With increasing racial and ethnic diversity and significant changes in understanding risk factors that can affect physical and mental health outcomes, healthcare must advance strategic, clinically-based efforts to improve individuals’ longevity and quality of life .
These issues relate to underserved, disadvantaged, and/or high-risk populations, such as racial and ethnic minorities, who have lower life expectancy than white Americans. 1,2,3 Furthermore, people with severe mental illness die 10 to 20 years earlier from largely preventable comorbidities – such as heart disease, diabetes, This health disparity is further exacerbated by cancer and lung disease—higher rates of these diseases, higher frequency and earlier onset in these vulnerable populations, and lower rates of prevention, detection, and treatment of comorbidities. 3,4
Addressing Multifaceted Physical Issues The physical, mental, and behavioral health needs of minorities in the U.S. population are complex issues that It deserves the attention of clinicians, researchers, scientists, public health professionals and policy makers.
When he was a surgeon, David Satcher, MD, PhD, developed the idea that “no mental health is possible without health” and published Mental Health: Culture, Race, and Ethnicity, the report It concluded that minorities have less access to mental health care, are less likely to receive treatment, and, when they do, tend to receive poorer quality of care than non-minority populations. As a result, racial and ethnic minority populations tend to bear a greater burden of disability related to conduct disorders. 5 In my clinical experience, I find that many of the same disjointed systemic issues of harmful behavior are still relevant. I recommend partnerships with selected community-based organizations, including community health workers and primary health care settings (e.g., federally qualified Strategies of Racial and Racial Differences through Culture-Centered Collaborative Nursing.
For many people, making an appointment with a primary care physician may be their first step, and in some cases, the only way they will be treated by a mental health professional to screen for depression or anxiety disorders. The primary care setting may be a key link in helping to identify and address mental health issues in individuals of diverse ethnicity and culture. 6,7 There is a strong need for an integrated approach to how to provide quality and effective mental health services while respecting the cultural orientation of patients.
Black adults in the United States who are seeking mental health care or suffer from severe mental illness disproportionately lack access to culturally sensitive care. 8 Only 2% of psychiatrists identify as black. 9 Integrated Collaborative Care is a multi-component healthcare system-level intervention that uses Case Manager to link primary care providers, patients, and mental health professionals. 9,10 Primary care providers receive counseling and decision support Diagnosis and treatment by mental health professionals who form a support network 9
Integrated Collaborative Care aims to (1) improve routine screening and diagnosis of mental health disorders; (2) increase provider use of evidence-based protocols for proactive management of illness; (3 ) to improve clinical and community support for clients who are actively involved in treatment goal setting and self-management. 10 Collaborative care is effective in improving quality of life and a range of behavioral health conditions. It empowers patients through community connections that engage patients in managing their overall healthcare and create meaningful connections with their primary care physicians. 10
As health care reforms are implemented, there is an opportunity to improve behavioral health care and support individuals, families, and communities care.
About the author Dr. Kisha Holden, MSCR, has dedicated her career to promoting the mental health and well-being to inform health policy. Dr. Holden is a paid consultant to Janssen Pharmaceuticals, Inc., associated with the Community Health Equity Coalition.
About the Community Health Equity Coalition
The Community Health Equity Alliance prioritizes community-informed solutions to meaningfully advance serious mental illness care. In partnership with Janssen Neuroscience, it brings together influential organizations in mental health advocacy, faith, civic and healthcare professional services to help provide more equitable mental health care for Black adults.