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News

Mental Health Advocates Share Stigmas They Face as a Person of Color with Mental Illness

August 6, 2018

In the world of mental health awareness, there are myriad stigmas that make it harder to get treatment. For people of color who live with mental illness, those stigmas can be compounding. Whether it’s the dangerous myth that Black men are “too strong” to seek mental health treatment, or that only certain women can experience an eating disorder, these stigmas are incredibly damaging, and often render people of color who experience mental health issues invisible.

But, of course, mental health issues affect people of any race or identity. According to Mental Health America (MHA), 8.9 million Latinx people in the U.S. live with a diagnosable mental illness, but, as the American Psychiatric Association (APA) found, only 36 percent of Latinx people with depression received care. And the National Alliance of Mental Illness (NAMI) reported that Black Americans are 20 percent more likely to be diagnosed with a serious mental health issue than the general population, but only 25 percent of Black Americans with mental illness receive treatment. What’s more, the APA reported that Indigenous Americans and Alaskans “experience serious psychological distress 1.5 times more than the general population,” and the rates of post-traumatic stress disorder (PTSD) in Indigenous communities are twice that of the general U.S. population.

Long story short, mental illness is far from being a health issue that only affects some people, and for people of color, the particular stigmas around mental health they face can create a uniquely isolating experience. These mental health advocates tell Bustle the unique stigmas they face as a person of color who lives with mental illness, and how they combat them.

Alison Mariella Désir-Figueroa

“I think that the myth of the strong black woman plagued, and continues to plague me as an Afrolatina woman who suffers from anxiety and depression. The burden of typically always being seen as resilient, tough and a ‘boss’ doesn’t leave much room for vulnerability,” says Alison Mariella Désir-Figueroa, an entrepreneur, athlete, activist, and mental health counselor in training.

“After not being on medication for several years, I recently started taking an anti-anxiety medication again, and I had to wrestle myself away from the line of thinking that this was somehow a personal failure or a step back in the wrong direction,” she says. “The messages we receive about mental illness, and the negative stigmas associated with it are ones that we all must continue to speak openly about because, even as a mental health professional and mental health advocate, I am affected. Through my work and advocacy, I hope to create spaces and communities that normalize mental healthcare, particularly for people of color.”

Elyse Fox

Elyse Fox, a filmmaker and the founder of Sad Girls Club, tells Bustle, “In the past, society has made me feel the most displaced as a woman of color with a mental illness. Growing up, I never had any examples of people of color striving through life while living with depression, anxiety, etc. Representation truly matters in making mental health conversations normal, and shameless to discuss.”

Amy Quichiz

“As a person of color with mental health issues such as depression and anxiety, people made me feel as if what I was going through wasn’t real. Specifically coming from Latinx households, my family made me feel like I needed to be at an ‘extreme’ point in order to access the care that I needed, which was therapy,” says Amy Quichiz, a writer, activist, and the co-founder of Veggie Mijas. “I believe there are still many stigmas such as not wanting to talk about it, dismissing it by saying, ‘ella está loca‘ [she’s crazy], instead of acknowledging mental health. It took me a while to believe that taking medication for my mental health was OK, and to talk about depression and anxiety without it being a ‘private issue that stays within family.'”

Quichiz adds, “I think the more we talk about it, the more we have other folks of color to acknowledge the truth, and face their vulnerabilities — which is a good thing and part of the healing process.”

Chamique Holdsclaw

Chamique Holdsclaw, an Olympic gold medalist and former WNBA player who’s now a vocal mental health advocate, and star behind the documentary Mind/Game, tells Bustle, “A unique stigma and discrimination I’ve faced as a person of color with mental illness is the expectation of praying away my illness. From others’ stories that have been shared with me, minority groups are faced with not being right in their religion or spirituality as to why they are experiencing mental illness, which to me is a dangerous point of view and keeps people from speaking up and seeking help.”

Gloria Lucas

Gloria Lucas, the founder of Nalgona Positivity Pride, says that “One of the unique struggles I faced as a brown womxn with an eating disorder was no advocacy for me in the professional eating disorders world, and no language to talk about unhealthy relationships with food in my own community. Considering how eating disorders are portrayed as mainly affecting white, thin, and affluent women, I was never able to see my own reflection — which only increased my isolation, and the severity of my eating disorder.

Deb Blake

“As a Latinx woman who struggles with multiple mental illnesses, it saddens me to admit that the most stigma I have received towards my mental health has been from my own family,” says Deb Blake, a mental health advocate and activist with Utah Against Police Brutality. “I grew up in a “no se habla de eso” [we don’t talk about it] culture. I was constantly told that I was just being dramatic, and that my illness wasn’t real. Trips to mental health facilities were ‘vacations.'”

Dior Vargas

“I was in a session with a therapist at college, and after explaining the dynamics and challenges with my family, she told me that I needed to stand up to my mother and fight against how she raised me. I felt attacked, and I also felt like my mother was being attacked,” says Dior Vargas, a mental health activist who founded the People Of Color and Mental Illness Project, which has since been transformed into a full-length book titled The Color Of My Mind. “The therapist wasn’t understanding that this was my [Latinx] culture.  Family is extremely important, and things aren’t done that way in my household. I stopped seeing her after that because I knew I couldn’t be comfortable and open with her again.”

Our conversations surrounding mental health awareness need to keep expanding by making space for people of color to safely voice their experiences and to share their unique experiences of mental health discrimination. It’s time to get rid of the mental health stigmas that have kept people of color with mental illness from either seeking treatment, or receiving quality care.

Read more on Bustle.com.

Filed Under: News

Mental Health is a College Stumbling Block. For Students of Color, it Can Be a Wall

August 3, 2018

As the daughter of Lebanese immigrants growing up in Minnesota, Rayyan Mikati was used to being one of few people of color in her high school classes.

But when she arrived at Northeastern University four years ago, she felt even more isolated by her culture and religion. Mikati developed an eating disorder, and she struggled to find people who could understand where she was coming from.

Her therapist was sympathetic but she couldn’t fully relate to cultural issues like how to handle Ramadan, a month of fasting. Mikati found a great student support group, but she felt unable to speak as openly as she could around other Muslims.

The obstacles are familiar to racial and ethnic minorities on campuses nationwide and affect how they get assistance. New national research by a Boston University professor shows minorities are less likely than white students to seek mental health services or have their problems properly diagnosed and treated.

Arab and Arab-American students have the highest prevalence of mental health issues and the lowest levels of knowledge about mental health, the study found. Asian students are least likely to believe they have a need for mental health treatment.

And at a time of renewed national attention to mental health issues and suicide among young people, the needs of students of color are of particular concern to college officials, whose student bodies have become increasingly diverse.

“We all know that there is need,” said Madeleine Estabrook, the vice president for student affairs who oversees Northeastern’s efforts around mental health. “I think we’re trying to come at it from as many angles as we think of.”

BU professor Sarah Lipson, whose research included a survey of 43,000 college students across the country from 2012 to 2015, measured not only their mental health status by race and ethnicity but also the rate at which they sought help.

Students of all races experience mental health issues at roughly the same rate, but students of color are less likely to seek help, the research shows.

Among those with clinically significant symptoms of a mental health condition, 46 percent of white students received mental health treatment in the past year, compared with 26 percent of African-American students, 23 percent of Asian students, and 33 percent of Latino students, according to the study.

Lipson found that many students of color deny they need help or opt to deal with the issues themselves.

Many worry about being a burden to their families, judged by other students, or misunderstood by counselors who don’t understand cultural issues.

“You’re held up as an example of what everyone else in your community is like,” Mikati said. “Basically you don’t want to pollute an idea of what your community is to people who are not a part of it.”

At Northeastern, Mikati’s therapist at one point suggested she take time off school to seek more intensive treatment for her eating disorder, but she declined because she didn’t want to fall behind in school or become more of a financial burden to her parents.

“I think that’s a really common idea of ‘I’m not going to accept more help from you because you’ve already gotten me to this point,’ ” she said.

Lipson, whose findings will be published in the Journal of Adolescent Health, said she hopes her work will spur not only more research but action by colleges to address the specific mental health needs of students of color and the barriers they face in seeking it.

“We have a more diverse student body in colleges across the country than we ever did before, which is something to celebrate, but that also comes with enormous responsibilities,” Lipson said.

Students with untreated mental health issues are more likely to drop out, research has shown. Students of color already face lower graduation rates, and if schools are serious about helping them succeed, they should do more to address their mental health needs, Lipson said.

Experts in the field of college mental health say schools have begun to take steps to reach more students of color.

McLean Hospital, a psychiatric institution, for the past 10 years has run a program focused on college students. The program director, Stephanie Pinder-Amaker, said nearly 80 percent of the requests she receives for consultation from colleges have to do with reaching students of color and other marginalized populations.

That wasn’t always the case, she said.

Pinder-Amaker said she tells schools to talk directly to students of color to find out what types of services would be helpful to them and what barriers might stop them from seeking help.

“It’s up to us to figure out what are the barriers,” she said. “Sometimes the barriers are real, sometimes they’re perceived barriers, but it doesn’t matter.”

Read more on BostonGlobe.com

Filed Under: News

NNED Partner of the Month – August 2018

August 1, 2018

In order to highlight pockets of excellence across the country, the NNED selects an organization to highlight once a month. Young People in Recovery (YPR) has been selected as the Partner of the Month for August.

YPR envisions a world where everyone can access the necessary resources to recover from substance use disorder. YPR’s mission is to provide the training and networks all individuals, families, and communities need to recover and maximize their full potential.

YPR serves the greater community through partnerships and collaborations with treatment centers, educational institutions, state and local agencies, nonprofit and for-profit organizations.  Some of the programs YPR offers include:

  • My Recovery Is EPIC: a life-skills curriculum offered exclusively by YPR that focuses on improving access to housing, education and employment.
  • Phoenix Program: a multi-purpose support program offered to criminal justice organizations, & more.
  • Project PHI: a preventative health initiative, aims to reduce alcohol and other drug misuse and to increase protective factors with the support of life skills training among youth aged 18-26 years by implementing the Botvin Life Skills Transitions Curriculum.
  • Recovery Coaching: YPR supports communities through providing Recovery Coach trainings and supervision for newly trained coaches. Recovery Coach Supervisors provide the necessary support for newly trained coaches to stay on the path to certification.

YPR utilizes an advocacy-in-action model to create recovery-ready communities at local, state and national levels. Advocacy-in-action means providing direct service and building community amongst those in recovery and their allies through facilitating workshops, all-recovery meetings, leadership development, community forums and more. Learn more about YPR’s advocacy.

YPR chapters engage young people in or seeking recovery and their allies in communities across the country to take a stand for recovery. Chapters support young people in or seeking recovery by empowering them to obtain stable employment, secure suitable housing, and continue and complete their educations. Chapters also advocate on the local and state levels for better accessibility of these services and other effective recovery resources.

  • Find a YPR Chapter near you, and join!
  • Find out how you can bring recovery resources to your community by launching a new YPR chapter!

Learn more about YPR and how they are advancing recovery efforts, health, and well being for young people across the country.

View a list of previous NNED Partners of the Month here.

Filed Under: News

National Alliance for Hispanic Health Announces Support for CDC’s Anti-smoking Campaign

August 1, 2018

“If you smoke, quitting is the single best thing you can do for your health and for your loved ones,” said Jane L. Delgado, Ph.D., M.S., President and CEO of the National Alliance for Hispanic Health (the Alliance). “The Tips Campaign offers advice from former smokers and free support from 1-800-QUIT-NOW (1-855-DÉJELO-YA) to help motivate smokers to quit, and prevent others from ever starting,” added Dr. Delgado.

The 2018 Tips from Former Smokers (Tips) Campaign’s 15 and 30-second ads are airing nationally on television, online, and in print advertisements through October 2018 to raise awareness of the dangers of smoking and offer tips on how to quit. Markets that have higher rates of cigarette smoking will have additional airings and advertisements for increased awareness. The ads feature former smokers and their stories that highlight serious smoking-related health conditions associated with cigarette use, promote the benefits of quitting for loved ones, and encourage smokers to call 1-800-QUIT NOW (1-855-DÉJELO-YA) for free cessation support.

The 2018 Tips ads feature Brian, 63, an Air Force veteran, who had his first heart attack at age 35 while on assignment overseas. He quit smoking in 2009 and received a heart transplant in July 2012. In January 2017, Brian was diagnosed with lung cancer and had part of his lung removed; Christine, 55, who began smoking at age 16 and was diagnosed at age 44 with oral cancer, which eventually required doctors to remove half of her jaw; Sharon, 58, who began smoking at age 13 and at age 37 was diagnosed with stage IV throat cancer; and, Tiffany, age 40, who started smoking at 19, even though her mother died of lung cancer due to smoking. Tiffany quit smoking in 2011 because she wanted to be around to support her own teenage daughter.

The Alliance is promoting the 2018 Tips Campaign through its Nuestras Voces (Our Voices) Network, spearheaded by 11 regional partners around the country, which works to reduce tobacco use and cancer incidence in Hispanic communities. Activities to support these efforts include providing training on evidence-based tobacco and cancer initiatives, connecting individuals to cessation support, and conducting bilingual national media activities and social media outreach.

Nuestras Voces is a national network of over 300 members working for a tobacco-free world and to eliminate disparities in cancer prevention and treatment services. You can be part of this effort led by the National Alliance for Hispanic Health!

According to Dr. Delgado, “With tobacco companies set to spend over $9.1 billion in 2018 to addict new customers on their poisonous products, the Tips Campaign is a critical tool to make sure our communities know the real costs of this dangerous habit and how to get the help they need to quit.” Click here for more information on the Tips Campaign, or call the Alliance’s Su Familia Helpline at 1-866-783-2645 for information on quitting smoking, talking to a loved one about smoking, or connecting to health services in local communities.

Read more on PRNewswire.com

Filed Under: News

Can Story Circles Build Support for Solutions Across Class and Racial Divides?

July 31, 2018

Like many cities across the country, Sacramento, Calif., is grappling with an affordable-housing crisis notes Jessika Maria Ross, writing for Current. We’ve had the fastest rising rents in the nation for two years in a row. We have record-high home prices, a skyrocketing homeless population, and intensifying gentrification and displacement. We also have many neighborhoods of color that for years have been overlooked due to historic housing policies and a lack of economic opportunity.

In other words, residents from all walks of life in Sacramento are affected by the shortage of affordable housing, just in different ways. But there isn’t a place where this diverse range of community members can come together and find common ground.

Capital Public Radio, where Ross works as senior community engagement strategist, responded to the crisis by spending the past year digging into the history, politics and economics of housing affordability in California’s capital. We produced TheView From Here: Place And Privilege, an eight-part podcast, hourlong radio documentary and online community platform.

To go beyond sharing content on-air and online, CapRadio tried something different. Ross organized “Story Circles” that brought wildly diverse residents face to face in intimate settings to talk about housing, hear one another and envision the way forward. It was an experiment in deep listening, radical hospitality and bridge-building. The results were astounding.

A Story Circle is pretty much what it sounds like — a group of people sitting together and sharing personal experiences on a theme guided by a facilitator. In CapRadio’s Story Circles, Ross invited participants to tell a story about when having a home made a difference in their lives.

This deceptively simple process opened participants up to each other’s struggles, fears, and dreams, creating an emotional intimacy and social bonding among people who usually wouldn’t be in the same room. Afterwards, group members explored what they heard and what it means. By the end, people saw both real differences and things their stories had in common. Most of all, they’d met people with different opinions, listened generously to their viewpoints and left with new insights.

One participant summed it up this way: “I’m coming away tonight with a more complete picture of Sacramento’s housing crisis because, frankly, there are a lot of people — people who experience homelessness, for example — that I don’t come in contact with in my daily life. And … hearing their stories and learning their struggles is, I think, a very important aspect that I didn’t have enough of before tonight.”

Designing for diversity

CapRadio partnered with 12 community organizations to co-host six Story Circles. Ross designed these events so that each gathering included residents with very different life experiences and perspectives on housing. Community partners brought homeless and low-income renters, social-service providers, activists who are people of color, affordable-housing advocates and developers to the gatherings.

CapRadio brought affluent, white homeowners — representative of their core audience — by marketing the events on-air and via our social media channels. Ross also recruited millennials from the regional YIMBY (Yes In My Backyard) group, business leaders, local government staffers and building-industry executives to participate in the Story Circles. We held these gatherings at affordable-housing complexes, community centers and public schools in low-income neighborhoods throughout Sacramento.

Story Circle groups were kept small to promote intimacy and honest storytelling. Chairs were set up in a circle with flowers and candles at the center to spark interpersonal engagement and convey a beautiful and inviting atmosphere. (Attention to beauty, radical hospitality and intentional curation are three of Ross’ core strategies for encounter design.) CapRadio staff personally greeted guests and introduced them to others in the room as they got dinner and sat down, creating a welcoming and inclusive vibe.

The Story Circles were two-and-a-half hours long. They began with thirty minutes to mingle and share a meal, as well as an opportunity to participate in CapRadio’s storybooth: a mobile portrait studio where guests could have a professional photo taken and write down their views regarding housing and home.

During the Story Circles, participants shared, in turn, a personal story illuminating the role of housing in their lives. Then they broke into trios to discuss themes and patterns. The full group reconvened to identify insights, epiphanies and action steps. To close, Ross recorded audio of participants reflecting on what they took away from the experience, and each completed a brief, anonymous survey. Everyone was offered a flower from the bouquet and mobile phone wallets with personalized thank-you cards tucked inside as gifts.

Story Circles was staffed with four people: a community partner, Ross, and two CapRadio community engagement interns. All participated in setting up the events, greeting people and getting to know them. The community partner began the events with opening remarks and told the first story. Ross facilitated the circle while one intern staffed the StoryBooth and the other took notes to share back with CapRadio’s newsroom and the project evaluator. Each event cost about $400 for food, flowers, supplies and child care.

What was learned

To assess CapRadio’s Story Circle outcomes, Ross administered participant surveys, recorded reflections and observed while Lindsay Green-Barber of Impact Architects interviewed community partners and analyzed the data. Here’s what was discovered:

  • 82 percent of participants said they met people with whom they wouldn’t normally connect and heard diverse perspectives and life experiences.
  • 83 percent reported an increased awareness about local housing challenges, the root causes of the crisis and potential solutions.
  • 83 percent said their empathy for others increased.
  • 89 percent said they planned to talk to friends and family about the stories they had heard, the issues and solutions.
  • 91 percent said they were inspired to act, which they described as staying connected with others at the event, getting involved in projects they learned about, or writing publicly elected officials.

Many participants said they appreciated the rare opportunity to explore ideas with people who are different from them. As one participant put it: “What I gained from this event was just really the multiple perspectives. I mean, to be honest, I probably wouldn’t be interacting with a lot of the folks here. I think just being put in a situation where everyone is kind of on equal footing you’re in this circle. You just kind of just chat it up. And after a few minutes it really feels like they are your neighbors or people you like.”

While each Story Circle generated unique stories based on the mix of community members present, common themes emerged across the events. The top three that Impact Architects identified included:

Commonality. Community members — whether dealing with homelessness, experiencing difficulty finding affordable housing or concerned generally about the crisis in the region — expressed surprise at the similarity of their experiences. Community members expressed a desire for more opportunities to have conversations across perceived divides in order to deepen this sense of commonality and shared humanity.

Stigma. Participants attributed society’s poor treatment of people dealing with homelessness to a lack of contact across socioeconomic lines and institutionalized racism. Community members said that society blames the individual, rather than looking at systemic factors contributing to homelessness, poverty, and inequality.

Hope and determination. Participants said that the shared sense of belonging to a greater community and the empathy and interest they saw in their neighbors during the Story Circles gave them hope that together they can tackle the challenges associated with the affordable-housing crisis in Sacramento. Community members told stories about overcoming challenges with the support of family and community, highlighting the importance of these networks.

Story Circle participants said they left with the feeling that there are solutions to the affordable housing crisis, as well as an increased sense that they could contribute to real, meaningful change. “I’m taking away hope that we can solve this problem,” one said. “… [I]t’s inspiring and encouraging to know that so many people are thinking about this. And I personally plan to get more involved, … contact public officials and … do my part more in the community than what I have.”

But this is Ross’ big takeaway: “We surround ourselves — consciously or not — with voices and views that align with our own. We need Contact Zones like CapRadio’s Story Circles that bring people together across silos to engage in meaningful conversations about pressing social issues. Designing those encounters takes effort, skill, and resources. The question is: Are public radio stations game to shift resources from their newsrooms or hustle additional funds to make it happen?

I’ve written elsewhere about Contact Zones and public radio’s unique position to create spaces for deep listening and community problem-solving. CapRadio’s experiment with Story Circles shows that we can design encounters that cause a shift towards empathy, often leading to a shared vision and collective action. These are the kind of outcomes that support democratic traditions and rebuild trust, not only among residents but also with the media institutions set up to serve them.”

For more on Story Circles, take a look at the methods pioneered by Roadside Theatre, the work of the U.S. Department of Arts and Culture, and this leader’s guide to hosting Story Circles on racial healing and equity produced by the Winter Institute.

Read more on Current.org.

Filed Under: News

In Efforts to Reduce Mental Health Disparities, Diversity Matters

July 27, 2018

The following was written by and from the perspective of Dr. Joshua Gordon, Director of the National Institute of Mental Health (NIMH).

Disparities in mental health play outsized roles in our society. People from racial and ethnic minority populations, as well as those from lower socioeconomic strata, and those who live in rural communities, are less likely to have access to mental health care and more likely to receive lower quality care. There have been recent investments in community mental health centers and the expansion of Medicaid, but more work is needed to eliminate these disparities. To address mental health disparities, we need to identify and understand the contributing factors and study the efficacy of programs to remedy them. In recognition of National Minority Mental Health Awareness Month, I am highlighting this important element of NIMH’s research portfolio.

From causes to effects

In some ways, addressing disparities in the mental health system should start with the basics—and by that, I mean basic science. In our search for the roots of mental illnesses, an area that has made great progress over the past five years is genetics. As I have written about before, we now know hundreds of places in the genome where genetic variation raises the risk for psychiatric disorders. While we can be justifiably proud of these successes, we must also acknowledge a serious shortcoming—historically, the vast majority of the subjects in these genetic studies were of European ancestry, and it is therefore unclear how much these discoveries will benefit the majority of people of differing ethnicities.

NIMH Figure: Suicide Rates for Males and Females by Race/Ethnicity in the U.S.

Emerging data from an NIMH-funded study of the genetics of post-traumatic stress disorder (PTSD), for which our Psychiatric Genetics Consortium made a concerted effort to include studies with participants from the African American community, illustrates the importance of recruiting subjects from diverse genetic backgrounds. This analysis, which combined data across 11 multiethnic studies, revealed strong heritability and overlap between the genetics of PTSD and that of schizophrenia.  These were interesting scientific findings—but limited in that they only applied to the Caucasian participants. It turned out that the genetics of the African American sample set was much more complex and varied than in Caucasians, so even though the researchers had included data from a large number of African American participants, there were still too little data to provide information on disease heritability with respect to African genetic ancestries. These and other data point to the need to increase the recruitment of individuals of African descent in our psychiatric genetics studies, as we are doing with NIMH’s component of the NIH-wide H3Africa program, a collaborative effort to enroll large numbers of individuals from sub-Saharan Africa in genetic studies of schizophrenia, as well as an NIMH-supported effort to increase the diversity in genetic studies of autism, schizophrenia and bipolar disorder.

Like the causes, the consequences of mental illnesses differ for minorities as well. Nowhere is this more evident than for one of the most devastating effects of mental illnesses: suicide. According to the Centers for Disease Control and Prevention, the rates of suicide vary significantly by race/ethnicity (see figure). In particular, individuals from American Indian and Alaska Native (AI/AN) communities die from suicide at significantly higher rates than whites or other racial or ethnic minorities—the suicide rate for AI/AN youths is especially alarming, being over 3.5 times higher than those among racial/ethnic groups with the lowest rates. To address this devastating issue, the NIMH, in partnership with the National Institute on Minority Health and Health Disparities (NIMHD), funds three collaborative research “hubs” that bring together academics, tribal leaders, and peers. These partnerships aim to build capacity for research in AI/AN communities; to determine what factors lead to this increase in suicide risk; to develop and tailor treatments that work in these communities; and, to learn how to implement these strategies using novel approaches and technologies suited to the unique needs of AI/AN communities.

In addition to supporting these research hubs, the NIMH has participated along with other federal partners in the Arctic Council’s RISING SUN initiative, aimed at reducing the incidence of suicide in indigenous groups living in the far northern regions of North America, Europe, and Asia. A major output of this effort is the RISING SUN toolkit, which aims to help clinicians, communities, policymakers, and researchers measure the impact and effectiveness of suicide prevention efforts in rural and tribal communities.

Understanding differences in treatment effects

The good news is there are treatments that work, even if they don’t always work for everyone. Recent research has shown, however, that paying attention to differences in treatment responses in specific groups can help make our treatments work better. Including diverse groups in research can also reveal why there are differences in treatment effects. A case in point: an NIMH-funded study published just last year showed one way to improve the effectiveness of depression and anxiety treatment in Hispanic youth. Scientists were studying two alternative methods of delivering treatment to adolescents suffering from anxiety and depression in primary care settings: one, an “assisted referral to care” method that helped patients get care at an outpatient mental health center, and the other, a “brief behavioral therapy” delivered in the primary care setting itself.

The results of the trial showed that in the non-Hispanic group, children generally did better with the therapy delivered in the primary care setting, with about 50 percent of children responding to the treatment compared to 30 percent who received assisted referral care. 

But this difference in efficacy was even more dramatic in Hispanic children. Nearly 80 percent of Hispanic children responded to the brief behavioral therapy delivered in a primary care setting, while less than 10 percent of these children responded to treatment delivered through assisted referral. These data demonstrate that delivering care to Hispanic children may be better off done in primary care offices than through specialty mental health care settings.

Of course, most mental health disparities are not so easily addressed. In particular, we need to know more about the “whys” behind these disparities, so that we can begin to design strategies to remedy them. An ongoing NIMH-supported study is examining the effects of dietary supplementation with vitamin D and omega-3 fatty acids on depression in the elderly. Early results from the study suggest that the effects of these supplements vary with ethnicity. The scientists are using the second phase of the study to try to ask why. Do individuals from different ethnic backgrounds absorb these substances differently? Do they have different metabolic responses to the supplements? That study is examining biological factors contributing to mental health disparities; other NIMH-supported efforts focus on psychosocial factors such as the impact of race-related violence exposure on mental health, or the environmental and social factors behind elevated rates of depression in minorities.

Finally, we must acknowledge that disparities in access to care arise from workforce issues as well. The distribution of psychiatrists and other mental health care professionals is skewed heavily towards urban areas. Rural areas, and areas with many residents of lower socioeconomic classes, are particularly underserved. NIMH supports several studies aimed at understanding the precise distribution of the mental health workforce in relation to its needs, the impact of this distribution on minorities and others in underserved communities, and potential remedies, including the use of task-shifting and telepsychiatry approaches.

The future of disparities research at NIMH

NIMH recognizes a unique and compelling need to reduce and eliminate mental health disparities in communities across the nation. Measuring, monitoring, understanding, and reducing mental health disparities that disproportionately affect minority communities are priorities of the NIMH. In keeping with our focus on high-quality, impactful science, we particularly want to expand opportunities for performing cutting-edge research in mental health disparities targeting underserved groups. We believe that increased focus on approaches such as big data, deep phenotyping, tailored therapies, personalized medicine, and rigorous implementation science will help meet the challenges imposed by mental health disparities.

One of the most important things we can do to understand the sources of these differences is to promote diversity in research, both in those who participate in clinical research and those conducting the research. Innovative approaches aiming to solve problems that contribute to mental health disparities will pave the way toward equitable and appropriate care for all individuals.

Read more on NIMH.NIH.gov.

Filed Under: News

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The NNED has been a multi-agency funded effort with primary funding by the Substance Abuse and Mental Health Services Administration (SAMHSA). It is managed by SAMHSA and the Achieving Behavioral Health Excellence (ABHE) Initiative.
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