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IntroductionSubstantial unmet need for mental health services (MHS) exists in the United States, with pronounced disparities among people of color. Research highlights the need to identify facilitators and barriers to MHS utilization among Black and Latinx individuals to better promote overall health. We tested an expanded model of MHS use based on Andersen's (1995) conceptual framework of health care utilization. Associations were examined between sociodemographic variables, trauma and adversity burden, living with HIV, and unmet need for MHS in a community sample of underresourced Black and Latinx individuals. Barriers to MHS utilization are described.MethodsFive-hundred participants completed the UCLA Life Adversities Screener (LADS), sociodemographic measures, and items assessing need for and barriers to MHS.Results228 (46%) participants reported a need for MHS; of these, 115 (51%) reported receiving MHS. A binomial logistic regression model estimated the relative contribution of the LADS on need for MHS. Severity of LADS, younger age, and living with HIV predicted unmet need for MHS. Barriers to MHS included financial and time constraints and health system-related issues. One-way analysis of variance (ANOVA) tests revealed differences in mental health symptoms by MHS need.DiscussionThe unmet need for MHS in this sample of Black and Latinx individuals highlights the importance of addressing the systemic roots of trauma and adversity burden, and eliminating structural barriers to treatment to reduce existing health and mental health inequities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

This article describes the nearly half a century career of Dr. Gail E. Wyatt, PhD, and her development of novel methodologies and measures of sexual trauma, specifically the Wyatt Sex History Questionnaire and the University of California, Los Angeles, Life Adversities Screener. These approaches broke the silence around experiences of sexual violence, particularly among African Americans, identifying their effects on sexual functioning and mental health. These novel methods are designed without assuming sexual literacy of respondents, knowledge of anatomy, or that discussing sex is easy or common; they include topics that are considered private and may evoke emotions. Trained professionals administering face-to-face interviews can serve to establish rapport and educate the participant or client while minimizing possible discomfort and shame around the disclosure of sexual practices. In this article, four topics are discussed focusing on African Americans, but they may also be relevant to other racial/ethnic groups: (a) breaking the silence about sex, (b) sexual harassment: its disclosure and effects in the workplace, (c) racial discrimination: identifying its effects as a form of trauma, and (d) the cultural relevance of promoting sexual health. Historical patterns of abuse and trauma can no longer be ignored but need to be better understood by psychologists and used to improve policy and treatment standards. Recommendations for advancing the field using novel methods are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Coronavirus 2019 (COVID-19) pandemic is an unparalleled crisis, yet also a unique opportunity for mental health professionals to address and prioritize mental and physical health disparities that disproportionately impact marginalized populations. Black, Indigenous, and People of Color (BIPOC) have long experienced structural racism and oppression, resulting in disproportionately high rates of trauma, poverty, and chronic diseases that span generations and are associated with increased COVID-19 morbidity and mortality rates. The current pandemic, with the potential of conferring new trauma exposure, interacts with and exacerbates existing disparities. To assist mental health professionals in offering more comprehensive services and programs for those who have minimal resources and the most profound barriers to care, four critical areas are highlighted as being historically problematic and essential to address: (a) recognizing psychology's role in institutionalizing disparities; (b) examining race/ethnicity as a critical variable; (c) proactively tackling growing mental health problems amidst the COVID-19 crisis; and (d) understanding the importance of incorporating historical trauma and discrimination in research and practice. Recommendations are provided to promote equity at the structural (e.g., nationwide, federal), professional (e.g., the mental health professions), and individual (e.g., practitioners, researchers) levels.