Darielle Connor

 

 

A Policy for Mental Healthcare Reform Among Minority Groups

 

Statement of Issue:  Mental illness and its awareness have been a hot topic in medicine lately. However, it is still in need of reform and more beneficial policies. Currently, there are over 40 million American adults who experience some form of mental illness per year, that’s 1 in 5. While that is an alarming number, it’s even more alarming that more than half (almost 60%) of these Americans living with a mental illness did not receive any form of treatment. This trend is more prevalent in minority groups, who received half as much mental health treatment as white Americans. It is believed that Mental illness is on the rise in America. More people report that they have increased anxiety due to many factors in their lives, including young adults and even children. There is still a stigma surrounding mental illness, especially in minority communities. This stigma can lead individuals to avoid seeking treatment due to misunderstanding by family and friends, and fear of ridicule.

More policies to implement the awareness of mental health are needed to normalize mental illness in society, and for minority groups. Normalizing will lead to more Americans to seek treatment. Greater availability will also lead to better treatment of those with mental illnesses.

• Mental health disparities lead to poor outcomes according to the American Psychiatric Association. Disparities can exist among a number of different minority groups such as gender minorities, sexual preference minorities, and ethnic/racial minorities. These disparities increase poor health outcomes.
• High-quality mental health services are not easily accessible.  Depending on low socioeconomic status, discrimination, cultural factors or other barriers, minority groups may have less access to proper care for mental health.
• Low cultural competence in the healthcare system is a barrier to mental health treatment.  Stigmas surround mental illness in many cultural minority groups. Without proper education within these groups, mental illness cannot be normalized for the affected to feel safe talking about mental health issues or seeking treatment. Factors such as language barriers and cultural presentation of symptoms are affected by low cultural competence. This incompetence, by providers, in diverse cultures also leads to misdiagnosis or underdiagnoses of mental illnesses in ethnic minority groups. A lack of diversity among healthcare providers perpetuates cultural incompetence.
• Youth Minorities of racial/ethnic groups more likely to receive lower-quality treatment for behavioral problems. They are more likely than white youths to be processed into the juvenile justice system than to receive high quality socialized mental health care.
• Sexual minorities are more likely to have mental illness.LGBTQ patients are more than twice as likely to suffer from a mental illness than a heterosexual patient. These illnesses include depression, anxiety, and substance abuse. Many of these individuals experience stigma and discrimination in society, have less social support and are less likely to seek treatment for mental health issues.
• LGBTQ youths are more likely to attempt suicide than heterosexual youths.The rate of suicide for these minorities are four times higher than in heterosexual majority youths.

 

Policy Options

• A federal program that mandates education about mental illness to youths in schools and youth centers in racial minority areas and areas of low socioeconomic status. All public school systems will require onsite guidance counselors and therapists for students to speak with. Students will be made aware of the availability of someone to speak with and counselors/therapists will visit classrooms and speak with students during mental health awareness presentations to encourage familiarity. Requires all public schools to have presentations to normalize mental health awareness and encourage minority youths to seek help and ask questions, for both students and parents when possible. Local legislature, communities and school officials will help to tailor presentations to reach most minorities possible with repeated presentations bi-annually in classroom settings. Education in recognizing mental issues among student bodies by students and teachers alike. These programs will be supported by all educational staff, school health officials, federal offices like the U.S. Department of Health and Human Services’ Office of Minority Health, Substance Abuse and Mental Health Service Administration. and national organizations such as the National Alliance on Mental Illnesses and the American Psychiatric Association.

• • • Advantages:  Provides mental health education to all youths within disparaged areas, resolves some issues of mental health education among minority groups. Reduces risks of ethnic minority youths being sent to the juvenile justice system prematurely, allowing for a chance to experience high-quality mental health treatment. Reduces stigma among racial/ethnic minorities by educating youths and families about mental health.
    • Disadvantages:  Increases tax dollars used in public school systems for mental health among students. Not all racial/ethnic groups may be represented in literature, causing feelings of non-inclusion among youths. Tailoring presentation information may be time-consuming and costly, or lack clarity and important information on certain racial groups. Some communities or states may be resistant to this type of education for youths.

 

• Mandates provided by the federal government for cultural competency training among healthcare providers/ law enforcement totaling once per month. Training to be given by mental health advocates from various federal branches as mentioned in the prior policy. Federal incentive programs included providers who practice cultural competency and show an increase in cultural minority group satisfaction. An initiative to also place more culturally diverse minority providers in disparaged and cultural minority areas.

• • • Advantages:  Provide education on various cultures to providers, more likely to take on minority patients and practice in minority areas. Incentives can be lumped in with other incentives from the MIPS legislature. Less costly than a full federal mandate separate from other incentive programs.  Provides mental health treatment to minority groups by providers already in these areas. It helps to perpetuate normalcy of mental health awareness and lessen stigma related to cultural biases. Fewer arrests or discouragement of processing of misunderstood minority disputes or culturally different behavior issues.
    • Disadvantages:  Non-inclusion of some cultures possible, limits the full reduction of cultural biases and disparities. Some providers/law enforcement agencies may be resistant to education and mandates. Possible fraudulent provided minority group information from providers to obtain incentives.

 

• LGBTQ mental health awareness, treatment, and education federally mandated to all schools, school officials, communities and healthcare providers. Similar to the other mandates for racial/ethnic minorities but tailored for sexual minorities. Geared toward youths and adults. Covered under education for providers and law enforcement mandates as discussed in earlier policies.

• • • Advantages:  Reduce suicide rates among the LGBTQ community with proper access to treatment and education. Reduce hate crimes and ostracization of LGBTQ individuals by educating the masses (communities, youths) on harm to mental health. Resolves issues of LGBTQ acceptance education among youths and adults alike. Similar advantages to those of earlier policies stated.
    • Disadvantages:  Due to extreme biases regarding the LGBTQ aspect, many communities may be resistant to accepting this education alongside cultural disparities. LGBTQ individuals may still have a hard time being accepted and learning to seek mental health assistance. Similar disadvantages to other stated policies on education.

 

• Creation of the Office of Behavioral Health Equity, a federal office to oversee and distribute quality behavioral health education to all Americans in need as a result of the Affordable Care Act. This office operates under SAMHSA, they will also make sure that funds are allocated where needed and equally. Funds allocated to different entities must have proof of need. This created office will oversee all other stated policy reforms and mandates from the federal government.

• • • Advantages: The federal office that is concerned with reducing mental health disparities will ensure a wider reach of education and treatment to patients. Creation of new initiatives to promote mental wellbeing among minority groups. Distribution of education and assistance in tailoring presentation to specific minorities represented in an area.
    • Disadvantages:  Non-inclusion of some cultures/ other minorities possible, limits full disparity elimination. States may be resistant to mandates set by these branches.

 

 

Policy Recommendation: With the ever-increasing rates of mental illness among Americans, especially among disparaged minority communities, reform on a federal level is necessary. Mental health awareness is needed to help minority groups understand how to get treatment and to lessen stigmas surrounding mental illness. Although there have been major breakthroughs in normalizing mental health issues, many disparities among cultural, racial, sexual and socioeconomic minorities still exist and need to be addressed. Mental health outcomes among minority groups are still lower than that of majority groups, addressing disparities will help to create more positive health outcomes. Reform is needed to provide access to quality mental health care and education for minority groups and minority youth. Access and awareness will encourage these groups to seek help for their mental health issues. Federally mandated mental health awareness education and federal offices dedicated to eradicating mental health disparities will lead to more positive health outcomes for minority groups in America.

 

 

Sources:

https://www.nami.org/NAMI/media/NAMI-Media/Infographics/GeneralMHFacts.pdf\

https://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/mental-health/art-20046477

https://www.mentalhealth.va.gov/mentalhealth/suicide_prevention/data.asp

https://www.psychologytoday.com/us/blog/our-changing-culture/201510/are-mental-health-issues-the-rise

http://thenationshealth.aphapublications.org/content/45/1/1.3

https://www.psychiatry.org/psychiatrists/cultural-competency/mental-health-disparities

https://www.nami.org/blogs/nami-blog/july-2017/challenging-multicultural-disparities-in-mental-he

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.22.5.51

Mental-Health-Facts-for-Diverse-Populations.pdf

Mental-Health-Facts-for-LGBTQ.pdf