This week’s blog contains some amazing resources for enacting true change. Let’s challenge each other to take one actionable step this week to reduce mental health care disparity for persons of color. This week we will look at mental health disparity for Asian Americans.
According to the US HHS Office of Minority Health:
Mental and Behavioral Health – Asian Americans
- Suicide was the leading cause of death for Asian/Pacific Islanders, ages 15 to 24, in 2019.
- Asian American males in grades 9-12 were 30 percent more likely to consider attempting suicide than non-Hispanic white male students in 2019.
- In 2018, Asians were 60 percent less likely to have received mental health treatment than non-Hispanic whites.
- Southeast Asian refugees are at risk for post-traumatic stress disorder (PTSD) associated with trauma experienced before and after immigration to the U.S.
- One study found that 70 percent of Southeast Asian refugees receiving mental health care were diagnosed with PTSD.
- The overall suicide rate for Asians is less than half that of the non-Hispanic white population.
Achieving equity in healthcare can feel overwhelming. The Office of Minority Health has an amazing resource for creating equity in behavioral health delivery: Behavioral Health Implementation Guide for the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (Behavioral Health Guide). This guide, report, and toolkit are filled with action steps that we can take to change the landscape we are currently working in.
What can we do to help reduce these disparities? (according to NAMI):
Advocating for Change
Write, call or talk to legislators — both local and federal — to support efforts to:
- Improve access to and the quality of mental health services for underserved people.
- Ensure providers are trained on cultural competence.
- Make linguistic services (interpretation and translation) available in treatment settings.
- Provide holistic mental health services and offer many care modalities (including trauma-informed care, psychiatry, psychology, faith-based care, community-based care, and low-cost alternatives to care).
Thank you for all you are doing to enact change!
Today begins our first full week of BIPOC Mental Health Month. What has your team planned for this week to raise awareness of mental health disparity? As mental health advocates, we need to create actionable steps to raise awareness and reduce the chasm of care experienced by persons of color. This week let’s start by looking at some statistics for Hispanic Americans.
According to the US HHS Office of Minority Health:
Mental and Behavioral Health – Hispanic Americans
- The death rate from suicide for Hispanic men was four times the rate for Hispanic women in 2018.
- However, the suicide rate for Hispanics is less than half that of the non-Hispanic white population.
- In 2019, suicide was the second leading cause of death for Hispanics, ages 15 to 34.
- Suicide attempts for Hispanic girls, grades 9-12, were 30 percent higher than for non-Hispanic white girls in the same age group in 2019.
- In 2018, Hispanics were 50 percent less likely to have received mental health treatment than non-Hispanic whites.
- Poverty level affects mental health status. Hispanics living below the poverty level are twice as likely to report serious psychological distress compared to Hispanics over twice the poverty level.
If you would like to understand better the complexities of mental health disparity and how the cultural influence of both patient and provider have influenced mental health care today, I would highly recommend watching this recent training done by The National Institute for Mental Health. Dr. Lewis-Fernández presented Addressing Ethnoracial Disparities in Mental Health Risk, Assessment, and Service Delivery last month. He is a professor of clinical psychiatry at Columbia University and director of the New York State Center of Excellence for Cultural Competence and the Hispanic Treatment Program, and co-director of the Anxiety Disorders Clinic, at New York State Psychiatric Institute (NYSPI). It is time well spent to watch this training!
If you are an APNA member, they offer a free CEU course for July titled: I’m Not Crazy! Destigmatizing Schizophrenia in the African American Community | Empirical Validation of the Racial/Ethnic/Cultural Sensitivity Scale. It is also a very good presentation as well.
What can we do to help reduce these disparities? (according to NAMI):
Providing Culturally and Linguistically Appropriate Care
- Follow the Culturally and Linguistically Appropriate Services Standards developed by the U.S. Department of Health and Human Services.
- Provide equitable and respectful quality care and services inclusive of the cultural health beliefs and practices of the community you serve.
- Offer free language assistance and other needed assistance to individuals with limited English proficiency.
- Hire diverse, bilingual staff that is representative of the community served.
Looking forward to hearing about the steps you are taking in the coming weeks!
Today kicks off BIPOC (Black, Indigenous, and People of Color) Mental Health Month. Health disparity continues to impact the BIPOC communities at much higher rates than white communities. Continued focus on reducing this disparity as mental health providers are our responsibility. Each week, I will highlight different groups to share their communities’ struggles and techniques for supporting change.
According to the US HHS Office of Minority Health:
Mental and Behavioral Health – African Americans
- In 2019, suicide was the second leading cause of death for blacks or African Americans, ages 15 to 24.
- The death rate from suicide for black or African American men was four times greater than for African American women in 2018.
- The overall suicide rate for black or African Americans was 60 percent lower than that of the non-Hispanic white population in 2018.
- Black females, grades 9–12, were 60 percent more likely to attempt suicide in 2019 than non-Hispanic white females of the same age.
- Poverty level affects mental health status. Black or African Americans living below the poverty level are twice as likely to report serious psychological distress compared to those over twice the poverty level.
- A report from the U.S. Surgeon General found that from 1980 – 1995, the suicide rate among African Americans ages 10 to 14 increased 233 percent compared to 120 percent of non-Hispanic whites.
What can we do to help reduce these disparities? (according to NAMI):
Promoting a Culture of Equity and Inclusion
- Be an advocate when there is an opportunity to speak out on behalf of mental health for underrepresented groups and communities.
- Share information you’ve learned about what forms quality care from a cultural and equity lens.
- Show compassion and seek to understand the experience of individuals with identities different from your own.
- Do not assume that low treatment rates by cultural or social group members are due to a lack of effort in seeking care. Instead, consider any underlying challenges — individuals are less likely to seek help or engage in treatment if they cannot find a provider they can trust, who understands their identity and will treat them with dignity and respect.
More to come in the following weeks; looking forward to learning more about reducing health disparities and advocating for the underserved. Thank you for all you do to help so many!
As we enter the last week of Mental Health Month, I hope you show up to make it count! This week I want to talk about mental health awareness that has been in the news. Our Bloomfield, Iowa, therapist shared a wonderful article on Oprah’s interview with Prince Harry about mental health. Oprah is doing a series called “The Me You Can’t See” on mental illness, health, and wellbeing, including people, and celebrities, from around the globe. Prince Harry discusses his trauma, how his wife identified his need for therapy, and how therapy has impacted him. He speaks about how telling your story can heal others. Click through to the article if you would like to learn more.
I attended a class this year on mental health healing through storytelling. Storytelling has a rich history that holds many purposes. Studies have shown storytelling even improves blood pressure in patients with hypertension. (ACP)
Here is a great article on tips we could use with our patients who want to write their own stories. It includes a poem by Della Hicks-Wilson that says it all about storytelling:
Darling,
You feel heavy
Because you are too
Full of truth.
Open your mouth more.
Let the truth exist
Somewhere other than
Inside your body.
Thank you for all you have done this May to break down barriers and end stigma!
As we enter the third week of Mental Health Month, let’s keep up the momentum! Today I want to share some statistics from Mental Health America’s 2021 The State of Mental Health in America report. They produce this report that includes specific state information that would be helpful to you and your communities, so please download the report to utilize.
Here are some key takeaways:
- Youth mental health is worsening.
- 9.7% of youth in the U.S. have severe major depression, compared to 9.2% in last year’s dataset.
- This rate was highest among youth who identify as more than one race, at 12.4%.
- Even before COVID-19, the prevalence of mental illness among adults was increasing.
- In 2017-2018, 19% of adults experienced a mental illness, increasing to 1.5 million people over last year’s dataset.
- Suicidal ideation among adults is increasing.
- The percentage of adults in the U.S. who are experiencing serious thoughts of suicide increased 0.15% from 2016-2017 to 2017-2018 – an additional 460,000 people from last year’s dataset.
- There is still an unmet need for mental health treatment among youth and adults.
- 60% of youth with major depression did not receive any mental health treatment in 2017-2018.
- Even in states with the greatest access, over 38% are not receiving the mental health services they need. Among youth with severe depression, only 27.3% received consistent treatment.
- 23.6% of adults with a mental illness reported an unmet need for treatment in 2017-2018. This number has not declined since 2011.
- The percentage of adults with a mental illness who are uninsured increased for the first time since the passage of the Affordable Care Act (ACA).
- Nationally, 10.8% are uninsured, totaling 5.1 million adults. This figure differs dramatically across states – in New Jersey (ranked #1), 2.5% of adults with AMI are uninsured, compared to 23% in Wyoming (ranked #51).
Thank you for all you do to make a difference in the lives of those we treat!
I read a powerful statement last week that I wanted to shout from the rooftops: MENTAL ILLNESS IS NOT A CHARACTER DEFECT! There are many reasons why people develop mental illness. Some are genetic or biological. Some result from childhood trauma or overwhelming stress at school, work, or home. Some stem from environmental injustice or violence. Sometimes, we simply don’t know. Regardless of the reasons, these are health problems just like cancer, arthritis, or diabetes. So why does society look at people with mental illness, including substance use disorders, differently?
The answer is Stigma. Stigma seriously affects the well-being of those who experience it. Stigma affects people while they are experiencing problems, in treatment, while they are healing, and even when their mental health problem is a distant memory. Stigma profoundly changes how people feel about themselves and how others see them.
Here are some disheartening statistics on mental health stigmas:
- Research published in the Journal of Health and Social Behavior (Vol. 41, No. 2) finds that 68 percent of Americans do not want someone with a mental illness marrying into their family, and 58 percent do not want people with mental illness in their workplaces.
- Minority groups experience greater Stigma around mental illness. (Connecticut DMHAS)
- Television often portrays people with mental illness in a damaging light. (PsychCentral)
What can we do in our communities to end the Stigma?
This website offers great suggestions on our language and how to use it to reduce Stigma.
This resource is from the United Kingdom; it provides great resources for ending the Stigma around mental health.
We have the opportunity to be at the forefront of stigma changes in our community. Thank you for all you are doing to fight the Stigma!
This week kicks off Mental Health Month (MHM) 2021. If this is the first May you have been on the PMC team, you are in for a great month! Every year our teams work diligently to stop the stigma and raise awareness of mental illness and its treatments in May. The pandemic’s effects make MHM even more important. According to WHO, far from being an equalizer, the COVID-19 pandemic has exposed just how vulnerable many of our social and health systems are in the face of major public health shocks. The impact of coronavirus for people from marginalized communities, particularly those with behavioral health conditions, who are experiencing disproportional health, economic, and social impacts from the evolving pandemic have been extreme. Let’s look at some of the diagnoses we treat across our service lines (according to the NIMH):
- Generalized Anxiety Disorder (GAD) affects 6.8 million adults or 3.1% of the U.S. population, yet only 43.2% receive treatment.
- Women are twice as likely to be affected as men. GAD often co-occurs with major depression.
- Panic Disorder (PD) affects 6 million adults or 2.7% of the U.S. population.
- Women are twice as likely to be affected as men.
- Social Anxiety Disorder (SAD) affects 15 million adults or 6.8% of the U.S. population.
- SAD is equally common among men and women and typically begins around age 13.
- According to a 2007 ADAA survey, 36% of people with social anxiety disorder report experiencing symptoms for ten or more years before seeking help.
- Specific phobias affect 19 million adults or 8.7% of the U.S. population.
- Women are twice as likely to be affected as men.
- Symptoms typically begin in childhood; the average age of onset is seven years old.
- Obsessive-Compulsive Disorder (OCD) affects 2.2 million adults or 1.0% of the U.S. population.
- OCD is equally common among men and women.
- The average age of onset is 19, with 25 percent of cases occurring by age 14. One-third of affected adults first experienced symptoms in childhood.
- Post-traumatic Stress Disorder (PTSD) affects 7.7 million adults or 3.5% of the U.S. population.
- Women are more likely to be affected than men.
- Rape is the most likely trigger of PTSD: 65% of men and 45.9% of women victims of rape will develop the disorder.
- Childhood sexual abuse is a strong predictor of lifetime likelihood for developing PTSD.
- Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15 to 44.
- MDD affects more than 16.1 million American adults, or about 6.7%of the U.S. population age 18 and older in a given year.
- While the major depressive disorder can develop at any age, the median age at onset is 32.5 years old.
- MDD is more prevalent in women than in men.
- Persistent depressive disorder or PDD (formerly called dysthymia) is a form of depression that usually continues for at least two years.
- PDD affects approximately 1.5 percent of the U.S. population age 18 and older in a given year. (about 3.3 million American adults).
- Only 61.7% of adults with MDD are receiving treatment.
- The average age of onset is 31 years old.
- Anxiety disorders affect 25.1% of children between 13 and 18 years old. Research shows that untreated children with anxiety disorders are at higher risk of performing poorly in school, missing important social experiences, and engaging in substance abuse.
- Mental health disorders are the most common diseases of childhood.
- Of the 74.5 million children in the United States, an estimated 17.1 million have or have had a psychiatric disorder — more than the number of children with cancer, diabetes, and AIDS combined.
- Half of all psychiatric illness occurs before the age of 14, and 75 percent by 24.
- Children and adolescents with psychiatric illness are at risk for academic failure, substance abuse, and a clash with the juvenile justice system — all of which come at a tremendous cost to them, their families, and the community.
The sobering statistics highlight the need for further work. This year’s MHM theme remains Tools to Thrive. The PMC Communications team worked hard to deliver amazing resources for your use. If you haven’t seen them yet, PMC employees can access them here.
Some themes to spread this MHM according to Mental Health America:
- Adapting after trauma and stress
- Dealing with anger and frustration
- Getting out of thinking traps
- Processing big changes
- Taking time for yourself
- Radical acceptance
Let’s work together to stop the stigma. Thanks for all you are doing to serve so many!
