Reflections on National Minority Mental Health Awareness Month: Addressing Root Causes of Behavioral Health Challenges

Thu, Aug 1, 2024  -  Comments (0)  -   Posted by Kim Byas, PhD

At the conclusion of National Minority Mental Health Awareness Month, observed in July, it is important to reflect on the enduring mission of Bebe Moore Campbell, who worked tirelessly to end the stigma surrounding mental health among underrepresented communities. Despite the efforts since the observance’s designation by the U.S. House of Representatives in 2008, the barriers to mental healthcare for underrepresented populations remain significant.

This year's theme, "Be the Source for Better Health: Improving Health Outcomes Through Our Cultures, Communities, and Connections," emphasizes the crucial role of social determinants of health (SDoH). Understanding the unique environments, cultures, histories, and circumstances that impact the health of racial and ethnic minority and American Indian/Alaska Native (AI/AN) populations is vital for improving overall health outcomes.

The Importance of Mental Health

Mental health is a critical component of overall well-being, affecting every individual regardless of race or gender. Yet, underrepresented populations face significant obstacles that prevent them from accessing necessary mental health support. These barriers are often rooted in the SDoH that include non-medical factors such as homelessness, hunger, unemployment, and the lack of reliable transportation – vulnerabilities that directly impact health outcomes.

Social Determinants of Health and Their Impact

According to the U.S. Department of Health and Human Services Office of Minority Health, SDoH profoundly affect the mental health of racial and ethnic minority populations. These factors can be grouped into five categories.

1. Access to Healthcare: Geographic proximity, affordability, and availability of healthcare providers influence how easily people can access care. Approximately 7.7% of the U.S. population lacks health insurance, a significant barrier to seeking mental healthcare.
2. Neighborhood and Built Environment: Where people live significantly impacts their physical and mental health. Underrepresented populations and low-income residents are more likely to reside in neighborhoods with higher health risks.
3. Social and Community Context: Relationships with family, friends, and community provide support, reduce stress, and influence healthy behaviors. In contrast, discrimination, unsafe neighborhoods, and lack of resources hinder the social support needed for good mental health.
4. Economic Stability: Economic stability tied to a steady income and resources to meet basic needs correlates with better health outcomes. Financial hardships that are often linked to poverty and structural racism exacerbate mental health issues.
5. Education Access and Quality: Education prepares an individual with knowledge and skills to understand health information and make informed decisions about their health.

Additional factors such as natural disasters, financial hardships, limited access to culturally appropriate services, and stigma surrounding mental health also contribute to poor mental health outcomes for underrepresented populations.

The Impact of Limited Access to Mental Health Treatment

The American Psychiatric Association (APA) notes that while underrepresented populations often have similar or fewer mental health diagnoses than white populations, the consequences of mental illness in these groups may be more severe and persistent. While these statistics may be linked to inadequate or limited access to behavioral health resources, available data show that depression rates are lower in Black (24.6%) and Latino (19.6%) populations compared to white populations (34.7%). Due to limited access to necessary services, however, population health experts consider the prevalence of depression to be higher and more persistent among melanated populations.

Misdiagnosis and underdiagnosis are significant issues – often due to lack of insurance and the financial resources needed to access the services that may be available in the community. Compounding this financial barrier are cultural ones such as language differences, the lack of concordance between the melanated patient and a melanated provider, and the stigma of mental illness among underrepresented populations. Consequently, fewer individuals from these groups receive necessary mental health services. While 48% of white individuals receive mental health services, only 31% of Black and Latino individuals and 22% of Asian individuals do so.

Ripple Effects of Untreated Mental Illness

Untreated mental illness has far-reaching consequences. For example, individuals with depression have a 40% higher risk of developing cardiovascular and metabolic diseases. Moreover, people with serious mental illness are nearly twice as likely to develop these conditions. The National Alliance on Mental Illness reports that 21.1% of homeless individuals in the U.S. have a serious mental health condition, and depression and anxiety disorders cost the global economy $1 trillion in lost productivity annually.

Prioritizing Minority Mental Health

To improve mental health outcomes for minority populations, health systems need to use several strategies from among those listed below and recommended by the Centers for Disease Control and Prevention (CDC).

• Screen patients for depression and other mental health conditions and refer them to accessible services.
• Provide mental health educational materials to all patients.
• Recruit mental health providers who reflect the racial and ethnic diversity of the populations they serve. This is considered racial concordance.
• Offer cultural humility training to health providers.
• Ensure services are culturally and linguistically appropriate.

Breaking the silence around mental health is crucial. Open and honest conversations, while respecting cultural beliefs, can dismantle barriers and prioritize mental health. Online screening tools, such as those available through Mental Health America, offer an accessible way for individuals to assess their mental health.

A Call to Address Root Causes

The Center for Health Affairs recognizes that healthcare organizations alone cannot meet the high demand for mental health services. Through deliberate policies and programs, society must address the root causes of mental health disparities – structural racism and poverty – while doing everything possible to meet current demands. It is only by tackling these foundational issues that we can achieve lasting change and improve mental health outcomes for underrepresented populations.

For more information on Minority Mental Health Awareness Month, visit the U.S. Department of Health and Human Services Office of Minority Health.

References

American Psychiatric Association. (n.d.). Mental Health Disparities: Diverse Populations. Retrieved from https://www.psychiatry.org/psychiatrists/cultural-competency/education/mental-health-facts

Centers for Disease Control and Prevention. (n.d.). Mental Health Among Racial/Ethnic Minority Populations. Retrieved from https://www.cdc.gov/healthequity/features/minority-mental-health/index.html

National Alliance on Mental Illness. (n.d.). Mental Health by the Numbers. Retrieved from https://www.nami.org/mhstats

U.S. Department of Health and Human Services Office of Minority Health. (n.d.). Social Determinants of Health. Retrieved from https://www.minorityhealth.hhs.gov/

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