One in four.
That's how many adults are facing mental health problems in our country - and there is evidence to suggest that the burden of mental health issues may be even greater among minority communities. But too often, the causes and consequences of untreated mental health problems are left out of the conversation when we talk about improving the health of our most vulnerable and underserved. For communities that are already confronting widespread barriers to health and opportunity, the consequences of mental health problems - among them, decreased worker productivity, increased economic costs to the health care system and heightened risk of premature death, according to the
Substance Abuse and Mental Health Services Administration - can have a devastating toll.
During National Minority Mental Health Awareness Month, we recognize the costly burden of mental health problems for diverse communities, and we shine a light on avenues for prevention, treatment, wellness and recovery. We acknowledge that mental health problems touch all communities, in all parts of our country - but that the struggle for equity persists in mental health as well.
As a pediatrician, I have seen the impact of mental health problems in minority communities first hand. Half of all mental health disorders show first signs before a person reaches the age of 14, and three quarters of mental health disorders begin before age 24.
Early in my career, I remember one of my teenage patients was diagnosed with paranoid schizophrenia. I remember her family's uncertainty. Some of her family members questioned the diagnosis, suggesting that perhaps she was simply in the habit of acting out, because it was difficult to accept the diagnosis. I have seen how the issue of mental illness is still a taboo topic in many minority communities. But it is important for our communities to understand that mental health is part of our overall health and wellness.
According to the Centers for Disease Control and Prevention (CDC), suicide is the second leading cause of death for American Indians and Alaska Natives between the ages of 10 and 34. Asian American teens are more likely than their white peers to report considering or attempting suicide. (View data on mental health problems and treatment in minority populations).
Fueling these disparities is the fact that minorities have less access to mental health services; are less likely to receive needed mental health services; and those in treatment often receive a poorer quality of mental health care. According to the CDC, African Americans tend to delay seeking help for mental health issues, although they are 20 percent more likely to report having serious psychological distress than whites, and Latinos receive mental health treatment half as often as whites. Those who do get help may receive care that is not always respectful, or culturally and linguistically appropriate.
To help reduce these disparities and improve quality of care, the Office of Minority Health released the enhanced National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care, as a tool to help providers and organizations provide services that fit each person's unique needs at every point of contact. The CLAS Standards take into account the distinct culture of individuals and groups, and include aspects like language preference, spirituality, sexual orientation, gender preference and disability status - in addition to race and ethnicity.
The National CLAS Standards are one of the many ways that we are working to advance health equity. Another is the
Affordable Care Act. The Affordable Care Act, signed into law by President Obama in 2010, improves access to quality, affordable health care, with a focus on prevention and wellness. Because of the health care law, millions of Americans will gain health insurance and with that, gain opportunities for better health. The Affordable Care Act also invests in community health centers, expanding the number of health centers across the country and the services they provide such as behavioral health care. Also, funds will be distributed to Federally Qualified Health Centers to increase their capacity to meet the needs of minority communities. Work is being done in these health centers to integrate primary care and behavioral health, introducing mental health care services in familiar community care settings.
The health care law will also provide one of the largest expansions of mental health and substance use disorder coverage in a generation. Beginning in 2014, most small group and individual health plans will be required to cover 10 Essential Health Benefit categories, including mental health and substance use disorder services, and will be required to cover them on par with medical and surgical benefits. More than 62 million Americans are expected to benefit.
The Affordable Care Act is one of the most powerful pieces of legislation for reducing health disparities and is already transforming the landscape of access to health care and services, including behavioral health care-especially for those communities in greatest need.
Throughout National Minority Mental Health Awareness Month, let us take this opportunity to raise awareness about mental health, and encourage all of our communities to speak out about these issues, so that no one has to bear the burden of mental illness alone and that everyone can live a healthy life.
To learn more about federal resources about mental health, visit Mentalhealth.gov. For more information about minority health and health disparities, visit the Office of Minority Health website at
This blog also appears on PsychCentral: http://blogs.psychcentral.com/all-things/
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About the author: J. Nadine Gracia, MD, MSCE is the Deputy Assistant Secretary for Minority Health (Acting) in the Office of Minority Health at the U.S. Department of Health and Human Services. The Office of Minority Health is dedicated to improving the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparities.