The Psychological Implications of Supreme Court Decisions for Minorities and Other Disadvantaged Groups

Mental health policies in the United States have advanced significantly over the past centuries. In the 1500s and 1600s, mental disorders were thought to be rooted in religious crises, leading to inhumane treatments for patients, such as exorcism. The 1700s and 1800s brought a more ethical approach to mental disorders by introducing humane treatment methods, including exercise. The first classification systems for mental disorders came in the 1900s. The effects of these periods manifest in experts’ understanding of mental illness today, which emphasizes research and treatments supported by scientific evidence rather than speculation.

Regardless of these promising advancements, mental health inequities blatantly persist and are reinforced at the institutional level. These sorts of discrepancies can be reinforced in subtle, nuanced ways which may go underacknowledged or even ignored altogether. In fact, growing evidence suggests that Supreme Court decisions sometimes perpetuate institutional discrimination towards mental health challenges. The outcome of Court decisions facilitates extensive discourse on what legal precedent has been set and how this precedent will change the current legal landscape. Often lost and silenced in these discussions are the implications for minority and other disadvantaged groups who have been directly targeted by these decisions. It is critical we give greater consideration to detrimental psychological consequences which may ensue for these groups.

The decision in Dobbs v. Jackson Women’s Health Organization (2022) to eliminate the constitutional right to abortion has created significant distress in women who now (1) experience diminished agency over something so deeply personal as their own bodies, and (2) feel concern over how they will balance their personal lives with birthing a child they do not feel prepared to have [1]. Benjamin Thornburg notes the Court’s opinion in Planned Parenthood v. Casey (1992) was “that reproductive autonomy was intimately related to personal and economic freedoms … [that are] arguably … very related to mental health” [2]. Lack of agency can often be characteristic of mental disorders. Models such as the learned helplessness theory of depression, for instance, suggest that individuals with depression have the schema that their symptoms are out of their control [3]. When the Court sets a precedent for women about how their bodies can be “regulated,” it sacrifices the extent of control women have over their bodies and, by extension, predisposes them to developing mental disorders, such as depression. According to the U.S. Centers for Disease Control and Prevention, “[m]ental health conditions were the leading underlying cause of pregnancy-related deaths from 2017 to 2019” [4]. This statistic becomes even more troubling in the context that at least 10 states forbid consideration of mental health in abortion permittals [5]. Distress women experience over their pregnancy and the conception of their child may already predispose them to developing mental disorders. Court decisions which facilitate the explicit disregard of women’s mental health exacerbate this issue.

The more recent affirmative action cases allow us to see the negative consequences these rulings have had on the mental health of Black, Indigenous, and other people of color (BIPOC). Namely, these cases are Students for Fair Admissions v. President and Fellows of Harvard College (2023) and Students for Fair Admissions v. University of North Carolina (2023), which banned the use of affirmative action in college admissions. BIPOC students, who are already underrepresented in American undergraduate institutions, may experience elevated feelings of “racial isolation” in the wake of this ruling that contribute to declining mental health [6]. An important sociocultural vaccine against several mental disorders is having a strong support network. BIPOC undergraduates often rely on affinity spaces with students sharing their racial identities to foster community, understanding, and pride. The overturn of affirmative action, which many expect could reduce racial minority enrollment at undergraduate institutions in the United States, directly deprives BIPOC students of support networks that benefit their mental health. This ruling also sets the precedent that BIPOC students do not legally deserve safeguards that open doors historically shut for them. A 2019 study at the University of Michigan reports that “one quarter of underrepresented minority students surveyed indicated they felt they did not belong at U-M” [7]. A Court ruling which inherently discourages minority enrollment at undergraduate institutions formally establishes, or at least implies, that the American legal system does not want to facilitate BIPOC students’ place-making at these institutions. This lack of belonging “can contribute to chronic stress and mental health concerns such as anxiety and depression” [8].

One could argue, however, that it is not the Court’s job to navigate mental health implications whilst ruling on cases. Who should, then, bear the burden of this issue? Perhaps policymakers who can provide institutional funding that supports at-risk groups disproportionately in mental harm’s way post-Court decisions. Although it might not be a justice’s duty to consider the mental health implications of Court decisions, appropriate support for groups left vulnerable by these decisions is arguably the most important measure we can take. Proactively doing so in the wake of a Court decision can protect at-risk groups’ mental health from declining into something harmful or even pathological.

It is particularly important to acknowledge that groups often harmed by these decisions are already at an increased risk of experiencing either severe psychological distress or any psychological distress at all [9,10]. Although the literal rates of mental disorders tend to not be “higher among [racial] minorities, psychological symptoms do tend to be higher among minorities” [11]. Women, on the other hand, “are nearly twice as likely as men to suffer from mental illness” [12]. The diathesis-stress model of psychology hypothesizes that people have certain diatheses, or predispositions, to developing mental disorders that, when aggravated by stressors, will actually lead to the development of a mental disorder. Dobbs and Students for Fair Admissions may serve as stressors for sociocultural or even biological diathesis that already predispose women and BIPOC individuals to mental disorders.

These two case studies into the impact of Court decisions on target groups’ mental health reveal the severity of this issue, exacerbated by its likelihood of being disregarded as the Court actually makes its decisions. But even in the wake of these decisions, mental health consequences are an area which many may turn a blind eye to. Is this underappreciation an outcome of the issue’s nuance or the broader tendency for Americans to overlook and discredit mental health? For instance, many Americans do not believe in the medical model of mental illness and therefore do not see mental health as necessitating treatment in the same way that more traditionally-recognized medical issues, such as a broken bone, do.

Perhaps this parallel between the disregard for mental health in a legal context and a more general context reveals that more efforts need to be made to break down the institutional stigma surrounding mental disorders. Mental disorders that have “long been underfunded, underappreciated and stigmatized” require more extensive support and funding from policymakers — otherwise, our country will continue to enable mental disorders in ways unbeknownst to it [13].

Bibliography:

[1] Christine Fernando. “Mental health emerges as a dividing line in abortion rights initiatives planned for state ballots.” PBS NewsHour, (February 13, 2024), https://www.pbs.org/newshour/health/mental-health-emerges-as-a-dividing-line-in-abortion-rights-initiatives-planned-for-state-ballots.

[2] Annalies Winny. “How Abortion Trigger Laws Impact Mental Health.” John Hopkins Bloomberg School of Public Health, (February 6, 2024), https://publichealth.jhu.edu/2024/abortion-bans-impact-on-mental-health.

[3] Courtney Ackerman. “Learned Helplessness: Seligman’s Theory of Depression.” Positive Psychology, (March 24, 2018), https://positivepsychology.com/learned-helplessness-seligman-theory-depression-cure/#definition-learned-helplessness.

[4] Christine Fernando. “Mental health emerges as a dividing line in abortion rights initiatives planned for state ballots.” PBS NewsHour, (February 13, 2024), https://www.pbs.org/newshour/health/mental-health-emerges-as-a-dividing-line-in-abortion-rights-initiatives-planned-for-state-ballots.

[5] Ibid.

[6] Annelle Primm. “The Impact of Affirmative Action on the Mental Health of College Students of Color.” Diverse: Issues in Higher Education, (August 9, 2023), https://www.diverseeducation.com/opinion/article/15543931/the-impact-of-affirmative-action-on-the-mental-health-of-college-students-of-color.

[7] Timothy G. Lynch, “Brief for the University of Michigan as Amicus Curiae in Support of Respondents.” University of Michigan. (August 2022). https://record.umich.edu/wp-content/uploads/2022/08/220804_AmicusBrief.pdf

[8] Annelle Primm. “The Impact of Affirmative Action on the Mental Health of College Students of Color.” Diverse: Issues in Higher Education, (August 9, 2023), https://www.diverseeducation.com/opinion/article/15543931/the-impact-of-affirmative-action-on-the-mental-health-of-college-students-of-color.

[9] Thomas G. McGuire and Jeanne Miranda. “New Evidence Regarding Racial and Ethnic Disparities in Mental Health: Policy Implications.” Health Affairs 27, no. 2 (2008), 393–403. https://doi.org/10.1377/hlthaff.27.2.393.

[10] Shoukai Yu. “Uncovering the Hidden Impacts of Inequality on Mental Health: A Global Study.” Translational Psychiatry, vol. 8, no. 1, (18 May 2018), www.ncbi.nlm.nih.gov/pmc/articles/PMC5959880/.

[11] Thomas G. McGuire, and Jeanne Miranda. “New Evidence Regarding Racial and Ethnic Disparities in Mental Health: Policy Implications.” Health Affairs 27, no. 2 (2008), 393–403, https://doi.org/10.1377/hlthaff.27.2.393.

[12] Shoukai Yu. “Uncovering the Hidden Impacts of Inequality on Mental Health: A Global Study.” Translational Psychiatry, vol. 8, no. 1, 18 (May 2018), www.ncbi.nlm.nih.gov/pmc/articles/PMC5959880/.

[13] “AHA House Statement: America’s Mental Health Crisis February 2, 2022.” American Hospital Association, www.aha.org/2022-02-03-aha-house-statement-americas-mental-health-crisis-february-2-2022#:~:text=While%20behavioral%20health%20care%20has.