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Disparities in mental health care access between Asian American and white patients are not completely accounted for by lower rates of perceived need among Asian American patients, according to results published in Psychiatry Services.  

Kelly Guanhua Yang, BS, and colleagues at the Albert Einstein College of Medicine in New York assessed disparities in psychiatric care utilization between Asians and whites in the United States based on 2012 to 2016 data from the National Survey on Drug Use and Health. The survey captures substance use and mental health data from noninstitutionalized adults (aged 18 to 65 years) in the United States. Respondents were categorized into 3 subgroups: past year perceived need for mental health treatment; past year serious psychological distress; and past year major depressive episode. The primary outcome measure of the study was utilization of any form of mental health treatment in the past year. The investigators used multivariate logistic regression models to assess differences in mental health treatment patterns among patients.

The final study cohort comprised 108,404 white respondents (53.1% women) and 8121 Asian respondents (52.2% women). Asian participants were significantly less likely than white participants to report past year utilization of any mental health treatment (5.8% vs 19.0%; P <.001), which remained significant after adjustment for health and sociodemographic factors.

Additionally, 8.1% of Asian participants reported a self-perceived need for mental health treatment, compared with 22.7% of white participants (P <.001). However, compared with whites with perceived need, Asians with perceived need still had decreased odds of receiving mental health care in the past year (odds ratio [OR], 0.57; 95% CI, 0.44-0.75). Asians with past year serious psychological distress (OR, 0.32; 95% CI, 0.25-0.42) and a past year major depressive episode (OR, 0.31; 95% CI, 0.21-0.45) were less likely to receive care compared with their white counterparts (both P <.001). As a treatment barrier, Asians were more likely than whites to endorse not knowing where to go to receive mental health care (OR, 1.61; 95% CI, 1.09-2.39; P =.017), although they were less likely to identify cost as a barrier (OR, 0.63; 95% CI, 0.43-0.94; P =.024).

The findings demonstrate significant disparities in mental health care between Asian and white patients, even when adjusting for lower rates of self-perceived need for care among Asian respondents.

As a study limitation, the investigators noted that more granular information on participants’ specific ethnic or immigration backgrounds were not available. “Outreach conducted in Asian communities could improve awareness of mental illness and make care more accessible for those in need. Peer outreach in particular may be helpful, and health centers should consider recruiting community-specific volunteers to encourage information dissemination,” the investigators recommended.

Read more on PsychiatryAdvisor.com.

The implications of the coronavirus are far-reaching and will particularly impact some of our most vulnerable communities, like the elderly and those with underlying health conditions.

Add to this list: immigrants, both documented and undocumented.

Documented immigrants already feel the pressure of a politicized national immigration rhetoric due to numerous policy changes—from the wealth test known as public charge and the new denaturalization task force, to skyrocketing difficulty in obtaining professional work visas and never-before-seen delays in adjudicating cases at Citizenship and Immigration Services.

Legal immigrants have been avoiding engagement with health centers out of fear that if they use public benefits that they are lawfully entitled to, it may hurt their ability to naturalize or to sponsor a loved one for a visa. 

This means pregnant women, mothers with sick children and many others are foregoing important medical treatment out of fear.

Undocumented immigrants have even more reason to worry with Department of Homeland Security (DHS) announcing that Customs and Border Protection (CBP) tactical units are being sent into communities, and detention rates for those with no criminal convictions rising significantly. 

Furthermore, Immigration and Customs Enforcement (ICE) has refused to designate courts as “sensitive locations”—areas where they agree not to “pick-up” individuals without status. In many parts of the U.S., undocumented individuals participating in court hearings are picked up by ICE—even if they are there simply because they are testifying as witnesses to a crime. 

With these policies and the administration’s vilification of immigrants, undocumented immigrants are afraid to come forward for medical treatment.

Read more on MsMagazine.com.

One morning last year, Brent Simcosky stepped out of a pickup truck in the middle of a sprawling field off Highway 101, stood in grass that brushed his knees and imagined an oasis from the scourge of opioids.

The epidemic had struck particularly hard here in Clallam County, where generations of families from the Jamestown S’Klallam Tribe live along the waterways of the Salish Sea. Simcosky, health director for the 537-member tribe, had too often seen the battered faces of neighbors and community members addicted to black tar heroin that sells for $5 a hit or to pain pills that for years saturated this remote corner of the Pacific Northwest.

In Washington, with 29 federally recognized tribes, Native Americans have died of opioid overdoses at a rate nearly three times higher than that of nonnatives. For heroin alone, it was four times higher, federal data shows. The tribe planned to offer treatment to residents — native and nonnative — across two counties.

“Indians,” tribe Chairman Ron Allen told Simcosky, “can be part of the solution.”

In May 2019, the tribe bought the land. The purchase initially drew little attention in Sequim, population 7,000, a town of retirees, artisan shops and an annual lavender festival that brings flocks of tourists every summer.

But a group of local residents rallied to block the project, arguing that tiny Sequim was no place for a regional drug treatment center. When tribe leaders called a public meeting to present their plan, more than 1,000 people spilled into a steamy room at the civic center and onto hundreds of folding chairs set up outside.

Scores came from a newly formed group: Save Our Sequim (SOS), a name that became a rallying cry.

SOS members worry a treatment facility would draw too many outsiders struggling with addiction into a small community without adequate law enforcement and social services. Tourism could falter. Housing prices could drop. Schools could quickly become overwhelmed, SOS members have argued.

Read more on the WashingtonPost.com.

As it confronts the COVID-19 pandemic, the US faces what could be its worst economic crisis since the Great Depression. A successful government response to the economic consequences of the pandemic is critical for sustaining families’ health and well-being and allowing families to remain housed as major sectors of the economy remain closed. The success of this response will partly depend on its effectiveness in reaching the families hardest hit by the loss of jobs and incomes. As relief is distributed, policymakers will need timely data on families’ financial and material well-being to evaluate and improve current efforts and inform new legislation.

This brief uses new data from the Urban Institute’s Health Reform Monitoring Survey, a nationally representative survey of nonelderly adults conducted between March 25 and April 10, 2020, to examine the effects of the coronavirus outbreak on families’ employment and abilities to meet basic needs, as well as racial/ethnic and family income–related disparities in the economic impact of the pandemic. As of late March/early April, we find the following:

• Just over 4 in 10 non-elderly adults (41.5 percent) reported that their families have lost jobs, work hours, or work-related income because of the coronavirus outbreak.
• Job and income losses are widespread but more prevalent among the families of low-income and Hispanic adults.
• In response to the crisis, 30.6 percent of adults reported that their families reduced spending on food, 43.1 percent put off major purchases, and 27.9 percent drew down savings or increased credit card debt. Among adults in families that lost work or income, 46.5 percent reduced spending on food, 58.1 percent put off major purchases, and 43.9 percent tapped savings or increased credit card debt.
• Low-income, Hispanic, and black adults were most likely to report that their families reduced spending on food, delayed major purchases, or used savings or increased credit card debt.
• As families cope with new financial challenges, many have experienced serious material hardships. Nearly one-third of adults (31.0 percent) reported that their families could not pay the rent, mortgage, or utility bills, were food insecure, or went without medical care because of the cost during the last 30 days. Among adults in families that lost work or income, the share experiencing these material hardships was 42.0 percent over the same time period.
• Over two-thirds (68.6 percent) of adults with family incomes below the federal poverty level and over 45 percent of black and Hispanic adults reported that their families experienced one or more of these hardships in the last 30 days.
• Looking ahead to the next month, adults are most likely to be worried about being able to work enough hours (38.5 percent) and pay their debts (33.1 percent), and more than one-quarter worry about paying for housing, utility, and medical costs and having enough food to eat.

Read more on the Urban.org.

July is National Minority Mental Health Awareness Month. This July, communities are facing the “perfect storm” of crises that are deepening the disparities in mental health and wellbeing. The current COVID-19 pandemic, economic crisis, behavioral health crisis, and the civil unrest stemming from recent incidents of police brutality has impacted all of America, but disproportionately affects communities of color.

Community and faith-based organizations play an essential role in helping these communities handle deeply experienced trauma, loss, and grief. Poor access to and mistrust of health care systems leads individuals to reach out to their familiar and trusted faith-based organizations and leaders. In many cultures, spirituality is a key driver of wellbeing and hope. Beyond this, faith-based entities have also been reliable providers of social services and emotional supports, and the coordinators of a wide array of health-related services and public health campaigns. Well-established and new models of faith-based partnerships are continuing to augment the limited behavioral health workforce in these communities. Faith leaders are coming together across communities to organize, support, provide, engage and instill hope.

Join this NNED virtual roundtable hosted by the NNED National Facilitation Center and SAMHSA’s Office of Behavioral Health Equity, in partnership with SAMHSA’s Mental Health Technology Transfer Center Network Coordinating Office. Learn how faith-based NNED partner organizations are supporting the mental health concerns of racial/ethnic minorities and providing opportunities to receive support and connection through faith-based practices and partnerships.

This NNED virtual roundtable will highlight:

• Faith-based partnerships that address the behavioral health in communities of color and augment the behavioral health workforce;
• Cultural and spiritual practices provided by faith-based organizations to strengthen community and social connectedness during times of crises;
• Faith leaders’ strategies to help diverse communities cope with trauma, loss, and grief; and
• The importance of and role of faith leaders in promoting self-care among the health care workforce, caregivers, and themselves.

NOTE: Due to the substantial interest in this Virtual Roundtable, the number of attendees able to join live may be limited by the platform. We strongly encourage you to join the Virtual Roundtable early to secure a spot. A recording will be sent to all who register. 

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Panelists

Rev. Dr. Charles Butler

Clarence Yarholar

Dr. Farha Abbasi

María del Carmen Uceda-Gras

Rev. Pausa Kaio “PK” Thompson

Dr. Sidney Hankerson

Weeks ago, college campuses around the country started closing their doors to curb the spread of the coronavirus. And it’s unlikely that the weeks and months to come will bring an end to both the pandemic, and the difficulties faced by students navigating a dramatically different campus (and world).  

Amid all the problems exacerbated by school closures, mental health support for LGBTQ students remains crucial, but potentially harder to access, according to experts consulted by Mashable. 

Everyone’s mental health should be a priority right now: The isolation necessary to flatten the curve, the process in which protective measures are taken in order to ensure the number of cases doesn’t overwhelm the capacity of the healthcare system, takes a psychic toll on those obeying mandated social distancing as well as those in states with stay-at-home orders, a toll that may last after the pandemic gets under control. 

For LGBTQ youth, there are increased risks associated with campus closures and the isolation that comes with it, which can cut them off from key mental health resources, according to Dr. Tia Dole, the chief clinical operations officer at the Trevor Project, a LGBTQ crisis intervention support network. 

In addition to lacking the support provided by peers and campus LGBTQ centers, some students, if they attend school away from home, might be returning to unwelcoming home environments. This can have a disastrous impact on mental health: According to recent research from the Trevor Project, over 25 percent of LGBTQ youth who lacked an accepting adult in their life reported attempting suicide in the previous year. LGBTQ youth who did have at least one accepting adult in their life were 40 percent less likely to report a suicide attempt in the previous year. Additionally, Dole notes that many students first embrace their LGBTQ identity in college, whether by finally getting others to use their proper pronouns or by first sharing this identity with others. As such, returning home on such short notice and being physically cut off from the campus community can halt a natural developmental process where young people form their identities within a supportive community. 

COVID-19, the official term for the disease caused by the virus, is already impacting the way LGBTQ youth engage with mental health resources: A Trevor Project representative told Mashable via email that nearly 20 percent of its crisis contacts from LGBTQ youth in the last week have mentioned COVID-19. 

A representative from the Trevor Project shared a few key tips with Mashable via email. First, just as you’re presumably checking in with loved ones right now, the Trevor Project recommends checking in with LGBTQ friends and family year-round. In interactions with LGBTQ youth, the representative encourages practicing empathy, and listening without judgment, which can help to foster a safe and accepting environment wherever you are. Additionally, try sharing mental health and self-care resources specifically geared towards LGBTQ youth. And finally, if you know of any LGBTQ young person who feels hopeless or suicidal, you should connect them with the Trevor Project’s crisis resources.

Read more at Mashable.com.