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Mental Health: Let's Talk About Culture, Race And Ethnicity

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It can be a mouthful to say in a conversation: Minority Mental Health Awareness Monthly (MMHAM). During its annual observance in July, I'm also sometimes asked why it is needed when we already have Mental Health Awareness Month in May.

One recent study provides an answer. Discussed in The Atlantic, research shows that psychotherapists, for example, are more likely to offer appointments to middle-class white people than to middle-class African-Americans or working-class people of any race.

There is a long history of discrimination. Fifteen years ago this summer, the U.S. Surgeon General published Mental Health: Culture, Race, and Ethnicity. The report revealed "striking disparities for minorities in mental health services." Racial and ethnic minorities have less access to mental health services than do whites. They are less likely to receive care when they need it. When they do receive care, the report said, it is more likely to be poor in quality.

Sixty percent of all Americans with mental health conditions do not receive the mental health services they need in any given year. Among those who do, African American and Latinos use mental health services at about one half the rates of Caucasian Americans; for Asian Americans the rate is even lower -- about one-third. Reasons for disparities vary: they may include racism, homophobia or other conscious or unconscious biases, lack of access to services in the community, lack of culture competence in service delivery and a sense of stigma in seeking help.

One recent study has noted that even with enactment of the Affordable Care Act, a universal approach to improving access to health care is not by itself enough to fulfill differing needs and cultural preferences among minority groups. More vigorous outreach "beyond clinical walls," flexibility in scheduling of appointments, expansion of a diverse, culturally competent mental health workforce, and better research on obstacles and alternative treatment options are needed.

That's why MMHAM exists. It's a time to focus on common mental health challenges, but without overlooking important differences and distinctions in the experience of multicultural communities. It's a time for education and dialogue that extends beyond that which was had during Mental Health Awareness Month in May. It is a continuation of efforts to understand how mental illness affects all of us.