July is Minority Mental Health Month. While we celebrate the gains made by minoritized populations in the United States, much remains to be done.
Notwithstanding the increased national dialogue around racism following the death of George Floyd, structural and interpersonal racism persist, with lasting effects on life expectancy and wellness of minorities. These disparities are endemic and affect access to and quality of healthcare and social and economic opportunities.
Some concerning facts about health and wellbeing of minorities in the United States:
- Although suicide rates went down during the pandemic, rates increased among minorities, particularly black pre-teen youth. The same trends are noted among LGBTQ individuals.
- LGBTQ youth are significantly more likely to become homeless compared with other populations.
- Marginalized populations experienced a disproportionate increase in anxiety and depression.
- Racial and ethnic minorities groups disproportionately lack access to mental health treatment and medications.
- Black and brown people are systematically overdiagnosed with psychotic disorders.
- Black and brown persons with mental illness are incarcerated for longer periods.
- 50 percent of white U.S. medical students hold inaccurate views on physical differences that are known to lead to discriminatory treatment.
- Compared to whites, minority ethnic populations are more likely to die of preventable cardiac causes.
- Reduced overall life expectancy (including higher rates of maternal and infant mortality) among minority populations has been linked to the trauma of systemic racism.
- Representation of minoritized ethnicities in the healthcare workforce remains low.
- Fear of deportation has been shown to significantly affect the mental health of immigrants, particularly children.
Stigma also remains a major factor in preventing minoritized groups from seeking help. Social determinants such as lack of transportation, unstable housing, lack of health insurance, and jobs that don’t provide paid time off for treatment constitute structural barriers to seeking help. Fortunately, many communities have developed effective approaches to facilitate resilience and healing. These include arts, music, community resources, and spiritual practices.
Utilizing the Trauma, Equity and Community (TEC) framework, the Philadelphia Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) has developed strategies to mitigate the impact of structural disparities on marginalized communities, along with improving access to care.
DBHIDS’ efforts include the following targeted programs, many of which disproportionately serve marginalized communities.
- DBHIDS’ Diversity, Equity, and Intervention Unit
- Mural Arts program
- Engaging Males of Color (EMOC)
- City-wide Language Access policy
- Facilitating/supporting virtual spaces/listening sessions across the City following traumatic events.
- Faith and Spiritual Affairs.
- Network of Neighbors program, which supports communities experiencing traumatic events.
- Immigrant and Refugee Wellness Academy.
- Community Wellness Engagement Units.
- Behavioral health screening.
- Mental Health First Aid.
- The SAMHSA ReCAST grant, which targets communities disproportionately impacted by trauma and civil unrest over the past two years.
Philadelphians experiencing a behavioral health crisis also can call the Philadelphia Crisis Line 24/7 at 215-685-6440 or the national Lifeline 1-800-273-8255 to get help from a trained counselor. If needed, a mobile team will be dispatched to the person’s location to provide help from a trained behavioral health team.
Sosunmolu Shoyinka, MD, MBA, is Chief Medical Officer for the City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services (DBHIDS).