APA's Department of Minority and National Affairs convened more than 20
advocates from government agencies, mental health organizations, and consumer
groups in March to design an action plan that will lead to improving mental
health care for racial and ethnic
minorities.FIG1
During the roundtable meeting, participants were charged with developing
specific recommendations to meet objectives such as expanding mental health
research on racial and ethnic minority subjects; developing outcome-based,
culturally competent training for psychiatrists and mental health
professionals; enhancing access to mental health care for minority
populations; and promoting mental health in minority populations through
collaboration and advocacy.
The Department of Minority and National Affairs is compiling the
recommendations made at the meeting into a resource document, and meeting
participants are expected to take the recommendations back to their respective
organizations to begin implementation.
"We must ensure that mental health disparities among minority groups
are a top priority of mental health advocacy agendas," said Annelle
Primm, M.D., M.P.H., director of the Department of Minority and National
Affairs and one of the meeting's chairs.
Altha Stewart, M.D., co-chair of the meeting, described the ultimate goal
that participants were to keep in mind while deliberating their
recommendations.
"We'd like to see a mental health system in which there are no
barriers to care for racial and ethnic minority populations," Stewart
said, and through which services would be delivered "in a linguistically
and culturally sensitive
manner."FIG2
She also emphasized that in the ideal mental health system, there would be"
no wrong door through which to enter treatment." Stewart is
president of the American Psychiatric Foundation, which helped fund the
meeting.
The mental health system known to many members of racial and ethnic
minority groups couldn't be more different from the ideal one Stewart
envisioned.
When he was U.S. surgeon general, David Satcher, M.D., brought national
attention to the disparity in access, quality, and availability of mental
health services for minorities in his 2001 report, "Mental Health:
Culture, Race, and Ethnicity."
In his report, Satcher noted that African Americans were less likely than
white Americans to receive appropriate care for depression or anxiety, for
instance, and that suicide rates in certain groups of Asian-American patients
surpassed those of any other racial group in the United States.
Some of the recommendations that participants discussed for APA were
expanding the role of minorities in mental health research and publication of
best-practice guidelines for mental health services for nonwhite populations.
Another recommendation that was discussed called for APA to strengthen its
relationships with congressional staff to increase the likelihood that
Congress will pass legislation on minority mental health issues.
"We're aware of the difficulty of getting minorities to participate
in research because of problems with trust" in medical research, said
Henry Chung, M.D., a clinical associate professor of psychiatry at New York
University School of Medicine and senior director of research and strategic
management at the Charles B. Wang Community Health Center in New York."
We need to conduct more translational research in nontraditional
settings such as correctional facilities and foster homes, because that is
where our minority patients are," he suggested at the meeting.
Collaborations with government agencies and state-licensing boards are
essential to improving the cultural-competency training of mental health
clinicians working with minority populations, the meeting participants
agreed.
They discussed recommending that APA link with individuals who are already
working to train mental health clinicians about cultural issues, such as the
those at the Department of Health and Human Services Interagency Work Group on
the Mental Health Workforce.
In addition, some participants thought it would be helpful to approach
state licensing boards and ask them to implement cultural-competency standards
for trainees applying for professional licenses.
Other recommendations were intended to increase access to mental health
services by minorities, for instance, by placing educational messages about
mental health in newspapers and radio stations popular in minority communities
and linking to "nontraditional" advocates in those communities,
such as clergy or civil-rights leaders.
More information about recommendations from the roundtable meeting
on mental health disparities in racial and ethnic minorities can be obtained
by sending an e-mail to
omna@psych.org.▪