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Minorities Get Different Mental Health Care in Rich Neighborhoods

By Becky Ham, Staff Writer
Health Behavior News Service

Minorities living in relatively wealthy New York City neighborhoods are
more likely to receive mental health care in emergency rooms and
hospitals than white people living in the same areas, a new study concludes.

The trend may suggest that minorities in these neighborhoods are
receiving sporadic “crisis” care rather than regular mental health care.
Blacks and Hispanics who live in low-poverty areas are also more likely to be referred to public mental health services by police or social
services personnel rather than family or friends, as is the case for white residents.

“Minorities in low-poverty areas may stand out as more
‘attention-worthy’ than others — more visible — such that their deviant behaviors are readily recognized and constrained,” suggest Julian Chun-Chung Chow, Ph.D., of the University of California, Berkeley, and colleagues.

The research, published in the American Journal of Public Health, is
one of the first studies conducted outside of California that compares
mental health services use by minorities living at different poverty
levels, the researchers say.

Chow and colleagues compared public mental health services use among 33,278 white, 23,683 black, 19,849 Hispanic and 1,275 Asian patients in low- and high-poverty areas in New York. In their study, low-poverty areas were defined as zip code regions where fewer than 20 percent of households were below the poverty level. High-poverty areas were those in which 20 percent or more of the households were living above the poverty level.

Minority mental health service users were more likely than white users
to live in high-poverty areas. Twenty-seven percent of Asian patients,
49 percent of black patients and 61 percent of Hispanic patients lived
in these poorer neighborhoods, compared with 15 percent of their white
counterparts.

Compared to the overall population in low-poverty neighborhoods, a
disproportionately high number of black and Hispanic residents in
low-poverty areas used public mental health services, the researchers found. The number of white and Asian patients using the public services in low-poverty areas was lower than expected.

Chow and colleagues’ findings also suggest that youth are important
users of public mental health services. They note that 25 percent of black and Hispanic public services patients, along 10 percent of white and Asian patients, were 18 years old or younger. These percentages were the same in both low- and high-poverty neighborhoods.

The study was supported by the National Institute of Aging.

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FOR MORE INFORMATION
Health Behavior News Service: (202) 387-2829 or www.hbns.org.
Interviews: Contact Julian Chun-Chung Chow at (510) 643-9288 or
jchow99@uclink4.berkeley.edu.
American Journal of Public Health: (202) 777-2511 or www.ajph.org.

Report: Minority less likely to receive needed mental healthcare

By Carl Gilbert, M.D.

Two thirds of Americans who need mental healthcare treatment fail to receive that care, and members of racial and ethnic minority groups are even less likely to receive the mental health services they need, according to a report released by the US Surgeon General's office.

The 200-page report, entitled "Mental Health: Culture, Race, and Ethnicity," reviewed mental health disparities among the nation's African Americans, Hispanics, Asian Americans/Pacific Islanders, and Native Americans/Alaskan Natives. The report is an add-on to the Surgeon General's "Report on Mental Health," which was released in December 1999.

"Minorities have a greater burden of mental illness, not because their illnesses are more severe or prevalent, but because of barriers in access to care and utilization of services," US Surgeon General Dr. David Satcher told a roomful of psychologists assembled in August 2001 at the 109th annual meeting of the American Psychological Association.

In what appeared to be a direct message to the nation's millions of ethnic group members, Satcher stated: "If you or a loved one is experiencing what you think might be a mental disorder, seek treatment and seek it now,..." The Surgeon General, who is an African American, added: "Insist on the services that should be available to you, whatever your race or your ethnicity."

The report found that, overall, mental health disorders such as depression, panic disorder and schizophrenia were as common in minority community members as in non-minorities. However, members of minority groups were significantly less likely to receive treatment for their illnesses.

The report points out that not only are minorities less likely to receive necessary mental healthcare, but they often receive an inferior quality of treatment or are misdiagnosed. This reduced quality of care causes more minorities to experience disabilities as a result of their mental illness, Satcher said.

The problem is compounded , he noted, by the fact that minority groups are over-represented in populations at risk for mental illness, such as homeless, impoverished or incarcerated individuals. "The failure to deal with this is playing out across our streets, prisons and jails," Satcher said.

According to the report, some of the reasons minorities may have reduced access to mental healthcare include language barriers, financial costs, lack of health insurance, and the stigma of being labeled mentally ill. Some Asian Americans and Hispanics reported, for example, having difficulty accessing mental health providers due to English-speaking limitations. About 25% of African Americans and more than one third of Hispanics do not have health insurance.

Satcher noted that after dealing with racism, members of a minority group may want to avoid the further shame of being labeled mentally ill. "Having another area of stigma is something people are not willing to bear," he said.

The Surgeon General called for more diversity among mental health professionals so minority populations could be better served. "We must build more culturally competent providers," he said. "We must find a way to make our mental health system relevant to these communities."

To see the full report of the Surgeon General, click here