessing services. The rate at which Allison received responses that encouraged further conversation was 12 percentage points greater than the rate at which Lakisha did.

Lance Smith, associate professor in counseling at the University of Vermont and a lead researcher on the study, spoke to Vermont Edition on Tuesday about the study, these findings and what he thinks are the next steps.

How the study was conducted

"Everything about the message for every therapist was exactly the same – it was the same voice, it was the same person and they were asking for the same services," Smith says. "Basically it was, 'I need counseling' and, 'Will you give me a call back?' The only difference was for half of the therapists, the person in the message identified as Allison and for the other half, the person identified as Lakisha ...

"It's been pretty well documented that Allison is a very popular name for women and girls in families that identify as white. And Lakisha is a popular name for women and girls in families that identify as black or African-American."

The study's findings

Smith explains that for a person to get the requested access to mental health services, they need not just to receive a call back from the therapist but also to be told there is availability to actually meet the therapist. That second step is where they found differences in the types of responses received by either Allison or Lakisha.

"We noticed that Lakisha was more likely to receive a message to the extent of, 'I'm sorry, I wish I could take you, but my caseload is full,'" Smith says.

"So when we were thinking about, 'What are responses that promote services?' and, 'What are responses that impede services?', what we found was a statistically-significant relationship around bias, in that Lakisha was ... more likely to have responses that impeded services than was Allison."

The next steps

"I would submit that most counselors and therapists and psychologists are very beneficent, well-meaning, well-intended people," Smith says. "The conversation we need to have is not if we are racist or not, but a conversation around how much bias has been downloaded into our 'software.' Because most of us have bias that's been downloaded into our lived software ...

"We also need to expand our research on implicit bias, specifically how to interrupt implicit bias. And some of the best research that we have speaks to the power of authentic and genuine relationships ... interracial relationships, relationships with people that identify from a different cultural or racial background than I do."

Listen to the full interview above.

Correction 5:14 p.m. 11/18/2016 This post has been updated to clarify the comparison of the rates of responses that encouraged further conversation that were experienced by Allison and Lakisha. The difference between the two response rates was 12 percentage points, not 12 percent as previously stated.