Minorities receive poor mental health care

Discrimination and poverty often contribute to minorities not receiving treatment for mental disorders, according to a report presented by U.S. Surgeon General David Satcher.\nSatcher's 200-page report "Mental Health: Culture, Race and Ethnicity" finds that racial and ethnic minorities collectively experience a greater disability burden from mental illness than do whites. This higher level of burden stems from minorities receiving less care and poorer quality of care, rather than from their illnesses being inherently more severe or prevalent in the community. Minorities also suffer from under-representation in mental health research.\nThe Surgeon General's report determines that the diagnosis and treatment of mental disorders greatly depend on verbal communication and trust between patient and clinician.\n"… Mental health care disparities may also stem from minorities' historical and present-day struggles with racism and discrimination, which affect their mental health and contribute to their lower economic, social and political status" said Satcher in the report. \nLower socioeconomic status -- in terms of income, education and occupation -- has also been strongly linked to mental illness.\nFor the school-age minority population, factors such as busing students into "whiter" neighborhoods can create more emotional strain for students.\n"Because of desegregation mandates, students are bused into foreign neighborhoods that do not have the same cultural makeup that they grew up in. This creates a tremendous hardship on anyone" said Basil Woodfork, school psychologist for Indianapolis Public Schools. "This situation is created to fill a state mandated quota."\nAccording to Indianapolis Public Schools, a "disproportionately high" number of African-American males in the IPS system are diagnosed as "emotionally handicapped." \nMany members of minority groups fear, or feel ill at ease with, the mental health system, according to research presented by Satcher. \n"These groups experience it as the product of white, European culture, shaped by research primarily on white, European populations. Minorities seeking care might find only clinicians who represent a white middle-class orientation, with its cultural values and beliefs, as well as its biases, misconceptions and stereotypes of other cultures" the report states.\nCindy Houston, manager of outpatient services at Bloomington's Center for Behavioral Health, has worked in mental health care for 30 years. She acknowledges there have been barriers between herself and her patients. \nAccording to Houston, cross-cultural communication can cause problems in dialogue between health care providers and patients.\nHouston also said that the language used in mental health can be a problem. \n"The concept of there being a 'mental illness' can mean something radically different to a person from a different culture," she said.\nDr. James Jackson, director of the Program for Research on Black Americans at University of Michigan, said "There is a lack of understanding of the way in which African Americans live their lives, particularly where the religiosity of African Americans is concerned. There is a tremendous religiosity in the lives of African Americans and the ways in which they express this religiosity is not understood (by non-African American health care providers.)"\n"The usual mental health care -- or rather lack of care -- for African Americans takes place in the hospital emergency room," Jackson said. \nThe phenomenon of African Americans going to hospital emergency rooms to seek treatment for mental illness and emotional disorders has been addressed in the past by researchers. It is usually attributed to factors such as lack of insurance and low income.\n"African Americans who get their mental health treatment from emergency rooms get to the emergency room through agents of social control like the police," Jackson said. "People don't come to the emergency room voluntarily. And if the system to treat the mental health problems of African Americans does not exist, then these problems will be treated in prison."\n"A lot of people who run into the criminal justice system would be better treated by the mental health system," Jackson said. "And regarding the mental health care provided to prison inmates, there is none."\nJackson also cited drug use as a problem that exacerbates existing mental health problems that African Americans may have while running them into contact with the police instead of the care providers they need.\n"The problem is lack of diagnosis. Poverty is the big issue, more so than discrimination," he said. "The issues are the quality of service available to minorities and the access to services minorities have."\nHouston said she thinks that the situation between minority patients and mental health care providers has improved over the past few years. \n"The fact that cultural differences between races and ethnic groups, language differences and body language differences can be a barrier between the patient and the care provider has been moved to the front burner in the past five years," she said.\nIn Satcher's report, Asian Americans have proven less likely than whites, African Americans and Hispanic Americans to seek care. Few differences were found between Hispanic Americans and whites in overall rates of mental illness. \nIn Native American communities, depression is found to be a significant problem. Suicide also occurs at alarmingly high levels within this community. And where seeking help from mental health care providers is concerned, the historical experiences of Native Americans have imparted a lack of trust of government, said the report. \n"As with African Americans, the historical relationship of forced control, segregation, racism and discrimination has affected their ability to trust a white majority population," said the Surgeon General's report.\nIn order to solve the mental health care issues that minorities struggle with, the issues of lack of access, poverty and lack of community support must be addressed, said the Surgeon General's report.\n"The cumulative weight and interplay of all barriers to care, not any single one alone, is responsible for mental health disparities"