Minority Mental Health Care

Respecting the culture, ethnicity, ability, values, and religious beliefs of different groups of people benefits everyone as individuals and as members of society. This is particularly true when it comes to your physical health and mental health.

Diversity and inclusivity reference the same concept – acceptance and respect of all, regardless of skin color, age, sexual orientation, physical ability, religion, and gender identification. However, the terms diversity and inclusivity are distinctly different. Diversity refers to a group of people with a wide range of demographic, philosophical, religious, political, and ethnic differences. Inclusion refers to the action steps taken to intentionally include people of different background, demographics, ethnicities, abilities, and religious beliefs.

Racial Minorities

While it can be difficult for anyone to get proper mental health care in the United States, it’s even harder for racial and ethnic minorities. In addition to the problems that most individuals experience – issues with high deductibles and co-pays, insurance, long wait times, and difficulty finding providers – there are added burdens of access and quality of care.

Studies show striking disparities for minorities in mental health services have not changed. In Eliminating Mental Health Disparities by 2020: Everyone’s Actions Matter, Regina Bussing and Faye A. Gary wrote “racial and ethnic minorities still have less access to mental health services than whites, and when they receive care, it is more likely to be of poorer quality.”

There are many barriers that prevent racial and ethnic minorities from receiving proper care (National Alliance on Mental Illness, 2017). Examples include:

• Language barriers and a lack of providers who speak languages other than English
• Transportation issues or difficulty taking time off work
• A high level of mental health stigma in minority populations
• Racism, bias, and discrimination in treatment settings
• A lack of adequate health insurance coverage
• The belief that mental health treatment doesn’t actually work

LGBTQIA+

Everyone has a gender identity and sexual orientation. Mental Health America defines gender identity as “the internal sense of being male, female, both or neither, which is separate from your biological sex” and sexual orientation as “who you are romantically or physically attracted to”. Although identifying as LGBTQIA+ is not a mental illness or disorder, many LGBTQIA+ people experience mental health struggles.

There is strong evidence from recent research that members of this community are at a higher risk for experiencing mental health conditions, especially anxiety disorders and depression (National Alliance on Mental Illness, n.d.). LGBTQIA+ adults are more than twice as likely as heterosexual adults to experience a mental health condition. Studies have shown that the bisexual and transgender communities have the highest rates of mental health concerns within the LGBTQIA+ population. Furthermore, forty-eight percent of transgender adults report that they have considered suicide in the last year, compared to 4 percent of the overall U.S. population (National Center for Transgender Equality, 2016). 

One study found that “LGBTQ+ people used mental health services at 2.5 times higher rates than their ‘straight’ counterparts. However they are also at particular risk for experiencing shame, fear, discrimination, and adverse and traumatic events.” (Platt, 2018). In a survey of LGBTQIA+ people, more than half of all respondents reported that they have faced cases of providers denying care, using harsh language, or blaming the patient’s sexual orientation or gender identity as the cause for an illness (Kates, Ranji, Beamesderfer, Salganicoff, & Dawson, 2016). Fear of discrimination may lead to some individuals concealing their gender identity or sexual orientation from providers or seeking care altogether.

Caregivers

Within the next fifteen years, “older people will outnumber children for the first time” in American history (United States Census Bureau). Already, 40 million Americans are providing informal care to family members, and an estimated 8.4 million Americans are unpaid caregivers for adults with mental health issues (Mental Health America, n.d.). Of that large number, approximately 30 percent of caregivers self-identify as a racial or ethnic minority, and this number is expected to increase in the coming decades. By expanding the resources available to all caregivers, regardless of experience, black and Latino (and all other racial and ethnic groups), LGBTQIA+, non-English speaking, and impoverished caregivers can be better heard and supported by the community at-large.

Existing programs typically focus solely on providing supportive services for those experiencing mental distress while not considering their families and caregivers. Mental disorders affect the family and caregivers by placing financial strain, increasing family conflict, isolation, and stigmatizing as well as other ways. Eighty-eight percent of caregivers for adults with mental illness are family members, and of that total percentage, 45% are parents, 14% are adult children, and 11% are spouses.

Our Response to Disparities Within Minority Mental Health Care

While it can be difficult for anyone to get proper mental health care in the U.S., we know it’s even harder for minorities. In response, we strive to be an inclusive organization that offers access to care for minorities that are often marginalized, excluded, or stereotyped, such as African Americans, Asian Americans, Middle Easterners, the LGBTQIA+ community, and caregivers. Here at Gateway to Hope, the Hope and Healing Center & Institute’s training program, we recognize that access to “social and holistic resources can be lifesaving” for racial minorities, LGBTQIA+ people, and caregivers (Singleton, 2020).

The evidence-based trainings and tools we offer emphasize peer support and can be adapted to suit the needs of diverse communities. We strive to understand the needs of minority populations and why they are seeking mental health trainings for their community. Discovery phone calls and virtual meetings prior to a training allow us to better understand the cultural influences that may affect a specific group. Our programs equip individuals with first-hand knowledge of what their group needs with the education and tools necessary to provide a restorative community.

The Empower Training is a two-hour awareness and response training that aims to break down stigma and provide education to encourage all to seek mental health care when needed. During this training, participants will gain the tools to identify mental illness, develop appropriate situational responses, and connect those in distress with professional help.

The Support Group Training equips leaders within minority groups with the skills and tools needed to establish and facilitate support groups that speak to the needs of the community. By equipping individuals within a minority community to lead these support groups, the facilitator can guide the group in a way that considers their specific needs and backgrounds. Participants in the Support Group Training will learn to lead three types of groups – specifically a Minds Transformed, Families Transformed, and Hearts Transformed group. The Families Transformed support group offers families and caregivers of those with mental illness a safe place to gather with others experiencing similar situations.

Additional resources ideal for caregivers come from the Community Bioethics and Aging Center (CBAC). CBAC mirrors the Hope and Healing Center & Institute by offering education, training, supportive services, and research; yet all geared towards the physical, mental, spiritual and relational health of those community members 65 years and older and their families. 

We know life can be tough for anybody. Although the stresses we all face may be different, the toll they take on us, our families, and our communities are the same. That’s why the Hope Line is here – as an outlet for the feelings and emotional distress we all face everyday. The Hope Line is a warmline that connects people with specific needs to the right provider. The support line operators are trained to understand the needs of callers and connect them with help with the help of a vetted provider database. We consider any barriers a caller may have, such as financial limitations, a lack of insurance, or transportation issues.

References

13 stats on Mental Health and the Church. Lifeway Research. (2018, May 1). Retrieved from https://research.lifeway.com/2018/05/01/13-stats-on-mental-health-and-the-church/

Kates, J., Ranji, U., Beamesderfer, A., Salganicoff, A., & Dawson, L. (2016). Health and access to care and coverage for lesbian, gay, bisexual, and transgender individuals in the U.S. Retrieved from http://kff.org/report-section/health-and-access-to-care-and-coverage-for-lesbian-gay-bisexual-and-transgender-health-challenges/

National Alliance on Mental Illness (n.d). Hispanic/Latinx. NAMI. Retrieved from https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Hispanic-Latinx

National Alliance on Mental Illness (n.d). LGBTQI. NAMI. Retrieved from https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/LGBTQI

National Center for Transgender Equality. (2016). The report of the 2015 U.S. Transgender Survey. https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf

Platt, L. F., Wolf, J. K., & Scheitle, C. P. (2018). Patterns of mental health care utilization among sexual orientation minority groups. Journal of Homosexuality, 65(2), 135-153

Singleton, Amanda (2020). The Future of Family Caregiver Support is Diverse and Inclusive. AARP. Retrieved from https://www.aarp.org/caregiving/basics/info-2020/inclusive-support-for-diverse-caregivers.html