- Need for Mental Health Care- A/A are over-represented in high-need populations that are particularly at high risk for mental illness
- Homeless: A/A represent only 12% of the US population, but make up 40% of the homeless population
- Incarcerated: nearly ½ of persons in state and federal persons and 40% of juveniles in legal controversy are A/A
- Foster care and child welfare: A/A child and youth constitute about 45% of children in public foster care and more than ½ of all children waiting for adoption
- Violence- a/ an of all cops are more likely to be exposed/ victims of service crimes than non-Hispanic whites
- A study reported- 25% a/a youth exposed to violence diagnosed criteria for PTSD
- Availability of MH Services
- The public MH safety of hospitals commonly health counters and local health department are initial to a/ an especially in high need populations
- Yet a/ an account for only 2% of a psychiatrist, 2% of psychologist and 4% of social works in the US. This leaves few options for those who prefer to by someone of their own race
- Access to MH Services- (Delayed TX hurts Blacks)
- Nearly 1 in 4 A/A is unsure, compared to 16% vs. pop
- The disparity in rates of employer-based health coverage
- Just 50% A/A employes vs 70% for non Hispanic whites
- Medicaid only covers 21% of A/A
- 25% A/A doesn’t have health insurance
- 37% of Hispanics don’t have health insurance
- Use of MH Services
- Overall only ⅓ of Americans with mental illness or MH problem get care
- The percentage of A/A receive needed care is on ½ of that of non Hispanic whites
- A/A is more likely to go to GP or the emergency than mental health specialist
- A/A are underrepresented in out pt. But over-represented in pt. setting
- And then they do get tx; it is often substandard too late
- Reconnection in silence has led to offers tx for mental illness and MH problems which should benefit every American of every race, ethnicity, and culture- according to satches
- Everyone in need must and should have access to high quality efficient and affordable mental health services
- Satcher says too often our mental health problems are left to play themselves out in the nations stress, homelessness, persons in the homes and schools of or childcare
- This morning news: 3-year-old allegedly killed by father on disability where mom was at work
- Recommendations to combat the disparities in minority access to mental health care
- Boosting research specific to minorities
- Tailoring tx to those fears diff. Cultures and speaking different languages
- Integrate MH care with primary medical cares
- Increasing mental health services in isolated areas
- Barriers to Mental Health
- Different types of barriers (i.e. individual, environmental, institutional)
- Individual
- Internalized racism (socio-political) Factor
- fear/mistrust (Cultural mistrust)- may come from experiences of sequenton, racism, and discrimination in America for the last 400 yrs
- beliefs/ values about MH problems
- When and whom to reveal personal problems to
- Economic factors (poverty, lower SES, more stress)
- The stigma of mental health
- A misconception of strength and weakness
2) Environmental barriers
- Family, kin, informed, support
- Clergy, church, common
- rural/urban locations and lack of access to MH care
- Environmental racism
- Language barriers
- The stigma attached to mental health issues
- Confidentiality3) Institutional Barriers
- Time
- Limitations
- Gatekeepers (discover between)
- clergy / church
- Primary care physicians
- Mental health specialist
4) Mental Health Insurances
- Access to empirically supported and culturally sensitive interventions
- Institutional racism
Strategies that may influence the engagement of MH service
I- Healthcare system and politics can influences engagement of A/A in the current MH system
- Many A/A do not have health insurance thus do not have access to MH tx in traditional setup (US) Dept. of Health and Human Services
- Politicians influence where MH Services are
- As well as agency