Plan Targets Disparities In Minorities' MH Care

APA's Department of Minority and National Affairs convened more than 20 advocates from government agencies, mental health organizations, and consumer groups in March to design an action plan that will lead to improving mental health care for racial and ethnic minorities.

During the roundtable meeting, participants were charged with developing specific recommendations to meet objectives such as expanding mental health research on racial and ethnic minority subjects; developing outcome-based, culturally competent training for psychiatrists and mental health professionals; enhancing access to mental health care for minority populations; and promoting mental health in minority populations through collaboration and advocacy.

The Department of Minority and National Affairs is compiling the recommendations made at the meeting into a resource document, and meeting participants are expected to take the recommendations back to their respective organizations to begin implementation.

“We must ensure that mental health disparities among minority groups are a top priority of mental health advocacy agendas,” said Annelle Primm, M.D., M.P.H., director of the Department of Minority and National Affairs and one of the meeting's chairs.

Altha Stewart, M.D., co-chair of the meeting, described the ultimate goal that participants were to keep in mind while deliberating their recommendations.

“We'd like to see a mental health system in which there are no barriers to care for racial and ethnic minority populations,” Stewart said, and through which services would be delivered “in a linguistically and culturally sensitive manner.”

She also emphasized that in the ideal mental health system, there would be“ no wrong door through which to enter treatment.” Stewart is president of the American Psychiatric Foundation, which helped fund the meeting.

The mental health system known to many members of racial and ethnic minority groups couldn't be more different from the ideal one Stewart envisioned.

When he was U.S. surgeon general, David Satcher, M.D., brought national attention to the disparity in access, quality, and availability of mental health services for minorities in his 2001 report, “Mental Health: Culture, Race, and Ethnicity.”

In his report, Satcher noted that African Americans were less likely than white Americans to receive appropriate care for depression or anxiety, for instance, and that suicide rates in certain groups of Asian-American patients surpassed those of any other racial group in the United States.

Some of the recommendations that participants discussed for APA were expanding the role of minorities in mental health research and publication of best-practice guidelines for mental health services for nonwhite populations. Another recommendation that was discussed called for APA to strengthen its relationships with congressional staff to increase the likelihood that Congress will pass legislation on minority mental health issues.

“We're aware of the difficulty of getting minorities to participate in research because of problems with trust” in medical research, said Henry Chung, M.D., a clinical associate professor of psychiatry at New York University School of Medicine and senior director of research and strategic management at the Charles B. Wang Community Health Center in New York.“ We need to conduct more translational research in nontraditional settings such as correctional facilities and foster homes, because that is where our minority patients are,” he suggested at the meeting.

Collaborations with government agencies and state-licensing boards are essential to improving the cultural-competency training of mental health clinicians working with minority populations, the meeting participants agreed.

They discussed recommending that APA link with individuals who are already working to train mental health clinicians about cultural issues, such as the those at the Department of Health and Human Services Interagency Work Group on the Mental Health Workforce.

In addition, some participants thought it would be helpful to approach state licensing boards and ask them to implement cultural-competency standards for trainees applying for professional licenses.

Other recommendations were intended to increase access to mental health services by minorities, for instance, by placing educational messages about mental health in newspapers and radio stations popular in minority communities and linking to “nontraditional” advocates in those communities, such as clergy or civil-rights leaders.

More information about recommendations from the roundtable meeting on mental health disparities in racial and ethnic minorities can be obtained by sending an e-mail to [email protected].▪