Mental Health Disparities in the U.S.

By: Remle Scott, LEAD, Inc. Fellow

“Have you ever tried to unlock a door that wouldn’t open? At first, you think you might be doing something wrong. Maybe there’s a trick to it. You pull the key back a little—doesn’t work. You wiggle the key—doesn’t work. You keep trying, but the door stays locked. After a while, you realize the problem isn’t you, it’s the key.

This is what it’s like for minorities trying to access mental health care.”

-Larry Shushansky, LICSW

Introduction:

Since President Truman passed the National Mental Health Act in 1946 and established National Institute of Mental Health, treatment disparities and cultural barriers among minorities have significantly improved. Over time, education, research, advocacy, and access to mental health services have increased, bridging the gap between physical and mental health for minorities in the United States.

Despite this promising momentum, people of color face higher rates of untreated mental illness and substance use disorders than their Caucasian counterparts. Since 1 in 2 adults experience a mental illness in their lifetime, mental health advocates continue to fight for widespread and cross-cultural change. In fact, the United States Department of Health and Human Services (HHS) and the Surgeon General have committed to eliminating mental health disparities by 2020.

Pertinent Terms:

Culture, race, and ethnicity play an integral role in shaping the care-seeking behaviors and cultural views of mental illness in minority populations. Health disparities are, “racial or ethnic differences in the quality of healthcare that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention” (HHS). Open dialogue about mental illness and health disparities has the potential to improve health outcomes and reduce stigma for millions of people who identify as minorities in the United States.

Mental health stigma is characterized by, “prejudicial attitudes and discriminating behavior directed towards individuals with mental health problems as a result of the psychiatric label they have been given” (PT). Additionally, perceived stigma or “self-stigma” is the internalizing by the mental health sufferer of their perceptions of discrimination, contributing to feelings of shame (Cullen, Struening & Shrout, 1989).

National Implications:

Prejudice and stigma, also called “minority stress,” also affects disenfranchised populations and members of the LGBTQ+ community. In the United States, individuals in the LGBTQ+ community are at a higher risk for suicide, substance abuse, and are three times more likely to experience mental illnesses such as major depression and generalized anxiety disorder (National Alliance on Mental Illness). Individuals who identify as both Muslim and LGBTQ+, for example, face a heightened risk for mental illness and suicidal ideation.

Mental health disparities are caused by a number of factors, including financial barriers to access health services and cultural norms that invalidate mental illness or project blame onto individuals suffering from mental disorders. Children and adolescents face heightened risk, with 70% of young people suffering from a mental illness failing to receive treatment (NAMI). Moreover, lack of cultural competence and diversity training in schools and healthcare facilities is a significant barrier to treatment for first and second-generation Americans.

In response, Let’s Empower, Advocate, and Do (LEAD), Inc. provides curriculum and training to schools, summer camps, and youth-serving organizations to promote mental health education and adolescent wellbeing. LEAD’s 90-min course, “Cultural Competency and Mental Health Disparities” describes how mental health disparities impact care-seeking behaviors of youth and builds confidence in participants to approach minority youth experiencing mental health challenges. LEAD also certifies individuals in Youth Mental Health First Aid, an international 8-hour training that teaches participants to identify and properly react to high-risk behavior in youth in both crisis and non-crisis situations.

Finally, LEAD is “revolutionizing health education” by introducing topics like cultural competency and mental health disparities into existing – and often outdated – health education courses in high schools.

LEAD’s TryHealth curriculum supplement is currently being piloted at four high schools in two states and has already shown promising results including students being 2x more likely to report suicidal ideation in a peer after taking the course.

By providing health education to students, LEAD intends to decrease mental health disparities in communities from the inside out! For more information, visit www.leadnow.org or contact LEAD’s Executive Director at kyrah@LEADnow.org.

 

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