Addressing Disparities During National Minority Mental Health Awareness Month

July 31, 2024

Each July, National Minority Mental Health Awareness Month brings attention to disparities in mental health care for communities of color.

According to the American Psychiatric Association, approximately 18% of adults in the U.S. have a mental disorder.¹ Individuals from historically marginalized communities are less likely to receive mental health services even though they face a “disproportionately high burden of disability” due to mental disorders.¹

Social Determinants of Health

Disparities in mental health care are, like all aspects of wellbeing, driven by social determinants of health (SDoH). SDoH refer to the social and environmental factors in which a person lives that affect certain life outcomes.

In 2023, The White House released “The U.S. Playbook to Address Social Determinants of Health.” The document frames housing and food security, education access, and healthy environment as SDoH that have a major impact on health outcomes, connecting these factors to an increased risk of mental health disorders.² This publication explains that there is a need for more focus on SDoH impact on mental health and calls for progress in research funding and policy that support interventions addressing them to reduce disparities.

Concerning the SDoH of health care access, the APA cites insurance issues, stigma, lack of culturally competent and diverse providers, and distrust in the medical system as barriers to proper mental health care in communities of color.¹

These elements in our health care system that hinder marginalized populations from being able to access mental health services are the result of a long history of medical discrimination, mistreatment, and exclusion of people of color. Commissioned by the American Medical Association and published in 1910, the Flexner Report recommended an overhaul of medical education in the U.S., resulting in the closure of five out of seven schools that trained Black physicians. This led to a decline in Black providers and is just one cause of underrepresentation that persists today.³

Lack of trust in the medical system among minoritized groups is also a result of the history of medical exploitation and experimentation on people of color. In the 1800s, several doctors experimented on enslaved women to develop gynecological, obstetric, and abdominal surgical procedures.³ Throughout the 1900s, the American Eugenics movement led to the forced sterilization in low-income communities of color.³ These are just a few examples.

It is important to acknowledge the history that led to modern-day disparities so that we can understand how to address them.
For example, the National Institute of Mental Health (NIMH) is currently working to understand and combat the disparities in mental healthcare through the Minority Mental Health and Health Disparities Research Program. They examine populations that are socioeconomically disadvantaged, underserved rural communities, sexual and gender minorities, and people living with disabilities.⁴ Through supporting research on mental health in marginalized populations and how SDoH affect them, they are helping to close the research gap that perpetuates disparities.⁴

Addressing SDoH in mental health care at JBS

JBS staff are partnering with the Heath Resources and Services Administration (HRSA) to provide training and technical assistance (TTA) related to behavioral health – which includes mental health – to staff from health centers funded by the HRSA Bureau of Primary Health Care (BPHC). The BPHC funds nearly 1400 centers, which provide affordable and accessible medical, dental, and behavioral care to more than 28 million people.⁵ Of the people who access care at these facilities, approximately 65% are people of color.⁶ Examples of activities include:

Community of Practice (CoP): A webinar series called “Advancing Health Equity to Improve Population-Level Behavioral Health” was held with health center staff to create a CoP, encouraging them to form peer-to-peer connections. To equip the participants with strategies and innovative solutions, subject matter experts teach on topics such as the evolution of racial and ethnic disparities in the U.S. and the practices – such as addressing housing needs, improving language access and health literacy, and using evidence-based practices – that can promote equity through addressing SDoH. These efforts from JBS build the capacity of the health centers to identify and intervene with patients experiencing mental health disorders in medically underserved populations.⁷
RCORP-TA SDoH Webinar Series: JBS has hosted webinars providing TTA for grantees from the Rural Communities Opioid Response Program. Webinars and training include topics such as Social Determinants of Health and Opioid Use Disorder in Racially and Ethnically Minoritized Communities and Building Trust with African American Rural Communities.

National Minority Mental Health Awareness Month shines a spotlight on the intersectional nature of mental health in communities of color. Bringing awareness to the factors that lead to disparities in mental health care is a step in the right direction for closing the care gap and healing communities that are often overlooked.

Resources

To reduce stigma and promote mental health equity, we can all learn more about mental health and coping strategies, share mental health information with those around us, and be intentional with the language we use when discussing mental health and disparities. It is also important to learn more about implicit bias and microaggressions, including how to avoid them in order to help facilitate a more equitable environment for all.

For more information on mental health in BIPOC communities, go to these resources:

References

¹American Psychiatric Association. (2017). Mental Health Disparities: Diverse Populations. https://www.psychiatry.org/getmedia/bac9c998-5b2d-4ffa-ace9-d35844b8475a/Mental-Health-Facts-for-Diverse-Populations.pdf
² The White House. (2023, November). The U.S. Playbook to Address Social Determinants of Health. https://www.whitehouse.gov/wp-content/uploads/2023/11/SDOH-Playbook-3.pdf
³ Kaiser Family Foundation. (2024). How History Has Shaped Racial and Ethnic Health Disparities: A Timeline of Policies and Events. https://www.kff.org/how-history-has-shaped-racial-and-ethnic-health-disparities-a-timeline-of-policies-and-events/
⁴National Institute of Mental Health. (n.d.). Minority Mental Health and Mental Health Disparities Research Program. https://www.nimh.nih.gov/about/organization/od/odwd/minority-mental-health-and-mental-health-disparities-research-program
⁵JBS International. (2024, July 9). Community of Practice “Advancing Health Equity to Improve Population-Level Behavioral Health. Bureau of Primary Health Care Behavioral Health Technical Assistance.https://bphc-ta.jbsinternational.com/technical-assistance-resources/community-practice-advancing-health-equity-improve-population-0
⁶Lausch, K. (2022, September 18). Federally Qualified Health Centers Reduce Health Disparity and Improve Health Outcomes. Health Affairs. healthaffairs.org/sponsored-content/federally-qualified-health-centers-reduce-health-disparity
⁷JBS International. (n.d.). About Us. Bureau of Primary Health Care Behavioral Health Technical Assistance.https://bphc-ta.jbsinternational.com/about-us