July is Minority Mental Health Awareness Month

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More than 60 years ago, Mental Health America (MHA), a non-profit organization committed to raising awareness and promoting the mental health of all Americans, held the first ever Mental Health Month. MHA has held Mental Health Month every May since. In 2008, in response to and in honor of the death of long-time minority mental health advocate Bebe Moore Campbell, U.S. House Representatives Albert Wynn of Maryland and Diane Watson of California co-signed legislation designating July as Bebe Moore Campbell National Minority Mental Health Awareness Month.

Bebe Moore Campbell’s story is one many people who’ve experienced mental illness either personally or through a family member or loved one can relate to. She spent years battling stigma in society, herself, and her family. When she and her family had their breakthrough moment, things began to change for the better.

In her words,

“Once my loved one accepted the diagnosis, healing began for the entire family. But it took too long. It took years. Can’t we, as a nation, begin to speed up that process? We need a national campaign to destigmatize mental illness, especially one targeted toward African Americans…It’s not shameful to have a mental illness. Get treatment. Recovery is possible.”

National Minority Mental Health Awareness Month exists to achieve two primary goals:

  1. Improve access to mental health treatment and services and promote public awareness of mental illness in general.
  2. Enhance public awareness of mental illness among minorities.

We know mental health is a serious issue for the general population. We also know stigma and misconceptions about mental illness and misunderstanding about treatment for mental illness are still prevalent in our society. And we know one more thing: the best way to reduce stigma and eliminate misunderstanding and misconception is through raising awareness.

Mental Health in the U.S.

To that end – eliminating misunderstanding and raising awareness – we’ll offer some general statistics about mental health in the U.S., then offer statistics on minority mental health in the U.S. Once you get an idea of how many people live with mental illness every day – including minorities – you’ll understand the importance of Minority Mental Health Month.

For the moment, though, we’ll look at the big-picture numbers. They’re impossible to ignore:

  • 20% of adults in the U.S. live with a mental health condition – that’s about 46 million.
  • 4% of adults in the U.S. live with a serious mental illness – that’s more than 10 million.
  • 50% of mental health conditions begin by age 14, and 75% begin by age 24.
  • 46% of people who die by suicide have a diagnosed mental illness.
  • Suicide is the 10th leading cause of death in the United States.
  • There’s an average delay of 11 years between experiencing symptoms of mental illness and starting treatment for mental illness.
  • Barriers to treatment include cost, stigma-based prejudice and discrimination, and practical, logistical issues like transportation.
  • Only 50% of people diagnosed with mental illness receive the treatment they need.

Consider the first bullet point with alongside the last: 46 million people live with a mental health condition, but only half of them get treatment. That means 23 million people live with a condition that would improve if they sought treatment.

Now consider the second bullet point alongside the last: 20 million live with a serious mental health illness, but only half get treatment. That means 10 million people live with a serious mental illness that may make their life extremely difficult.

That’s the lay of the land in the U.S. – big picture – with regards to mental health.

But what about minorities?

That’s what this article is about, after all.

Minority Mental Health: Facts and Figures

First, we’ll set the stage for understanding factors related to minority mental health in the U.S. The statistics are indicative of larger, structural challenges around access to health care for various racial and ethnic minorities. It will probably come as no surprise that there are disparities in access to mental health care for minorities, just as there are disparities in access to health care in general for minorities in the U.S.

Research from the Agency for Healthcare Research and Quality (AHRQ) shows that racial and ethnic minority groups in the U.S. are:

  • Less likely to have access to mental health services
  • Less likely to use community mental health services
  • More likely to use emergency departments
  • More likely to receive lower-quality care

These disparities in access to mental health services lead to insufficient access and low-quality overall care, which in turn lead to subpar mental health outcomes in racial and ethnic minority populations, up to and including suicide.

And so far, we’ve only been talking about access.

Now, we’ll move on to discuss the prevalence of mental illness and mental health care in minority populations. Here are the latest statistics, compiled by the Health and Human Service Office of Minority Health and published in the 2017 National Survey on Drug Use and Health (NSDUH).

Minority Mental Health Statistics

  • African Americans are 20% more likely to experience serious mental health problems than the general population. Common problems include:
  • African Americans and Hispanic Americans used mental health services half as often as whites.
  • Asian Americans used mental health services a third as often as whites.
  • 28.6% of people of two or more races had a mental illness, compared to 20% in the general population.
  • 86% of people of two or more races experienced psychological distress, compared to 3.4% for whites, 3.5% for African Americans.
  • 41.5% of youth ages 12-17 diagnosed with depression received care for a major depressive episode:
    • 35.1% of diagnosed African American youth received treatment.
    • 32.7% of diagnosed Hispanic youth received treatment.

These statistics reveal the truth of the matter: minorities fight an uphill battle with regards to mental health treatment in the U.S. Not only do some minorities experience mental health issues at a higher rate than the general population – especially those of two or more races – but they also experience significant barriers to treatment.

That’s why we have Minority Mental Health Awareness Month – to help rectify that situation.

But there’s a topic we haven’t discussed yet, which is directly related to minority mental health: the prevalence of substance use disorders in minority communities.

Minority Mental Health and Substance Use Disorder

Data indicates that while rates of alcohol and drug use – and rates of alcohol and substance use disorders – for African Americans and Hispanic Americans are similar to the national average, the rates of alcohol and substance use and alcohol and substance use disorder for Native Americans and for people of two or more ethnicities are significantly higher, in comparison to people of only one ethnicity.

Here’s how the rates compare for the year 2017:

[Note: this data represents percentages of individuals who had an alcohol or substance use disorder within a year prior to answering the survey. We included data for Whites for comparison]

  • Alcohol Use Disorder, Adults 18-25:
    • Total all groups: 10.0%
    • Two or more ethnicities: 13.8%
    • Native American: 11.2%
    • African American: 11.3%
    • Hispanic American: 9.7%
    • Asian American: 6.3%
    • White: 11.3%
  • Alcohol Use Disorder, Adults 26+:
    • Total all groups: 5.0%
    • Two or more ethnicities: 6.3%
    • Native American: 9.9%
    • African American: 5.4%
    • Hispanic American: 4.3%
    • Asian American: 2.6%
    • White: 5.1%
  • Substance Use Disorder, Adults 18-25:
    • Total all groups: 14.8%
    • Two or more ethnicities: 19.8%
    • Native American: 15.4%
    • African American: 12.6%
    • Hispanic American: 14.1%
    • Asian American: 8.8%
    • White: 16.1%
  • Substance Use Disorder, Adults 26+:
    • Total all groups: 6.4%
    • Two or more ethnicities: 8.2%
    • Native American: 13.4%
    • African American: 6.2%
    • Hispanic or Latino American: 5.2%
    • Asian American: 3.0%
    • White: 9%

These statistics show that consistently, across almost all categories, Native Americans and individuals of two or more ethnicities live with higher rates of alcohol and substance use disorder than other groups – this is an important fact that bears reiterating. We also want to point out something else: while African Americans and Hispanic Americans experience alcohol and substance use disorder at rates similar to the national average, they’re less likely to have access to mental health services – which is what treatments for alcohol and substance use disorder are – and they’re also less likely to use community mental health services.

This is where the data and research get interesting.

Disparities in Treatment Completion

The 2017 NSDUH – the source of all the stats above – shows that African Americans with an alcohol or substance use disorder are more likely to:

  1. Be aware they need treatment.
  2. Be open to seeking treatment.
  3. Seek treatment.

However, several studies – including this one – show that African Americans and Hispanic Americans are less likely to complete an alcohol or substance use disorder treatment program after starting one, in comparison to Asian Americans, Native Americans, and Whites. Here’s the twist: when controlled for socioeconomic status, the completion gap between African Americans/Hispanic Americans and other groups closed significantly. Since the poverty rate in the African American and Hispanic American communities is double the rate of poverty in the Asian American and White communities, this means that socioeconomic status is a real barrier to treatment completion.

Now we connect the dots.

The big picture data on mental health indicates that though minorities experience mental illness at similar rates to the general population – with the exception of Native Americans, whose rates are much higher – they’re less likely to have access to mental health services and less likely to use community mental health services when they do have access.

Combined with the data on rates of alcohol and substance use disorders in minority populations – which mirrors almost exactly that of mental illness, including high rates for Native Americans – and the research that indicates socioeconomic factors may prevent certain minorities from completing treatment for alcohol and/or substance use disorders, we now know that minorities face major challenges not only in accessing basic mental health services, but that those barriers also reach past the beginning of treatment – and in some cases, for some minorities, reach into the treatment itself – and prevent its completion.

Removing Barriers, Completing Treatment

Therefore, during Minority Mental Health Awareness Month, in addition to raising awareness on minority mental health in general, we need to do our part to raise awareness specifically about barriers to treatment completion for alcohol and substance use disorders in minority communities. When we remove those barriers, people in minority groups – who already face obstacles to adequate mental health support – might stay in treatment longer. And since decades of data link treatment length with improved treatment outcomes, removing barriers to treatment completion might increase their chances of living a life free of alcohol and drugs.