1. 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

 

  1. 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

 

  1. 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

 

  1. 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

 

  1. 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
  1. Boosting research specific to minorities
  2. Tailoring tx to those fears diff. Cultures and speaking different languages
  3. Integrate MH care with primary medical cares
  4. Increasing mental health services in isolated areas
  1. Barriers to Mental Health
  • Different types of barriers (i.e. individual, environmental, institutional)
  1. Individual
    1. Internalized racism (socio-political) Factor
    2. fear/mistrust (Cultural mistrust)- may come from experiences of sequenton, racism, and discrimination in America for the last 400 yrs
    3. beliefs/ values about MH problems
    4. When and whom to reveal personal problems to
    5. Economic factors (poverty, lower SES, more  stress)
    6. The stigma of mental health
    7. A misconception of strength and weakness

    2) Environmental barriers

  1. Family, kin, informed, support
  2. Clergy, church, common
  3. rural/urban locations and lack of access to MH care
  4. Environmental racism
  5. Language barriers
  6. The stigma attached to mental health issues
  7. Confidentiality3) Institutional Barriers
    1. Time
    2. Limitations
    3. Gatekeepers (discover between)
      1. clergy / church
      2. Primary care physicians
      3. Mental health specialist

    4) Mental Health Insurances

    1. Access to empirically supported and culturally sensitive interventions
    2. 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