July is National Minority Mental Health Month

More than a decade ago, a supplement to the Surgeon General’s report on mental health found that minority groups are less likely than whites to seek mental health services. When they do seek help, they tend to receive poorer quality mental health care. This health disparity continues, the American Psychological Association reports, as African Americans, Latinos, Asian Americans and Native Americans today face inequities in cost, stigma and quality of care.

Bebe Moore Campbell’s advocacy

To draw attention to this disparity, in 2008 the U.S. House of Representatives passed a resolution declaring July as Bebe Moore Campbell National Minority Mental health Awareness Month. African-American author Bebe Moore, who died in 2006, used her status as author and NPR commentator to raise awareness of mental health issues, particularly among minority populations. Her children’s book Sometimes My Mommy Gets Angry, is the story of a young girl learning to cope with her mother’s bipolar disorder.

 Poverty, lack of health insurance, part of the problem

The National Health Interview Survey, released by the Centers for Disease Control and Prevention in May 2015, revealed what many have suspected: The poor suffer from mental illness at a greater rate than those who are economically stable. The report found that 8.7 percent of people living below the Federal Poverty Level claim to suffer serious psychological distress. The rate drops to 1.2 percent among those with incomes at or above four-times the poverty level. Nationwide, the poverty rate among blacks and Hispanics is more than double that of whites.

The survey also showed that adults who lacked health insurance coverage were more likely to suffer serious psychological distress than those with health insurance. While the gap between whites and minorities’ uninsured rates has been narrowing since the inception of the Affordable Care Act, overall, minorities still fall behind.

Cultural differences create barriers

San Francisco psychotherapist CK Olivieri Blackmore notes that accessing the American mental health care systems can be difficult, even for those raised in Western society. “Add in the logistical dilemmas of language barriers, immigration status concerns, transportation challenges, childcare,” says Olivieri Blackmore, “and a once intensive barrier becomes a wall.” 

Many cultures do not believe in the Western biomedical model. “We consider a plethora of behaviors in Western society to be maladaptive,” says Olivieri Blackmore, “when within cultural context they are entirely normative.” This becomes a problem, according to Olivieri Blackmore, when individuals are diagnosed. While many cultures embrace a much broader view of health to include spirituality, medical billing codes don’t allow for this — “… thus we are forced to diagnose people who may be going through a culturally normative experience with a disorder if they want to use insurance.”

The need for culturally competent practitioners

Psychologist Dr. O’Shan D. Gadsden believes the greatest cultural barrier in treating minority patients is “…culturally unresolved and distorted mental health practitioners.” Gadsden, who specializes in black masculinity and cultural psychodynamics, says social science research focuses on a pathology model that sees minority populations as “in crisis” and “deviant.” This model is internalized by mental health practitioners and lacks cultural nuances, knowledge of which is necessary to provide viable, holistic treatment. Additionally, Gadsden believes negative portrayals of minorities in the media distort a practitioner’s ability to competently treat minority populations.

Gadsden sees better training of mental health practitioners as the solution —“Training programs and continuing education seminars should promote serious inquiry and curiosity about one’s positionality (i.e., beliefs, values, and attitudes) and potential bias. This inquiry and reflection should promote a more fluid understanding of the cultural self in relation to the cultural other.”

In a 2005 commentary, Bebe Moore Campbell told the story of a close family member who was diagnosed with bipolar disorder. “The illness became our family’s deep, dark secret,” she wrote. There is a stigma attached to mental illness, one that minorities feel more keenly. “In a race-conscious society,” Campbell wrote, “some don’t want to be perceived as having yet another deficit.” The celebration of National Minority Mental Health Month is aimed at shedding light on the “deep, dark secret.”