July — a fitting time to examine the intersection of race and mental health

 

Struggles surrounding mental health do not discriminate, and as topics surrounding mental wellness have slowly become less taboo, understanding and awareness have become all the more important. While May marks Mental Health Awareness Month, July is recognized as Bebe Moore Campbell National Minority Mental Health Awareness Month.

 

BEBE MOORE CAMPBELL

 

Moore Campbell was an author, journalist, educator and someone the National Alliance on Mental Illness has called “a literary trailblazer.” As a New York Times bestselling author, many of her books, including 72 Hour Hold, addressed the profound impact of racism, mental health and disparity in care. In addition to shedding light on the unique struggles faced by people of color, she also co-founded NAMI Los Angeles, where she changed the way mental health was typically approached in underserved communities.

 

In 2008, July was nationally declared Bebe Moore Campbell National Minority Mental Health Awareness Month in order to achieve two bipartisan goals: to improve access to mental health treatment and services while promoting public awareness of mental illness and to name the month in order to bring public awareness to mental illness among underserved communities. According to NAMI, Moore Campbell’s legacy lives on through its work to create a future that embraces diversity, uplifts marginalized communities and listens to every voice.

 

NATIONAL NUMBERS

 

Millions of people are affected by mental illness each year across the United States, and according to NAMI, 22.8 percent, or 57.8 million adults, experienced mental illness in 2021. Of that, 1 in 20 adults experienced serious mental illness. Mental illness also rose in prevalence among all demographics, and treatment rates reflected disparity in care, the report states.

 

According to the report, the average delay between symptom onset and treatment is 11 years. About 47 percent of adults with mental illness, 65 percent of adults with serious mental illness and 51 percent of youth with mental health conditions receive treatment in a given year.

 

Of adults with a mental health diagnosis, 52 percent of white adults, 52 percent of biracial and multicultural adults, 25 percent of Asian adults, 36 percent of Hispanic or Latino adults, and 39 percent of Black adults received treatment or counseling in 2021, NAMI states.

 

BARRIERS TO CARE

 

According to the American Psychiatric Association’s most recent Mental Health Disparities in Diverse Populations, there are many factors within diverse groups that affect access to mental health treatment. They include lack of insurance or underinsurance; mental illness stigma, which is often greater among minority populations; lack of diversity among mental health care providers; lack of culturally competent providers; language barriers; distrust in the health care system; and inadequate support for mental health service in safety-net settings.

 

Kenya Eddings, director of the Arkansas Department of Health Minority Health Commission, said there are several barriers that commonly affect minority patients when it comes to receiving treatment for both physical and mental health conditions.

 

“Social determinants of health play a huge role in access — or lack thereof — to preventative health care. Where one lives in proximity to healthy food, health care or places for physical activity are all potential barriers,” Eddings said. “Moreover, Arkansas is a rural state, and even in certain urban areas, transportation is a barrier to the aforementioned. Additionally, some minorities are underinsured or uninsured, which lends itself to limited access to preventive health care and treatment.”

 

Eddings also cited systemic hurdles such as geographic location and health literacy as major barriers. With a variety of deserts such as food, transportation and health care, lack of access can lead to an increase in chronic disease.

 

When referring to different cultures, Eddings said language, in particular, can be one of the most significant barriers for patients. As Marshallese communities and communities in which members only speak Spanish have grown exponentially, there is a greater need for help from organizations such as the Arkansas Coalition of Marshallese, Arkansas Human Development Corp. and the Arkansas Medical, Dental and Pharmaceutical Association. The MHC works in partnership with organizations to provide programming statewide to help meet that need.

 

After almost 20 years in the corporate world, Erica Walter, owner of Live Well Counseling in Fayetteville, switched paths in order to help people find peace in their personal lives and relationships. As a wife and a mother of four, she said she understands how some of life’s hurdles are unavoidable and is equally as passionate about mental health services as she is about creating inclusivity in her services.

 

“Some of the largest barriers for minorities seeking mental health services include stigma within our communities, lack of culturally competent mental health providers and discrimination in health care settings,” Walter said. ”These barriers can prevent individuals from seeking help to receive adequate support for their mental health needs.”

 

As a therapist specializing in trauma and ADHD, Walter identified not only the issue of stigma surrounding therapy in general, but also stigma surrounding disorders and diagnoses.

 

“To reduce stigma, we must acknowledge and validate the existence of racial trauma, and recognize the unique, yet real experiences faced by BIPOC individuals living in this country,” Walter said. “[Bebe Moore Campbell National Minority Mental Health Awareness Month] is important for several reasons, but overall, it is essential in promoting mental health equity, validating diverse experiences, and fostering a more inclusive and supportive mental health landscape for all individuals. This inclusivity will also reduce stigma.”

 

BIPOC stands for Black, indigenous and other people of color.

 

Walter combats inequity at her own practice by offering reduced rates; through advocacy and allyship; by relaying information about community resources; and by offering trauma-informed care, which takes systemic inequities in mental health into consideration.

 

Cameisha Brewer Dickerson, owner of Cameisha Brewer Consulting in North Little Rock, a virtual, full-service mental health consulting company, also addresses barriers to care and the disproportionate impact they have on minority populations. While there are many ways providers work to match needs to services, awareness and education allow for greater equity, she said.

 

“I think for a lot of minorities, it is hard to know where to start in finding a provider. It’s public information, but if you don’t know where to go, then you’re not going to know where to look for a therapist,” Brewer Dickerson said. “Knowing how to pay for sessions is also a large barrier.”

 

Depending on insurance, policy coverage, lack of insurance or switching insurance, options for mental health care coverage can quickly become limited. Other barriers Brewer Dickerson identified were scheduling conflicts, access to telehealth, limited paid time off and waitlists.

 

One way both Brewer Dickerson and Walter have created options in care is by providing telehealth appointments. While telehealth is not new, it spiked in popularity following the COVID-19 pandemic.

 

Telehealth has existed in mental health services for much longer than it has been popularized and, like many practitioners, both Walter and Brewer Dickerson offer telehealth appointments. Brewer Dickerson said while many of her patients prefer telehealth due to busy schedules, she plans to open a brick-and-mortar in the near future to better serve potential clients who prefer in-person services.

 

While stigma continues to deter patients from seeking mental health care, Brewer Dickerson works to continue conversations on mental health topics by informing others and creating awareness.

 

“I think [conversation] is what really changes the world. In my opinion, there is not a single place where we can’t have a conversation about mental health,” Brewer Dickerson said.

 

When seeking care, Brewer Dickerson stresses the importance of engaging in consultations, which are not only beneficial for providers but also for clients. As is true in any other sector of health, mental health professionals commonly specialize in different treatment areas.

 

Many insurance policies and employee assistance programs only allow for a certain number of visits per year, so Brewer Dickerson stressed that those who are seeking help must be clear and intentional about finding the right providers for themselves.

 

“If you’re having heart issues, you don’t just Google for a general doctor; you need to find the cardiologist,” Brewer Dickerson said. “Therapy is the same.”

 

TOOLS FOR SUCCESS

 

The Arkansas Department of Human Services works to make sure services are available to all Arkansans who need them, including underserved populations. Eddings said Medicaid beneficiaries who have been clinically diagnosed as seriously mentally ill or seriously emotionally disturbed are served through the Provider-Led Arkansas Shared Savings Entity program. Additionally, Medicaid provides access to outpatient counseling and medications in order to treat mental health conditions, including anxiety and depression.

 

“We are proud that the Arkansas Department of Human Services, [the University of Arkansas for Medical Sciences in Little Rock] and [Arkansas Children’s] have programming in place to assist people of all ages get help they or a loved one may need with mental health services statewide,” Eddings said. “As always, we encourage people who are struggling with mental health challenges to call or text 988. If someone is thinking of harming themselves or someone else, call 911 immediately.”

 

Recently, Gov. Sarah Huckabee Sanders and the DHS announced a comprehensive plan to invest $30 million in a variety of initiatives tied to mental health and substance abuse services, including the creation of a statewide coordinated crisis response system.

 

“The plan will create several key support services that address service gaps and improve quality for children and at-risk populations, including adding therapeutic community beds for adults with co-occurring mental illness and community reintegration programs for children and supportive housing for adults with mental illness,” Eddings said.

 

The statewide crisis response network will also include a 24-hour call center that allows first responders to use tablets to connect individuals in crisis with clinicians, as well as establish new training programs and create mobile crisis teams.