Tuesday, July 16, 2013

Mental Health & Minorities


The Statistics

African Americans
   African Americans are 20% more likely to have serious psychological distress than non-Hispanic Whites.
   African Americans are half as likely as non-Hispanic Whites to receive antidepressant prescription treatments.
   The suicide rate among African Americans ages 10 to 14 increased 233% from 1980-1995, as compared to 120% of Non-Hispanic Whites.

American Indians/Alaska Natives
   Adolescent American Indian/Alaska Native females have four times the death rate due to suicide than non-Hispanic White females in the same age group.
   In 2009, suicide was the second highest cause of death among American Indian/Alaska Natives between the ages of 10-34.
   Violent deaths (i.e. unintentional injuries, homicide, and suicide) make up 75% of all deaths during the second decade of life among American Indian/Alaska Natives.

Asian Americans/Pacific Islander
   Asian American women over 65 years old have the highest suicide rate of all women in the same age group in the United States.
   Southeast Asian refugees are prone to suffer from post-traumatic stress disorder (PTSD) as a result of immigrating to the U.S. One study found that 70% of Southeast Asian refugees receiving mental health care were diagnosed with PTSD.
   (National Native Hawaiian/Pacific Islander mental health data is limited at this time.)

Hispanic/Mexican American
   Suicide attempts for Hispanic high school girls are 70% higher than for non-Hispanic White girls in the same age group.
   Hispanics are half as likely as non-Hispanic Whites to received mental health treatment.

Serious psychological distress among adults 18 years of age and over, percent, 2009-2010
African Americans
American Indian/ Native American
Asian Americans
Hispanic
Mexican American
Non-Hispanic White
3.8
5.2
1.6
3.6
2.8
3.1

Suicidal ideation among students in grades 9–12: Percent of students who seriously considered suicide

African Americans
American Indian/ Native American
Asian Americans
Hispanic
Non-Hispanic White
Male
7.8
14.3
17.1
10.7
10.5
Female
18.1
29.9
21.1
20.2
16.1

Suicidal ideation among students in grades 9–12: Percent of students who attempted suicide

African Americans
American Indian/ Native American
Asian Americans
Hispanic
Non-Hispanic White
Male
7.7
10.0
7.0
6.9
4.6
Female
8.8
19.9
15.0
13.5
7.9
Total
8.3
14.7
10.8
10.2
6.2


Why are minorities disproportionally affected?

According to the Office of Minority Health (OMH), evidence points to a constant inequality in the health status of minorities when compared to the general population of the United States.  In part, this is attributed to the much higher rates of poverty among minorities (when compared to non-minorities).  A report by the U.S. Surgeon General indicates that living in poverty has the greatest impact on mental illness rates; poor people are two to three times more likely to have a mental illness.  This means that not only are minorities more likely to be poor, they are also more likely to have a mental illness as well.

Other factors that contribute to the higher rates of mental illness among minorities include: racism, discrimination, lack of access to health care, lack of preventative care, lack of insurance, and lack of culturally/linguistically competent health care providers/services.  In many cases, lack of access to preventative care and lack of insurance delays diagnosis.  When minorities finally seek medical care, their illness may be more chronic and require more care than non-minorities.

Possible Solutions

While racism, discrimination, shame, and stigma prevent many members of minority populations from seeking help, those who seek medical care go to a primary care setting.  Therefore, it is important that primary care physicians go through training that gives them the tools they need to help these patients.  In addition, it is important to have culturally and linguistically competent health care providers at primary care settings.  
While these options may help solve some problems, they do not completely eliminate health inequities among minorities.  Policies related to social determinants of health have a great influence on health care use.  Therefore, policy advocacy is also an important factor to achieve health equity through social justice.
           
Community Organization at Work

The California Reducing Disparities Project (funded by the Mental Health Services Act) focuses on reducing disparities among minorities.  Specifically, they focus on five populations: African Americans; Asian/Pacific Islander; Latinos; Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ); and Native Americans.  To help reduce disparities, a Strategic Planning Workgroup (SPW) was created for each population to provide the California Department of Mental Health with community-defined evidence and strategies that are population-specific.
The Latino SPW consists of researchers, policy makers, public mental health leaders, consumers and advocates, community health leaders, ethnic services managers, and education professionals.  Together they have developed a long-term research and policy agenda to help reduce disparities in mental health services for Latinos in California.  The Latino SPW has created several goals including:

Short-term Outcomes
• Increase knowledge and awareness of systems, providers, communities, schools, and resources toward prevention and early intervention
• Infuse Latino SPW recommendation into all MHSA funded programs
• Conduct a series of statewide workshops and training sessions on implementation of Latino SPW recommendations
• Design metrics and measures to assess the impact of community defined solutions
• Establish local capacity-building panels aimed at reducing Latino mental health disparities

Long-term Outcomes
• Access to timely and high quality health care services
• Develop a culturally and linguistically competent mental health workforce
• Design integrated mental health and primary care services that are culturally and linguistically appropriate
• Employ community capacity building that promotes the connection of community strengths and health
• Create an educational campaign designed to reduce stigma and social exclusion
(Aguilar-Gaxiola, Loera, Méndez, Sala, Latino Mental Health Concilio, & Nakamoto, 2012, p. 12)

Latino SPW Matrix of Organizations with Community-Defined Evidence Programs
(Aguilar-Gaxiola, Loera, Méndez, Sala, Latino Mental Health Concilio, & Nakamoto, 2012, p. 47-50)

Information provided by:
U.S. Department of Health and Human Services Office of Minority Health
Mental Health Data & Statistics
Mental Health 101
&
University of California Davis Center for Reducing Health Disparities
Community-Defined Solutions for Latino Mental Health Care Disparities: California Reducing Disparities Project
http://www.ucdmc.ucdavis.edu/newsroom/pdf/latino_disparities.pdf

3 comments:

  1. Vanessa,
    Wow! These statistics are incredibly powerful. Mental health is such a special issue for me from both a personal and professional perspective, and I really believe in individualistic care. The statistics that you provided validate this by showing the distinct needs across different minority groups. What a great reminder of the importance of meeting our patients/clients where they are and creating solutions from their lens!

    Thank you so much for your post!
    Emily

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  2. I completely agree with Emily- your statistics were very powerful. It is sad the vicious cycle we find ourselves in when poverty is considered. So many things (of which you mentioned can be prevented with better access to health care. I like that you brought up lack of culturally competent health care providers. Many culture do my trust the health system and will not seek care because of this. Great job on your detailed discussion!

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  3. Vanessa,

    This statistics are so very true. I have experienced them first hand through my job as a Death Investigator. I noticed that Hispanic females that are young in age often commit suicide by hanging. There have been cases of African American men committing suicide. There are a number of factors as to why these minorities are not seeking treatment. First, if the person is in a low-income home with no health and mental health insurance. They are less likely to seek treatment for depression.

    Loan

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