Written By: Larke Huang, Director Office of Behavioral Health Equity
In the past decade, key policy reports have documented disparities in behavioral health for diverse racial and ethnic populations in the United States. The Surgeon General’s report Mental Health: Culture, Race and Ethnicity (2001), the President’s New Freedom Commission on Mental Health (2003), and the IOM Reports, Unequal Treatment and Race, Ethnicity and Language Data: Standardization for Health Care Quality Improvement (2009) have called for a national approach to reducing disparities. While the prevalence rates of behavioral disorders are generally similar across populations groups and in comparison to the white majority population, the burden of disease is often greater for diverse populations due to the disparities in access, quality and outcomes of care.
Many racial, ethnic and sexual minority groups have called for improved behavioral health care that takes into consideration the cultures of these populations and their culturally-based help-seeking behavior. Some groups, particularly African American and Latino, are diverted to more restrictive, less treatment-oriented systems, such as the criminal and juvenile justice and child welfare systems instead of to the behavioral health specialty care system. Native Americans experience high rates of trauma in their families and communities yet this is rarely addressed in their treatment for mental or substance use disorders. Asian Americans and Latinos have among the highest rates of uninsurance, curbing their entry into care. And sexual minority populations experience high rates of victimization, depression associated with family rejection, and too few behavioral health services skilled in working with this population.
The Health and Human Services Department (HHS) has a new charge to address these behavioral health disparities. The Affordable Care Act of 2010 (health reform legislation) called for the development of Offices of Minority Health in six agencies within HHS. SAMHSA was one of the agencies named in this legislation and will address the nations behavioral health disparities.
In accord with this legislation, SAMHSA created the Office of Behavioral Health Equity (OBHE). SAMHSA is charged with reducing the impact of substance abuse and mental illness on America’s communities, with the knowledge that prevention works, treatment is effective and people recover from these disorders. The vision of OBHE is to ensure that populations experiencing behavioral health disparities are equally served by this vision. It is OBHE’s intent that diverse populations, i.e., culturally, racially and ethnically diverse individuals, and families, sexual minority populations and other groups vulnerable to behavioral health disparities, are provided the services and support to thrive, participate in, and contribute to healthy communities.
OBHE will coordinate SAMHSA policies and programs to promote cross-cultural partnerships, relevant data collection, culturally appropriate outreach and engagement, and ready access to quality services. Some of the key drivers for OBHE’s work include:
- The HHS Secretary’s plan to reduce health disparities.
- The HHS Office of Minority Health five core goal areas: awareness, leadership, health system and life experience, cultural and linguistic competency, and data, research and evaluation
- The Agency for Health Research and Quality’s National Healthcare Disparities Report which identifies improving, maintaining and worsening health indicators, including depression, illicit drug use and suicide.
- SAMHSA’s Eight Strategic Initiatives: Prevention of Substance Abuse and Mental Illness; Trauma and Justice; Military Families; Health Reform; Recovery Support; Health Information Technology; Data, Outcomes and Quality; and Public Awareness and Support. These eight initiatives are the drivers for SAMHSA’s program, policies and budgeting. The SAMHSA Administrator is committed to ensuring that the specific issues for minority and disparity populations are addressed in each strategic initiative.
As SAMHSA develops this new Office, SAMHSA will welcome input and guidance from ethnic/racial and LGBT stakeholder groups, national and local leadership, and researchers and providers with expertise in behavioral health disparities.