Did you know that July is National Minority Mental Health Awareness Month? If not, you’re not alone. Sadly this month is often overlooked by the majority of Americans. It is a time when summer has bloomed, fireworks have entered the scene, and multiple summer parties and cook-outs are in full swing. It comes at a time of the year when so many people are outdoors, enjoying the summer time weather and penetrating sun. This lack of awareness, however, not only affects minorities struggling with mental health problems, but our society at large.
Building Awareness is Key
Building awareness of ethnic minority mental health concerns is key because ethnic minorities tend to be disenfranchised in the field of mental health. Even more, they also tend to avoid mental health services for fear of being racially profiled against, misunderstood, diagnosed incorrectly, ignored, treated indifferently, or due to trust issues. As one who has worked with juvenile delinquents who are ethnic minorities, I can safely say that many requested therapy services from staff who were considered “minorities” or individuals who had great exposure to and acceptance of their culture(s). One 15-year-old Native American adolescent boy with a history of burglary and psychosis said to me during a psychiatric assessment in which I asked why he had never sought services: “why would I go to someone who oppressed my entire culture and continues to segregate in parts of the world?” This question was eye-opening and earth-shattering as I realized that he not only suffered from the oppression of his psychiatric illness, but also fear and lack of trust of a so-called “dominate culture” in the U.S. According to the National Alliance on Mental Illness (NAMI), Native American males account for 64% of suicides among those ages 15-24. It’s an issue that many clinicians and mental health professionals neglect to pay attention to.
NAMI also reports that there aren’t many Latino or Hispanic mental health professionals. This tends to affect the level of Latino or Hispanic individuals who feel comfortable with therapy. There are a reported 29 Latino mental health professionals for every 100,000 Latinos. Asian Americans are also highly ignored in matters of mental health. Interestingly, 20% of Asian Americans are problem gamblers and about 9.1% struggle with substance abuse.
Services are hard to locate
Even more, mental health services are often underutilized and highly stigmatized by the ethnic minority community. Treatment is typically the last resort for cultures who rely heavily on holistic health, alternative and nontraditional healing practices (e.g., the Native American and Alaskan/Indian culture), faith-oriented practices, and Christian counseling. Sadly, for urban or inner-city residents the majority of services are found in suburban or “well-to-do” areas as well as larger cities. Securing transpiration or funds to travel and being able to pay for services can be a headache for many families. As a result, various alternative avenues are sought before traditional psychiatric services are even considered. These “alternative solutions” may even include illegal use of drugs such as narcotics, marijuana, alcohol, or other street drugs. The pressure continues to mount as the individual with untreated mental health problems now struggles with substance abuse problems as well. Dual treatment programs are also often out of reach for these individuals.
Many theories on ethnic minority mental health support the view that services continue to be out of reach physically (i.e., location) or financially. While this is true, other pressing issues include personal lack of interest or knowledge about mental illness, high clinical fees, and lack of cultural competence among mental health therapists.
Tips for clinicians or therapists
It’s important to be mindful of the emotional expression of ethnic minorities seeking mental health treatment. This is especially important for clinicians and mental health therapists who perform psychiatric evaluations, assessments, or brief therapy or medication appointments. It is also important for clinicians and mental health professionals to be mindful of cultural competence (a sensitivity to the culture and issues of an ethnic group) at all times. It’s something I must remind myself of in many of my sessions with clients of other cultures and even the same culture as myself. Cultural competence includes an array of skills necessary to empathize with and fully understand the needs of individuals from other cultures. For example, it may be difficult for a clinician to understand why a young Native American male would rather engage in indigenous healing practices such as the Shaman healing ritual as opposed to seeking medical attention for thyroid disease. But cultural competence would help you understand not only their preferences for treatment, but their emotional and psychological connection to their preference(s).
The same is true for the Hispanic or African American culture. An African American or Hispanic male may find it difficult to accept counseling services from a Caucasian male due to an incorrect perspective that all White males are controlling, intimidating, and oppressive. As many mental health professionals will recall, the field of psychiatry was historically dominated by White, middle-class males. It was difficult for females to even enter the field and be respected! Today, this has changed and many cultures as well as females have entered the field. But some individuals who do not understand this change may continue to run from counseling because of what they’ve always known about psychiatry.
Issues we all need to be reminded of
Before we can properly educate others about National Minority Mental Health Awareness Month we need to understand the issues that prevent proper psychiatric care:
- Poor understanding: Many ethnic minority families have poor knowledge of how mental health influences behavior, thought patterns, and lifestyle. Most behavior is viewed as problematic due to an inborn characteristic that cannot be changed
- Lack of ethnic support: Only 2% of Psychiatrists and 2% of Psychologists in the U.S. are African American. For many ethnic minority families, it can be stressful considering the need for mental health treatment and can become even more daunting if there are limited opportunities to meet with therapists who you feel can relate to you.
- Lack of cultural competence: Because psychotherapy has been an avenue largely sought and researched by middle class Europeans, ethnic minorities, primarily African Americans and Native Americans, have had little access to services and have not been included in research. We are just beginning to incorporate ethnic minorities in research and provide avenues for access to treatment.
- Gender: It can be difficult for males of all races to express feelings of depression or anxiety. But it can be even more difficult for African American males due to their cultural background. In African American communities, males should “tough it out and get over it.” In other cases, many are far more represented in the criminal/juvenile justice system than the mental health system.