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Transgender people, African Americans, and Hispanics face mental health disparities. While mental health care can help, minoritized groups could face discriminatory barriers in accessing it. Discrimination may be particularly pronounced in mental health care because providers have more discretion over accepting patients. Research documents discrimination broadly, including in access to health care, but there is limited empirical research on discrimination in access to mental health care. We provide the first experimental evidence, from a correspondence audit field experiment (“simulated patients” study), of the extent to which transgender and non-binary people, African Americans, and Hispanics face discrimination in access to mental health-care appointments. We find significant discrimination against transgender or non-binary African Americans and Hispanics. We do not find evidence of discrimination against White transgender and non-binary prospective patients. We are mostly inconclusive as to whether cisgender African Americans or Hispanics face discrimination, except we find evidence of discrimination against cisgender African American women. 

The COVID-19 pandemic increased the rate of mental health disorders, as well as demand for mental health services. It remains unclear, however, the extent to which it impacted access to mental health care. Using data from an audit field experiment, which ran from January to May 2020 and overlapped with the onset of the COVID-19 pandemic, we examine the impact of COVID-19 on access to mental health care appointments in the United States. We find that increased intensity of COVID-19–measured by daily cases, daily fatalities, and weekly excess deaths–is associated with decreased access to mental health care appointments.