July 30, 2015

By Sarah Powell

dr-africa.jpgMental health within minority communities is a sensitive issue that needs addressing. In a report from the Surgeon General in 2001, these issues were highlighted while exploring the problems of biases, stereotypes and racism within the healthcare system. The report also emphasized the benefits of shared historical experiences and culture.

At NAMI’s 2015 National Convention in San Francisco, Dr. Jei Africa examined the question, “What do we know right now?”

And what do we, as caretakers, as providers, as people with mental illness, actually know right now?

We know that:

  • People living with mental illness die an average of 25 years younger than the general population
  • The causes of these premature deaths are mostly preventable issues including: a lack of exercise (diabetes), smoking (cardiovascular), diet (hyper tension) and misuse of medication (liver damage)
  • Until the Mental Health Parity/Addict Equity Act of 2008, substance abuse therapy was paid for out-of-pocket by patients

These issues often affect people in minority communities at a much higher rate due to the additional issues including:

  • Language barriers
  • Communication barriers
  • Lack of family involvement from the provider’s end, with only focus on medical model
  • Lack of access to mental healthcare
  • Poorer quality of care
  • A culturally insensitive structural system
  • Lower rates of insurance
  • LGBTG members are two times more likely to have mental health issues
  • Transgendered have the highest level of suicide ideation at 36%-65%
  • Transgendered have a high level of suicide attempts at 16%-32%
  • Racism, bias, homophobia and discrimination in treatment settings
  • Providers who hold levels of stigma against minorities

In 2012, SAMSHA conducted a study that pointed out the major issues within Minority Mental Health. The study put financial hardship and lack of insurance as the ethnically universal concern. They found that the idea that mental healthcare “would not help” was the least cited reason across the board.

Studies show that depression is mentioned as a possible diagnosis for a person 43% of the time if the person is white, and only 27% if the person is black. This is despite the findings that 38% of white people were less likely to talk about their depression opposed to only 11% of black people. When questioned on this vast difference of behavior, providers answered that they think white people suffer more than black people. Acknowledging the present disparity in the system and hold providers to a standard that accommodates minorities is a necessary next step.

How can we change the healthcare system for the better?

  • Administering cultural training to providers
  • Providing financial literate classes for healthcare needs
  • Implementing a medical model that is adaptive instead of coercive

It is difficult at times for any person living with a mental health condition to receive the care that they need, but every person deserves equal opportunity for treatment.

Jei Africa, PsyD, MSCP, CATC-V, is a part of the Office of Diversity and Equity and Behavioral Health and Recovery Services within the San Mateo County Health System. For more highlights of the 2015 NAMI Convention, visit our convention page.

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