WHO has the least access to mental health care?
There are significant disparities in mental healthcare access among different racial and ethnic groups. One survey finds that white adults (23%) are more likely than black (13.6%) and Hispanic (12.9%) adults to receive any mental health treatment.
Which ethnic group in the US uses mental health services the least?
Asian American/Pacific Islanders are least likely to seek mental health services than any other racial/ethnic group. They are also three times less likely to access mental health services than their white counterparts. Trauma also has an outsized impact on diverse populations.
Which racial group is most likely to receive mental health services?
Outpatient mental health service use in the past year was highest for adults reporting two or more races (8.8 percent), white adults (7.8 percent), and American Indian or Alaska Native adults (7.7 percent), followed by black (4.7 percent), Hispanic (3.8 percent), and Asian (2.5 percent) adults.
Which group is least likely to seek mental health services because of the stigma associated with it?
Mental health stigmas exist worldwide and can impact anyone of any race or ethnicity, creating barriers to access available mental health treatment. According to Mental Health America (MHA), Asian Americans are the least likely racial group in the United States to seek mental health services.
What race has least mental illness?
Results: Asians had the lowest lifetime prevalence of mental disorders (23.5%), followed by Blacks (37.0%), Latinos (38.8%), and Whites (45.6%).
What race has the highest depression rate?
Major depression was most prevalent among Hispanics (10.8%), followed by African Americans (8.9%) and Whites (7.8%). The odds of depressive disorders among older Hispanics were 44% greater than among Whites (OR = 1.44; 95% CI = 1.02, 2.04), representing a significantly greater prevalence of major depression.
What demographic is most affected by mental illness?
Prevalence of Any Mental Illness (AMI) This number represented 21.0% of all U.S. adults. The prevalence of AMI was higher among females (25.8%) than males (15.8%). Young adults aged 18-25 years had the highest prevalence of AMI (30.6%) compared to adults aged 26-49 years (25.3%) and aged 50 and older (14.5%).
Why do minorities have less access to healthcare?
Compared with white persons, black persons and other minorities have lower levels of access to medical care in the United States due to their higher rates of unemployment and under-representation in good-paying jobs that include health insurance as part of the benefit package (Blendon et al., 1989; Trevino et al., 1991 ...
How does race affect mental health treatment?
As documented in “Mental Health: A Report of the Surgeon General”24 and its supplement, “Mental Health, Culture, Race and Ethnicity”19, racial and ethnic minorities have less access to mental health services than do whites, are less likely to receive needed care and are more likely to receive poor quality care when ...
What groups are stigmatized?
Blacks, the obese, people with disabilities, the mentally ill, the homeless, the physically unattractive, and car-crash victims are all examples of stigmatized groups. Journal of Applied Social Psychology, 2005, 35, 1, pp.
How does culture affect mental health?
Culture can influence how people describe and feel about their symptoms. It can affect whether someone chooses to recognize and talk about only physical symptoms, only emotional symptoms or both. Community Support.
What ethnic group typically has the highest rate of mental illness disorder?
People who identify as being two or more races (24.9%) are most likely to report any mental illness within the past year than any other race/ethnic group, followed by American Indian/Alaska Natives (22.7%), white (19%), and black (16.8%).
Why are minorities underrepresented in mental health research?
Finally, minorities are underrepresented in mental health research, a factor that is related to the differential research infrastructure.
Why are mental health issues culturally influenced?
People’s conceptions of the nature, causes, and cures of mental illness are culturally influenced. 11 In some Asian cultures, for example, there may be no distinction between physical and psychological problems because “the psyche and soma” are seen as a whole. However, the dominant Western conceptualization of mental health relies on the notion of Cartesian dualism, which views the mind and the body as separate entities. This difference in the conceptualization of mental illness may explain why some Asian Americans experience psychological distress in somatic terms and seek help from medical doctors for their psychological problems. While primary care physicians are essential in recognizing and diagnosing mental illness and can provide pharmacotherapy to their clients, they can rarely provide psychotherapy. Therefore, it may be challenging for primary care physicians to address problems such as stigma, underutilization of therapy, and premature termination.
What are the physical barriers to mental health?
Physical and Structural Barriers. Physical barriers to seeking mental health services may be related more to social class than to culture. Some researchers have suggested that the lack of knowledge or awareness of available services stands out as one of the major reasons for underutilization.
Why do ethnic minorities drop out of therapy?
Few research studies have explored the factors related to treatment dropout among ethnic and racial minorities, largely because of the costs and the resources associated with psychotherapy studies. But Stanley Sue and his colleagues at the University of California, Los Angeles, and the University of California, Santa Barbara, found that lack of accessibility to culturally appropriate services and the lack of bilingual and bicultural staff may relate to clients’ decisions to initiate and continue treatment. 18 The ethnic match between therapist and client has been found to be especially effective in reducing premature termination and producing better outcomes with clients who do not speak English as their primary language. Other studies have shown that clients, especially Asian Americans, who received ethnic-specific mental health services had higher return rates and stayed in treatment longer. The relevance and credibility of the mental health treatment also plays an important role in retaining clients, since racial and ethnic minority clients may prefer a more directive and problem-solving approach that provides quick solutions and tangibly relieves the distress. Such an approach may differ from more traditional psychoanalytic techniques that rely on exploration and interpretation and take a less directive stance. In addition, a recent meta-analysis summarized findings from 76 studies and provided support for the effectiveness of culturally adapted interventions, especially when they targeted a specific group and were conducted in the clients’ native language. 19
What are the barriers to accessing mental health services?
But mental health service delivery systems can often be complicated, and clients may encounter a variety of barriers in their attempt to access services. Financial concerns and social stigma are among the most frequent deterrents to receiving appropriate care.
What are the barriers to seeking help?
In general, research shows that individuals who have low levels of acculturation may perceive more barriers to seeking help. Cross-cultural barriers to seeking help can be classified in four categories: cognitive, affective, value orientation, and physical or structural. 11. Cognitive Barriers.
What was the purpose of the President's Freedom Commission on Mental Health?
President Bush established the President’s New Freedom Commission on Mental Health in 2002 to recommend policies for adoption by federal, state, and local governments to better coordinate and take advantage of existing mental health services. The commission’s findings, similar to those of previous studies, revealed the existence of unmet needs and barriers to receiving mental health services and noted the prevalence of mental disorders across all populations, regardless of age, race, ethnicity, or gender. The commission recommended setting six specific goals to transform the existing mental health system: (1) understanding that mental health is essential to overall health, (2) providing consumer- and family-driven mental health care, (3) eliminating disparities, (4) providing early detection, assessment, and treatment, (5) incorporating research findings into practice, and (6) using technology in mental health care and information access. 10
How does culture affect mental health?
Attitudes toward mental illness vary among individuals, families, ethnicities, cultures, and countries. Cultural and religious teachings often influence beliefs about the origins and nature of mental illness, and shape attitudes towards the mentally ill. In addition to influencing whether mentally ill individuals experience social stigma, beliefs about mental illness can affect patients’ readiness and willingness to seek and adhere to treatment. (6) Therefore, understanding individual and cultural beliefs about mental illness is essential for the implementation of effective approaches to mental health care. Although each individual’s experience with mental illness is unique, the following studies offer a sample of cultural perspectives on mental illness.
Why should concepts and treatments for depression take into account diverse perspectives on mental illness?
The authors report that “conceptualizations and treatments” for depression should take into account diverse perspectives on mental illness in order to maximize the effectiveness of mental health care delivery programs. (14)
What is stigma in mental health?
Mental illness stigma is defined as the “devaluing, disgracing, and disfavoring by the general public of individuals with mental illnesses”. (1) Stigma often leads to discrimination, or the inequitable treatment of individuals and the denial of the “rights and responsibilities that accompany full citizenship”.
Does genetic attribution affect mental health?
Genetic attribution of mental illness significantly reduced unwillingness to marry and reproduce among Chinese Americans, but it increased the same measures among European Americans, supporting previous findings of cultural variations in patterns of mental illness stigmatization. (8)
What is the role of ethnicity in psychopharmacology?
9 Research has demonstrated ethnic differences in the clinical presentation, treatment, clinical response, and outcome of mental illnesses. Some of these differences can be explained by genetic factors; others are influenced by culture. Pharmacogenomic and pharmocogenetic research aims to identify clinically meaningful predictors of drug efficacy and/or adverse-effect burden. 10 While this is a promising approach, few studies in psychiatry have yielded compelling results.
How many people will be ethnic minority by 2050?
1 By 2050, it is projected that these groups will account for nearly half of the US population. The landmark report Culture, Race, and Ethnicity 2 documented the lack of access and the poor quality of mental health care among minorities-patients are less likely to receive diagnosis and treatment for a mental illness and are more likely to die by suicide; ethnic minority patients are even less likely to get help.
What is ethnocultural diversity?
As ethnocultural diversity within the US grows, psychiatrists are increasingly evaluating attitudes, beliefs, and behaviors of a broad spectrum of ethnocultural groups. This article is the first in a series appearing in Psychiatric Times on Minority Mental Health. Topics will present different perspectives on efforts and directions ...
What is cultural tailoring?
Cultural tailoring refers to the creation of interventions that use information about a given individual to determine what specific content he or she will receive, the contexts surrounding that information, by whom it will be presented, and the way it will be delivered. Overall, tailoring aims to enhance the relevance of the intervention and improve intervention response.
When did cultural tailoring become popular?
Use of cultural tailoring has grown exponentially since the 1990s, especially with chronic diseases and, to a lesser extent, with mental illness. More research is needed that compares the effectiveness of different models of care and culture.
What are the dimensions of cultural tailoring?
Bernal and colleagues4 developed a framework with 8 dimensions as foci in the cultural tailoring programs: language, persons, metaphors, content, concepts, goals, methods, and context. In a critical review of tailoring interventions, Baker and colleagues 5 found that interventions tailored to address barriers of existing practices may improve care and patient outcomes.
What are the differences between cultures in mental health?
Cultures vary in how they interpret and understand mental illness . A 2010 study conducted in inner-city Hartford, Conn., found that European-Americans “tended to express beliefs about mental illness that were aligned with the biomedical perspectives on disease.” In contrast, Latino and African-American study participants more commonly emphasized “non-biomedical interpretations” of mental illness symptoms—meaning that they focused more on spirituality, moral character and social explanations for mental illness.
What is the culture of mental health?
Many people are unable to attain their highest level of mental wellness for several reasons, and the culture of mental health is just one barrier. Closely tied to race and ethnicity, “culture” refers to a group of people who share a set of beliefs, norms, values and attitudes. The culture we associate with influences what we think and what we do—especially when it comes to mental health.
How can public education help with mental health?
Public education is an important tool that can be used to combat stigma and reduce the shame surrounding mental illness. Educational materials—such as pamphlets, videos and PowerPoints—should cover the symptoms and signs of mental illness, treatment options, and what mental health services are available and how to access them. Include relatable personal stories from individuals who received care in the community.
What should be covered in mental health training?
The training programs should cover what is known about the culture of mental health, including symptom expression and general attitudes and beliefs regarding mental illness. Staff should be taught to be open and accepting of patients’ preferred coping styles.
Why do mental health organizations need to provide ongoing education and training?
Mental health organizations must provide ongoing education and training in culturally appropriate service delivery for their staff especially if the staff comes from backgrounds that are different from their clientele’s. This education will help build trust between patient and professional and increase engagement.
How can community partnerships help with stigma?
Community partnerships are also vital to improving use of local services and reducing culture-based stigmas. Start a mental health conversation or program in a part of the community that makes sense to the target population. Teach community leaders how to respond to mental health concerns, educate on the topic of mental health and start peer-led support groups.
What is culture in psychology?
Closely tied to race and ethnicity, “culture” refers to a group of people who share a set of beliefs, norms, values and attitudes. The culture we associate with influences what we think and what we do—especially when it comes to mental health.
How can we eliminate mental health disparities?
Strategies to improve health care in general, such as improving access to care and improving the quality of care , would do much to eliminate mental health care disparities. However, a diverse mental health workforce, as well as provider and patient education, are important to eliminating mental health care disparities.
How can a diverse workforce help reduce mental health disparities?
Increasing the proportion of racial minority providers is considered an important factor for improving health disparities. This is even more important for mental health care where ethnic minorities are even more poorly represented than in health care in general, and where diversity may make more of a difference in addressing minority patients’ concerns about trust. A more diverse workforce would likely provide not only more culturally appropriate treatment, but language skills to match those of patients. A federal commitment to the outreach and educational support necessary to build a truly diverse mental health workforce is a critical policy recommendation for decreasing disparities in mental health care.
What is IOM in healthcare?
The IOM definition is distinct from that applied by the Agency for Healthcare Quality and Research (AHRQ) in its annual National Healthcare Disparities Reports, where anydifference between populations is a disparity, with no adjustment for underlying need for care.
What is disparity in health care?
Here, we rely on the definition employed by the Institute of Medicine (IOM) in its Unequal Treatment1report: a disparity is a difference in health care quality not due to differences in health care needs or preferences of the patient. As such, disparities can be rooted in inequalities in access to good providers, differences in insurance coverage, as well as stemming from discrimination by professionals in the clinical encounter.
What is mental health disparity?
Mental health care disparities , defined as unfair differences in access to or quality of care according to race and ethnicity, are quite common in mental health.1Although some studies question this consensus, 2, 3the weight of the evidence supports the existence of serious and persistent mental health care disparities.
What would happen if mental health coverage was universal?
Specifically, policies that would result in universal coverage for mental health care would significantly improve access for ethnic minorities. Similarly, improving the quality of mental health care treatments would likely improve, but not eliminate, mental health care disparities.
How does the report recommend that health care systems take steps to improve access to care?
Specifically, the report recommends that health care systems should take steps to improve access to care, ensuring that they do not disproportionately burden or restrict minority patients’ access, as well taking further steps to improve access when necessary, such as providing interpreter services.
How does cultural diversity affect mental health?
Cultural diversity across the world has significant impacts on the many aspects of mental health, ranging from the ways in which health and illness are perceived, health seeking behavior, attitudes of the consumer as well as the practitioners and mental health systems.
How do cultures differ in their treatment?
Cultures vary also in terms of how they seek treatmentfrom mainstream Western health system. Biswas et al. (15) argue that those seeking help from mainstream health systems in India tended to present more often with somatic symptoms whereas those in the United States tended to present more with cognitive based symptoms. Further, research in High Income Countries (HICs) like Australia, Canada and the United States emphasizes that diverse cultures in these countries tend to seek help much later than those from the majority community and many of them tend to present in acute stages of mental distress (12, 17). One of the reasons for this can be the nature of shame as discussed in some of the research with migrants and refugees in HICs as well as with general populations in Low and Middle-Income Countries (LMICs) in Asia and Southeast Asia. Hampton and sharp (24) have explored the nature of shame quite comprehensively using a framework of external, internal and reflective shame to argue that mental health systems, professionals, and researchers need to recognize and mediate the effects of shame on individuals from diverse cultures if they wish to ensure effective management of mental health issues. Hechanova and Waedle (14) suggest that shame related reasons for low access to mental health systems could be due to several reasons. The first possibility is about the desire to protect the family reputation and their own dignity. The second relates to the possibility that the mental health professional would see them as “crazy,” similar to the notion of external shame, and finally that the person may be reluctant to open up to strangers, due to a number of factors such as fears of “loss of face,” lack of trust, or the fear of revisiting painful events (17, 25, 26). Research indicates that talking therapies may not be the most useful form of intervention among many cultural groups. The National Child Traumatic Stress Network in the United States argues that “talking about painful events may not be experienced as valuable or therapeutic by refugees from societies where psychological models are not hegemonic” (27). This perception of talking therapies in turn raises the possibilities of more effective utilization of movement-based therapies, expressive therapies, online therapies (28).
What is resilience in psychology?
Closely associated with coping, resilience is the ability to do well despite facing adversity, and is often discussed in the context of traits and characteristics of individuals. Kirmayer et al. (42) argue that the psychological approaches to resilience have emphasized individual traits rather than the systemic or ecological roots of resilience. They go on to suggest that, in the context of the Aboriginal Peoples of Canada, resilience is embedded in cultural values, renewed cultural identity, revitalized collective history, language, culture, spirituality, healing, and collective action. As discussed earlier, collectivist cultures can play a key role as both a protective factor and a risk factor in issues of mental health. In many cultural groups, the familycan be very involved in all aspects of a person's life (43). Family factors such as supportive extended families and strong sibling relationships can act as protective factors in mental health, while perceptions of stigma, severe marital discord, breaking of norms and other such factors can be major risk factors (19, 44). Which would suggest that interventions that include cultural renewal and community and family support systems can be very useful in some or most cultural groups.
How can partnerships help mental health?
A range of partnerships could be useful toward developing more effective mental health systems. They could include cultural partnerships between mental health providers and diverse cultural communities. It would certainly add to the nature of these partnerships if the providers also followed a deliberate policy of hiring workers of diverse backgrounds, and especially those from the communities that the service users come from. Murray and Skull (66) suggest that these forms of partnerships between refugee groups and health service providers have been shown to be more effective in terms of responding to health and other needs of the refugees than traditional top-down approaches. Partnerships could also be developed between mental health providers and traditional healers and/or community elders where synergies could be built on (54, 67). Finally, the relationship between the therapist and the client could be viewed as a cultural partnership, very much in line with the recovery approach, where the client would be an active participant in the process.
How does stigma affect mental health?
Stigmacan play a key role in terms of variations in treatment-seeking. Stigma can be viewed as a “mark of shame, disgrace or disapproval which results in an individual being rejected, discriminated against, and excluded from participating in a number of different areas of society” [(29), p. 16]. Stigma around depression and other mental illness can be higher in some cultural groups and often is a major barrier to people from diverse cultures when accessing mental health services (12, 15). Stigma can cause people to feel so ashamed that they hide their symptoms and do not seek treatment until the issues becomes acute (19). Stigma can be examined from a range of related issues such as the perceptions of etiology as well as notions of shame and levels of interdependence in the community (20, 24). In the context of Low and Medium Income Countries, these issues become even more significant as the family is often the only safety net that individuals have. Where government safety nets are minimal or do not exist, lack of support from the family due to perceptions of stigma can lead to total neglect of a person with mental health issues (11).
What is Helman's view of disease?
To begin with, the perceptions ofetiology of disease can be very different across cultures. Helman (20) presents us with a framework of views of illness causality that may be at the individual level or situated in the natural world or in the social world, and argues that each cultural group views these differently.
What is culture in sociology?
Giddens (2), from a sociological perspective, presents culture as the set of values that the members of a given group hold and includes the norms they follow and the material goods that they create. For the purposes of this paper we are using the term in the context of ethnic identity, or the multidimensional set of ascriptive group identities to which religion, language, and race (as a social construct) belong and all of which contribute to a person's view of themselves (3–5).
What is culture in mental health?
Satcher defined culture as a common set of norms, beliefs and values that influence mental health. "It can have an impact on how mental illness is perceived or diagnosed, how services are organized and how they're funded. It also affects how patients express their symptoms...and how they cope in the range of their community and family supports," he said.
What ethnic groups are included in the report?
The 200-page report broadly focuses on specific ethnic groups in the United States: African Americans, American Indians and Alaskan Natives, Asian Americans and Pacific Islanders, and Hispanic Americans. Statistics about African Americans demonstrate the mental health needs they face.
How many African Americans are uninsured?
One in four African Americans is uninsured and only one-third receive care for mental disorders. They are more likely to use emergency services. And African Americans represent close to half of many high-need populations, such as the homeless, incarcerated, children in foster care and people exposed to violence.
Who uses the APA convention?
U.S. Surgeon General David Satcher uses APA's Annual Convention as the forum for releasing a special report on mental health. By JENNIFER DAW.
Do minorities get mental health care?
Minorities are less likely than whites to receive needed mental health care , and the quality of care they do get tends to be less than good, says a Surgeon General report unveiled at APA's 2001 Annual Convention. The report, Mental Health: Culture, Race and Ethnicity, is a supplement to Mental Health: A Report of the Surgeon General, released in 1999.
Which group is the least likely to seek mental health services?
According to Mental Health America (MHA), Asian Americans are the least likely racial group in the United States to seek mental health services. This article discusses Asian American mental health statistics, common stigmas and why they occur, cultural influencing factors that impact different groups of people, how to combat stigmas, ...
Why do Asian Americans have the most trouble accessing mental health care?
Some estimates claim Asian Americans also have the most trouble accessing mental healthcare due to language barriers of all ethnic and racial groups living in the U.S.
What is stigma in mental health?
Stigmas are unfair, inaccurate ideas or beliefs that people use to negatively isolate and discriminate against others with certain traits or qualities. Mental health stigmas exist worldwide and can impact anyone of any race or ethnicity, creating barriers to access available mental health treatment. According to Mental Health America (MHA), Asian ...
What are the factors that affect mental health in Asian Americans?
Other cultural factors. Various mental health stigmas impact certain groups of Asian Americans differently depending on certain cultural factors. Factors influencing stigmas in children include: being pressured to excel in academic life and become a highly skilled professional regardless of the emotional, social, or physical toll.
Why is stigma important in APA?
The APA claim stigma may play an important role in someone’s likelihood to access care willingly. And according to the Substance Abuse and Mental Health Services Administration, mental health stigmas are common in Latinx and Hispanic communities in the U.S. While more research is necessary, mental health stigmas may exist for several reasons, ...
How to combat stigma?
The best way to combat stigmas is to become educated about mental health facts and engage positively with people who experience mental illness. Other ways to combat stigmas include: talking openly with family, friends, or using social media. promoting the idea that physical and mental illness are equal.
Why do people with mental illness seek outside help?
This can discourage people with mental illness, or their families, from seeking outside help to avoid being labeled as defective or damaged.
Why do people not seek mental health care?
Let’s take a look at eight of the most common reasons that prevent people from obtaining needed mental health services: 1) Fear and shame. One of the most common reasons for not seeking help is fear and shame. People recognize the negative stigma and discrimination associated with having a mental illness and don’t want to be labeled “mentally ill” ...
What are the barriers to mental health care?
8) Practical barriers. Another common barrier to mental health care is inability to pay for treatment due to financial hardship or lack of health insurance.
Why is it helpful to schedule an appointment with a mental health professional?
Alan, it's often helpful to schedule an appointment with a mental health professional to share these concerns and to get feedback about resources and other options. Hope things start to improve.
Why are some of the more hidden factors challenging?
Finally, many of the more “hidden” factors (fear, shame, inadequacy, limited awareness, and hopelessness) are challenging, because the person may function fairly well on the surface and can generally conceal their mental health concerns.
Why do people believe they are inadequate?
Many people believe they are inadequate or a failure if they have to admit something is “wrong” with their mental health. Further, they believe they “should be able to handle things” on their own without assistance and that they must be weak or inferior to have to ask for help.
Why do people worry about telling a stranger about their problems?
Many express concern about “telling a stranger” about their problems. Additionally, they worry that their personal information won’t be kept confidential. Some people have become demoralized by their mental health issues and believe “nothing will help me” or “I’ll never get better.”.
Do people with mental health issues seek treatment?
It’s probably no big surprise that many people with mental health issues don’t readily seek treatment for their concerns. But how widespread is this pattern?
Interpretations of Mental Illness
Stigma
Getting Support and Treatment
- Bailey et al. (2011) also report negative attitudes toward health care professionals among many African Americans, noting that stigma, religious beliefs, distrust of the medical profession, and communication barriers may contribute to African Americans wariness of mental health services.(10) In a 2007 study, approximately 63% of African Americans v...
Symptom Presentation
What We Can Do to Eliminate Disparities Involving The Culture of Mental Health
