In a pandemic that has exacerbated health disparities in the U.S., the prolonged health crisis is also taking a toll on people’s mental health.

As the winter months approached, roughly 41% of people reported experiencing symptoms of anxiety or depression, according to a survey conducted by the Centers for Disease Control and Prevention between Nov. 25 and Dec. 7.

Black and Latinx respondents reported even higher rates of anxiety and depression. Challenges with getting mental healthcare covered, or finding a culturally competent therapist, have served as barriers to care for these communities.

But with the pandemic shining a spotlight on the need for better mental healthcare, people see an opportunity for change.

“I’ve spent my entire career in public health. Racism and the impact of race has always been the elephant in the room. There was a polite conversation around it but very seldom were people willing to address it,” said Kevin Dedner, CEO and founder of mental health startup Hurdle Health. “The pandemic and the death of George Floyd — the two of those events together forced us to a completely new place in society. Life will never be the same because of those two events.”

Dedner co-founded Hurdle two years ago with the idea of bringing culturally competent therapy to Black men. Since then, that work has expanded to include Black women and other underrepresented groups.  Like other mental health startups, it has seen continued growth over the past several months.

“In the startup space, most investors want founders who are flexible and agile. One of the things I was very stubborn about was this idea that mental healthcare as we know it does not work for everyone,” he said. “The last couple of months have been soberly affirming.”

Hurdle Health offers telehealth visits with its therapists, who receive cultural responsiveness training to address issues of race, ethnicity, class and culture.  The majority of psychologists and therapists are white, and most don’t receive any sort of cultural training.

“Being in therapy and not being able to address things that are rooted in your identity means the therapist is unlikely to be successful,” Dedner said. “So, if I’m a Black man in therapy with another white man and I’ve got to convince him of my daily experiences, that is me reliving that trauma all over again.”

The startup started by selling its service directly to consumers, but has expanded to take insurance from most payers in Maryland, Virginia and Washington, D.C. Hurdle Health is also making inroads with businesses, who see the value in making mental health available to their employees.

“The majority of our clients have never been to traditional therapy, they never considered therapy. it was our narrative, how we talk about mental health, that they see us as a trusted provider,” Dedner said. “Culturally, we’re starting to normalize mental health and reframe it as part of what it means to be healthy.”


Disproportionate impact on youth

The pandemic has also had a disproportionate impact on the mental health on youth and young adults. In the CDC survey, 56% of adults ages 18 to 29 reported symptoms of anxiety or depression, and 22% said they recently needed counseling or therapy, but did not get it.  

“More than 80% of youth globally had their plans disrupted or had to rethink their futures,” said Bill Smith, who recently started Inseparable, a nonprofit that is pushing for policy changes to improve mental health access. “Stress is up and measures of happiness are lower… Those numbers are all going in the wrong direction. They also aren’t happening equally.”

Months before the start of the pandemic, the Congressional Black Caucus published a report raising the alarm over rising suicide rates in Black youth. While half of all adolescents with depression never received mental health treatment, Black adolescents were significantly less likely to receive care for depression, according to the report.

The emergency taskforce, which was led by Rep. Bonnie Watson Coleman (D-New Jersey), and included leaders from several mental health nonprofits, including the AAKOMA Project and the Steve Fund, put forth several recommendations to help students access mental healthcare.

For example, they recommended establishing a curriculum around mental health in schools, and training more providers to address the dearth of school-based personnel who can address the mental health needs of Black students.

Inseparable is pushing for many similar policy changes, as well as mental health care that is better integrated in people’s communities.

“Not just in a doctor’s office but wherever people show up in life, they should have access to mental healthcare — at the community level, in schools,” Smith said. “We needed a lot of that before the pandemic, but the pandemic’s made it worse.”

The nonprofit is also partnering with peer support groups, such as Active Minds or Bring Change to Mind, to create peer support groups on high school and college campuses.

“The biggest problem we have is our system has always before the pandemic, we weren’t reaching everyone we needed to reach, and that’s just compounded,” Smith said. “Not just individual discrimination, but systemic race-based traumatic stress has had a huge impact. We have to address systemic racism in our country in all its forms. We also have to fix our health system, and make sure everyone has access to treatment.”

The toll-free line for the National Suicide Prevention Lifeline is available at 1-800-273-TALK (8255).

Photo credit: Evgeny Gromov, Getty Images

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