BACKGROUND Individuals with severe mental illnesses experience high rates of chronic health conditions; however, the extent to which risk of chronic physical health problems varies by race and gender among these individuals is understudied. AIMS This study examines variations in health problems by race and gender among individuals with severe mental illnesses. METHOD Administrative data, which included blood pressure, body mass index (BMI), and glycated hemoglobin (HbA1c) values, were obtained from 603 individuals with serious mental illnesses who received integrated health and behavioral health services from a large mental health agency in the Midwest. Bivariate and multivariate statistical models were used to examine variation in physical health problems by race and gender. RESULTS Compared with men, women with severe mental illnesses were more likely to have BMI levels indicating obesity or morbid obesity ( p < .001). Compared with White participants, Black participants were less likely to have high HbA1c levels ( p < .001) but were more likely to have high blood pressure ( p < .001). Among race and gender groups, Black women were more likely to have high BMI ( p < .05), Black men were more likely to have high blood pressure ( p < .001), and White men were more likely to have high HbA1c levels ( p < .01) when holding constant all other variables. CONCLUSIONS There is evidence that types and severity of physical health problems among individuals with severe mental illnesses varies by race and gender. Replication of these results and more research is needed to ensure that health-related education and integrated health and behavioral health interventions meet the needs of individuals with serious mental illnesses.

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The social inequities highlighted by the racial injustice protests of 2020 and the COVID-19 pandemic challenge the social work profession to respond to the past and present social consequences that disproportionately impact Black, Indigenous, and People of Color (BIPOC). We argue that social work's commitment to social justice has not taken up an explicit anti-racism mission to eradicate white supremacy, racism, and coloniality in the profession. We further argue that although social service agencies often include a commitment to cultural competence/humility, practices continue to be rooted in color-blind approaches to service and treatment. Social work's failure to address racism poses challenges for those from racialized backgrounds experiencing psychological distress due to racism and other inequities. Building upon the theoretical foundations of Critical Race Theory (CRT) and Anti-Colonialism, we provide a conceptual framework for practice and service delivery with BIPOC clients through social work praxis. This conceptual framework offers three overarching directives that include integrated critical race and anti-colonial theoretical concepts for social work practice and service delivery. We discuss the implications for application of this conceptual framework in practice and service delivery.

Little research exists about PTSD and traumatic experiences among justice-involved individuals with mental illnesses and how those experiences differ by race and gender. We examined traumatic experiences and PTSD among 187 individuals with serious mental illnesses on probation in the United States: 94% of participants experienced a traumatic event, rates of PTSD were highest among Black women ( p < .001), and rates of sexual assault were highest among White women ( p < .001). Justice-involved individuals with mental illnesses have complex needs and an elevated risk of PTSD and exposure to traumatic events, which has implications for probation policy and practice.