Mental illness does not discriminate!
According to the World Health Organization, one in four
people in the world will be affected by mental health or brain disorders
during their lives, but few will seek or receive help.
With proper treatment, people with mental illness can
lead productive lives and be a vital part of their communities (United
Nations 2001, Agency’s Annual Health Report).
Mental health is fundamental to health. It is paramount to physical
well-being, family relationships and successful contributions to society
(Mental Health: A Report of the Surgeon General, 1999).
Effective treatments are available for most disorders,
but Americans do not share equally in the best that science has to offer
(Mental Health: A Report of the Surgeon General, 1999).
Even when help is available, nearly two-thirds of people
with a known mental disorder never seek professional help, often because
of shame (United Nations 2001, Agency’s Annual Health Report).
Stigma and shame deter many Americans, including racial
and ethnic minorities from seeking treatment (Mental Health: A Report
of the Surgeon General, 1999).
Disparities in mental health services exist for racial
and ethnic minorities, and thus, mental illness exacts a greater toll
on their overall health and productivity (Mental Health: A Report of
the Surgeon General, 1999).
United States 2000 Census data shows people of Hispanic backgrounds
are the fastest growing ethnic group in our country. In fact, the U.S.
Census Bureau estimates that ethnic and racial minorities will constitute
47 percent of the nation’s population by the year 2005.
Multiple studies show that in comparison to the majority
population, minorities have less access to and availability of care,
and tend to receive poorer quality mental health services (Mental Health:
Culture, Race, and Ethnicity, A Supplement to Mental Health: A Report
of the Surgeon General). This finding has been found repeatedly when
studying use of services by Hispanics.
Studies show that poor mental health and psychological
distress are linked to poverty – In 1999, the overall rate of poverty
in the U.S. was 12
percent. The rates were much higher among most racial and ethnic minority
groups (i.e., 23 percent for Hispanics; 24 percent for African Americans;
and 26 percent for American Indians).
According to Mental Health: Culture, Race, and Ethnicity,
A Supplement to Mental Health: A Report of the Surgeon General, those
in the lowest strata of income, education and occupation are two to
three times as likely to have a mental disorder as the highest strata
and often lack health insurance.
Barriers to minorities seeking treatment include cost of care,
societal stigma, and the fragmented organization of services (Mental
Health: Culture, Race, and Ethnicity, A Supplement to Mental Health:
A Report of the Surgeon General). According to the same report, additional
barriers include clinicians’ lack of awareness of cultural issues, bias,
or inability to speak the client’s language, and the client’s fear and
mistrust of treatment. Many minorities have also been found to have
different styles of coping with day to day problems and unique perspectives
on mental illness and its treatment
for Mental Health Professionals:
According to the U.S. Department of Health and Human Services,
culture is broadly defined as a common heritage or set of beliefs, norms,
and values. It refers to the shared, and largely learned attributes
of a group of people.
Mental health workers must be aware of and have an understanding
of the wide-ranging role culture plays in shaping what people bring to
the clinical setting and how it shapes treatment professionals.
Mental health workers must consider cultural factors
and influence when working with people of all ethnicities and cultures.
Cultural influences account for variations in the way
consumers communicate their symptoms, which ones they choose to report,
whether they seek treatment or not, what type of help they may seek,
and what types of social support and coping styles are available.
According to the U.S. Surgeon General’s report, Mental
Health: Culture, Race and Ethnicity, a supplement to the Surgeon General’s
1999 report on mental health, “Cultural differences must be accounted
for to ensure that minorities, like all Americans, receive mental health
care tailored to their needs”.
according to the above report, cultural influences have been found to
shape treatment professionals, who share a set of beliefs, norms and
values with their colleagues. As a result, clinicians can view symptoms,
diagnoses and treatments in ways that diverge from the views of the
patients they treat.
Needed to Close the Gap:
Nationally accepted cultural competence standards must
be established and practiced to ensure clinicians have adequate training
in working with the country’s diverse groups.
information is needed to understand the belief systems and attitudes
of minority groups and how those beliefs and attitudes impact their
decision to utilize or not utilize mental health services, which services
they choose to utilize, and at what point they enter the mental health
system. To conduct quality research, funding and qualified researchers
who are representative of the target community are needed.
More effort is also needed to improve geographical availability
of mental health services, improve language access, coordinate care
to vulnerable, high-need populations through early intervention programs,
and to integrate mental health with primary care, where most minorities
appear to prefer to receive treatment.
must be made to encourage and support racial and ethnic minority group
members to enter into and succeed in health care and research professions.
This would address such issues as language barriers and help to increase
representation of Hispanics in services utilized by members of this
ethnic group. Having a larger pool of Hispanic health care and research
professionals may contribute to the development of professionals more
likely to dedicate themselves to providing care in underserved Hispanic
communities and/or who may provide their knowledge and skills to advance
solutions to health problems faced by Hispanics.
awareness and education campaigns must be developed in order to educate
Hispanics about mental health problems and illnesses. These campaigns
must address issues
Support the development of and expansion of programs
available in Spanish for families caring for a person with mental illness.
These programs can help reduce the stress and burden experienced by
many family members caring for a mentally ill relative.
New Jersey Mental Health Institute, Inc.