The Hidden Obstacles in Mental Health Diagnosis: Addressing Bias for Better Care

In mental health care, a diagnosis can change everything. It opens doors to the right treatment, support, and understanding. Yet, mental health diagnoses are not immune to bias, which can have serious consequences, both in terms of treatment and finances. 

One example is the diagnosis of PTSD among veterans, which, if inaccurate, can prevent veterans from receiving the disability compensation they’re rightfully owed. Understanding these biases—and working to overcome them—is essential for creating fair, effective mental health care.

Diagnostic bias and its consequences

Bias in mental health diagnosis occurs when factors unrelated to a person’s symptoms—like their race, gender, or socioeconomic status—affect the type of diagnosis they receive. This bias has significant consequences, as it can delay access to the right care and, in the case of U.S. veterans, prevent them from receiving necessary disability compensation.

For a veteran to receive PTSD-related disability compensation from the Veterans Benefits Administration, a clinician’s diagnosis is required. Yet, research comparing diagnoses made using a psychometric assessment against those made by clinicians alone found disparities. The diagnoses made using a formal assessment are considered more accurate due to the rigorous diagnostic criteria and gathered extensive information. 

More troubling, Black veterans were less likely than white veterans to receive a clinician’s diagnosis of PTSD. There was, however, one set of cases where this race bias disappeared: when clinicians used a PTSD checklist or a psychological test as part of their evaluation. 

This finding highlights the importance of structured assessments in clinical decision making. Sometimes clinicians may form a first impression and seek information that confirms it rather than questioning their initial impression. By using objective testing and data, clinicians are more likely to make unbiased diagnoses.

Bias in diagnosing other mental health conditions

Bias isn’t limited to PTSD or veterans. Historically, research has shown that Black and Hispanic patients were more likely than white patients to be misdiagnosed with schizophrenia, while white patients were more likely to be accurately diagnosed with depression or bipolar disorder.

Additionally, the study reveals that women are often underdiagnosed or misdiagnosed with neurodivergent conditions, including ADHD and autism, partly due to diagnostic criteria that emphasize symptom presentation in men. This gap leaves many women untreated or inappropriately treated, affecting their quality of life, relationships, and career progression.

Psychometric testing can help to reduce diagnostic bias

By providing an objective way to measure symptoms, mental health assessments reduce racial and gender disparities in clinical diagnosis. For example, the racial disparities seen in PTSD diagnoses for veterans were eliminated when clinicians used objective PTSD checklists or tests, as these assessments help counterbalance the influence of subjective impressions. By combining psychometric testing with culturally sensitive approaches, clinicians can make diagnoses that better reflect patients’ true needs.

Incorporating standardized mental health assessments into practice is a significant step toward achieving diagnostic accuracy and providing equitable care. Objective assessments can help clinicians move beyond assumptions, focusing instead on the specific symptoms each patient presents. 

The path to fair and accurate diagnosis

Bias in mental health diagnosis doesn’t just delay the right treatment—it can have life-changing implications, from prescribing the wrong medication to withholding financial support.

Incorporating standardized mental health assessments into practice is a significant step toward achieving diagnostic accuracy and providing equitable care. In a mental health system that acknowledges and addresses bias, people can receive the right diagnosis and treatment without unnecessary obstacles.  Accurate diagnoses are just the beginning, but they pave the way toward a fair and equitable mental health care system for all.

Sources

1. psyche_the_mag. (n.d.). Bias in mental health diagnosis gets in the way of treatment: Psyche ideas. Psyche. https://psyche.co/ideas/bias-in-mental-health-diagnosis-gets-in-the-way-of-treatment