Email me back: Examining provider biases through email return and responsiveness

Area of Science:

• Mental Health Services Research
• Healthcare Disparities
• Psychotherapy Access

Background:

• Research on mental health service access predominantly focuses on patient barriers.
• Provider biases influencing initial client access remain under-explored.
• Understanding these biases is crucial for equitable healthcare delivery.

Purpose of the Study:

• To investigate psychotherapy provider responsiveness to simulated patients from diverse backgrounds.
• To identify potential provider biases affecting initial access to mental health care.

Main Methods:

• An email-based field experiment using the audit method.
• 725 therapists in Chicago received simulated patient inquiries.
• Simulated patients varied by race, gender, diagnosis, and ability to pay.

Main Results:

• 21.7% of providers did not respond; 32.5% were somewhat responsive; 45.7% were highly responsive.
• Male providers showed less responsiveness to minority simulated clients compared to White clients.
• Providers were more responsive to depression than schizophrenia or BPD, and to full-fee payers over sliding-scale.

Conclusions:

• Psychotherapy provider biases related to race, diagnosis, and payment ability significantly impact access.
• Female providers demonstrated more equitable responsiveness across simulated client demographics.
• Provider education on implicit biases is essential to improve care access for vulnerable populations.