Written By: Larke Huang and Michelle Flores, Office of Behavioral Health Equity July is Minority Mental Health Awareness Month. This gives us an opportunity to pause and ask ourselves: are we making progress in meeting the mental health needs of our diverse racial and ethnic populations across the country. In terms of disparities for these populations, have we improved access to care? Have we improved the quality of care? And, as a result, are we seeing better mental health outcomes in terms of promotion of mental health and appropriate treatment and recovery outcomes? The National Health Disparities Report, issued annually by the Department of Health and Humans Services (DHHS), shows that on selected access and quality indicators –including mental health measures - health care for minority populations has not improved and for poor populations has markedly worsened. A 2012 analysis of a dataset of 30,000 youth found that “disparities in use of mental health services persist for Black and Latino children” with 10% of white youth using mental health care compared to 4-5% of Black and Latino youth. Money spent for mental health care for white children increased; however for Latino children it decreased significantly. Suicide rates for American Indians in the 15-39 year old age range continue to be two to three times higher than other population groups. Suicide ideation and suicide rates continue to increase with age in the Asian American population.
So, what are we doing? Driven by a demographic imperative and a mental health system that has traditionally not reached out to diverse populations, there are increasing federal, state and local collaborative efforts to tackle these disparities across population groups. The Affordable Care Act (ACA) supports multiple strategies to target access issues: over half of the uninsured population are minorities, the ACA will expand coverage for potentially 13 million of these individuals; ACA provisions for integrating mental health and primary care and the support for “health homes” have been highlighted as strategies that will improve access for minority populations who more readily access services in primary care settings; improvement in standards for data collection will help pinpoint needs in these populations; and support for community health workers and promotoras will bring trusted messengers to engage people in these underserved communities.
The ACA also created offices of minority health in six agencies across the Department of Health and Human Services. SAMHSA developed the Office of Behavioral Health Equity (OBHE) to carry out workforce development, policy and practice initiatives and to implement requirements of the Secretary of DHHS plan of action to reduce disparities. To learn more about these efforts, go to www.samhsa.gov/obhe. To get the first-ever Secretarial Plan to reduce racial and ethnic disparities, go to http://www.minorityhealth.hhs.gov/npa/files/Plans/HHS/HHS_Plan_complete.pdf.
SAMHSA’s OBHE coordinates the National Network to Eliminate Disparities in Behavioral Health (NNED). This network of over 500 community –based diverse providers, plus over 500 state, county, academic affiliates, highlights innovative policies and practices around the country that improve outreach, engagement, and culturally appropriate services. The NNED offers virtual trainings and “communities of practice” and peer to peer technical assistance on specific needs and interventions requested by the NNED community. Information on funding opportunities, health reform, recent policy reports, and discussion groups are provided by the NNED. To learn more these opportunities, go to www.nned.net. To learn and participate in strategies around the country that are creating awareness of Minority Mental Health Month, see the NNED home page.
While we haven’t significantly moved the dial on mental health disparities, bringing together federal, state and local efforts in a new health environment, may begin to result in improvement in mental health outcomes for our diverse communities.