Mental Health in Minority Populations – Cleveland Clinic
Each July, organizations across the country join the U.S. Department of Health and Human Services’ Office of Minority Health in observing National Minority Mental Health Awareness Month. The month is dedicated to bringing attention to racial and ethnic disparities in mental health care.
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We spoke with psychologist Kia-Rai Prewitt, PhD, about the unique mental health challenges faced by racial and ethnic minority communities and how you can access services.
“Many people don’t realize the impact race-related stress has on racial and ethnic communities. Or they don’t think about some of the barriers that prevent people of color from accessing quality health services, including mental health treatment,” says Dr. Prewitt. “National Minority Mental Health Awareness Month gives us the opportunity to create space for people to learn about the specific issues that minority populations face when it comes to mental health.
The role of physical health in mental health
Research has shown that minority populations live with higher incidences of several chronic diseases. Black Americans, for example, experience higher rates of asthma, chronic liver disease, diabetes, heart disease and several other conditions, compared to non-Hispanic white adults. Black and Hispanic communities have also experienced higher rates of severe COVID-19 infection cases and COVID-19-related deaths than white communities.
A state of poor physical health can create significant stress and take a toll on your mental health, says Dr. Prewitt.
“A lot of the health issues that we see in minority communities are due to a lack of access not just to mental health care, but to health care in general,” she adds. “If you can’t afford prescriptions to manage your diabetes, for example, that can contribute to anxiety. If your quality of life has changed because you can’t manage some of your health issues, it often leads to depression. It’s a domino effect. »
Access health services
According to the American Psychiatric Association (APA), approximately 18% of all adults in the United States live with a diagnosable mental health condition. Rates of mental health problems are relatively similar among adults of all racial and ethnic identities.
What is surprisingly different, however, are the rates at which American adults receive care for their mental health.
Take these statistics from 2015. APA research shows that, among American adults living with mental illness:
- 48% of people who identify as white (non-Hispanic) have received services related to their mental health condition.
- 31% of people who identify as Black have received services related to their mental health condition.
- 31% of people who identify as Hispanic have received services related to their mental health condition.
- 22% of people who identify as Asian have received services related to their mental health condition.
Further illustrating the disparities, a 2019 research report from the US Substance Abuse and Mental Health Services Administration shows that 6.5% of black adults received medication prescriptions to manage their mental health issues, compared to 16.6% of black adults. white adults. Among those who experienced a major depressive episode, about 60% of black adults received treatment, while 70% of non-Hispanic and white adults received treatment.
Barriers to accessing services
The APA report noted several barriers that minority populations face that prevent them from seeking care for a mental health disorder. Among them are:
- Lack of insurance or underinsurance.
- Stigma of mental illness.
- Lack of diversity among mental health care providers.
- Lack of culturally competent providers.
- Language barrier.
- Distrust of the health system.
Dr. Prewitt helps us understand some of these barriers.
The impact of geography
Dr. Prewitt points out that quality mental health services are often not located in predominantly black or Hispanic neighborhoods.
“You may have heard of food deserts, where you see communities that don’t have access to nutritious food or grocery stores. Unfortunately, it’s the same with mental health care,” says Dr. Prewitt.
“Mental health resources tend to be in higher income communities, and much of the funding for community mental health centers has sadly declined. You find a lot of people of color only accessing mental health care through the emergency room instead of being able to access regular appointments with a licensed mental health provider.
The stigma of mental health care
The tides may be slowly changing in favor of Americans becoming more comfortable discussing and prioritizing their mental health, but the stigma is still widespread. Cultural norms around mental health issues can vary.
“A lot of people learn to keep their problems to themselves or not to share family problems with other people. In some communities there is a stigma that if you have a mental health problem, you are “crazy”. It’s something we hear often and, unfortunately, it’s something that’s been passed down from generation to generation,” notes Dr. Prewitt.
What is culturally competent care?
One of the ways the medical community is working to overcome barriers that prevent minority populations from seeking appropriate care is by emphasizing the training of physicians in culturally competent care. Culturally competent health care providers and systems strive to care for their patients in a targeted manner that meets their social, cultural, and linguistic needs. The goal is to reduce health disparities in minority communities.
One way for healthcare providers to achieve this goal is to acquire training on the National Standards for Culturally and Linguistically Appropriate Services (CLAS), which emphasizes respectful care of the individual in as a whole and meeting their health needs and preferences. The CLAS standards emphasize “effective, equitable, understandable, and respectful care and services that respond to diverse cultural health beliefs and practices, preferred languages, health literacy, and other health needs. communication “.
“There’s a difficult history there in terms of how doctors have provided care to minority groups, and there’s a lot of distrust of health systems in some communities,” says Dr. Prewitt. “It has been very important for institutions and health care providers to provide culturally appropriate services. It’s something we talk about a lot, and it’s certainly something that mental health providers and health systems consider very important.
How to get help
If you are experiencing mental health issues, Dr. Prewitt encourages you to seek appropriate mental health care. Signs to look out for include:
- Feeling tired every day.
- Feeling unable to keep up with daily tasks.
- Feeling “depressed” for several days in a row.
- Excessive worry.
- Difficulty sleeping.
- Appetite changes.
- Thoughts of harming yourself or others.
- Seeing or hearing things others do not see or hear.
If you have a primary care provider, they can help you with a referral. If you don’t have a primary care provider, look for community resources, such as clinics or support groups. You can also try looking outside your neighborhood, if you can afford to get there. Dr. Prewitt adds that if you have Medicare or Medicaid, you may be able to find a provider through your plan.
Dr. Prewitt also suggests that people with mental health issues can contact the 988 Suicide and Crisis Lifeline (also called the National Suicide Lifeline). The National Service is available to anyone in need of mental health support, including those who do not have suicidal thoughts. It is a 24/7 support network for anyone in need of emotional support.
Call 988 for free and confidential assistance.