Study: Black People Visit ER for Mental Health at Highest Rates | Healthiest Communities

New research finds Black adults are more likely to visit emergency departments when experiencing a mental health problem than white adults but face longer delays, and are less likely to be admitted to a hospital for treatment.

A new analysis released Wednesday by the Centers for Disease Control and Prevention’s National Center for Health Statistics shows that from 2018 to 2020, non-Hispanic Black adults visited the emergency department for any mental health-related concern at an annual average rate of 97 visits per 1,000 adults, nearly double the rate of the national average. By comparison, the rate of mental health-related emergency department visits among non-Hispanic white adults was 53.4 per 1,000 from 2018 to 2020, while Hispanic adults had the lowest rate at 36 visits per 1,000.

Black adults had higher rates of emergency department visits compared with white and Hispanic adults across all categories of mental health disorders studied, including substance use disorders, anxiety disorders, mood disorders and schizophrenia.

Black adults were nearly twice as likely to visit an emergency department for a substance use disorder than white people, coming in at an annual average rate of 53.1 visits per 1,000 people compared to 27 per 1,000, according to the study. The rate among Black adults was more than double that of Hispanic adults, who had an annual average rate of 20 visits per 1,000. Black adults had higher visit rates for all types of substance use disorders, including alcohol disorder and nicotine dependence.

Overall, an average of 774,508 mental health-related emergency department visits occurred each year from 2018 to 2020 among adults in the U.S., according to the study, which accounted for 12.3% of all emergency department visits made by adults.

The analysis did not examine contributing factors for the racial disparities found, but previous research has indicated people of color are routinely underdiagnosed and undertreated for mental illness, which has in part led to rising rates of drug overdose death and suicide.

Researchers found racial differences around certain characteristics of emergency department visits, with Black and Hispanic adults more likely to wait an hour or longer to see a health care professional compared to white adults. The study did point out that the difference between the percentage of Hispanic and white patients was not statistically significant.

Higher percentages of Hispanic and Black patients reported having their overall visit last four hours or more compared to white adults. And only 15.6% of Black adults were admitted or transferred to a hospital for treatment of a mental health-related condition, compared to 22.5% of white adults, 21.3% of Hispanic adults, and 21% of all adults.

By gender, 51.7% of visitors to an emergency department for a mental health disorder from 2018 to 2020 were men, compared with 48.3% who were women, the study found. But wider gender disparities were found between Black and Hispanic men and women. Black men made up 55.8% of Black adults who had a mental health-related emergency department visit, while women made up 44.2%. Among Hispanic visitors, 57.1% were men and 42.9% were women.

The chance of visiting the emergency department for mental health emergencies decreased with age. The study found that a higher share of younger adults reported visiting an emergency department between 2018 and 2020 for a mental health concern compared to other age groups, with 56.3% of visits among adults between the ages of 18 and 44 years, 30.1% of visits among people ages 45 to 64 years, and 13.6% among individuals ages 65 years and older.

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