Minority Mental Health Month 2023: Culture, Connection, Community

Mental health awareness is an important component in bringing health equity to minority communities around the U.S. Black, Indigenous, and People of Color (BIPOC) face social stigma, cultural stigma, and structural inequity that creates mental health challenges people in demographic majorities rarely experience and often don’t understand.

Minority Mental Health Awareness Month (MMHAM): 15 Years Strong

Mental Health America (MHA), a non-profit mental health advocacy group, held the first ever Mental Health Month (MHAM)in 1949. To learn more about MHAM, please navigate to the blog section of our website and read these articles:

May is Mental Health Awareness Month

Mental Health Awareness Month: The Loneliness Epidemic in the United States

Mental Health Awareness Month: Mental Health Among Older Adults and Seniors

In 2008, to honor the life and work of minority mental health advocate Bebe Moore Campbell, the U.S. Congress passed a law establishing the month of July as Bebe Moore Campbell National Minority Mental Health Awareness Month (MMHAM).

Here’s how she described the need for an increase in awareness about mental health in minority communities, and the importance of events like MMHAM:

“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.”

Bebe Moore Campbell wrote a book on generational trauma among called “Your Blues Ain’t Like Mine” and a children’s book called “Sometimes Mommy Gets Angry” about how a young girl manages growing up with a mother with mental illness.

Her work on trauma and mental health among minority populations in the U.S. earned praise and accolades from politicians and cultural leaders from all walks of life. “Your Blues Ain’t Like Mine” made the New York Times Magazine Most Influential Books of 1992 list, and “Sometimes Mommy Gets Angry” won the Outstanding Literature Award for 1993 from the National Alliance on Mental Illness.

However, her enduring legacy is MMHAM. This year, Mental Health America chose the following theme for MMHAM:

Culture, Community, and Connection

Here’s their reasoning behind this choice:

• Minority populations face disproportionate historical trauma and displacement
• These inequities challenge the foundation of minority communities
• Despite decades of systemic attempts to take away power, invalidate/erase history, and prevent success, minority communities find ways to thrive
• Culture, community, and connection are the core components of the minority experience in the U.S.
• When oppression and systemic racism threaten minority communities, culture and connection keep them together

The survival of minority communities in the face of inequity is a testament to their strength and resiliency. In this article, we’ll discuss how MHA and other advocates plan to honor these communities during MMHAM 2023.

First, though, we’ll talk about the big picture – mental health-wise – in the United States right now, with the latest reliable data from the National Institutes of Health (NIH) in the 2021 National Survey on Drug Use and Health (2021 NSDUH).

Mental Health: A Growing Challenge Nationwide

We need to address the overall, big-picture numbers, because they’ll help us understand the broader context of mental health disorder prevalence and mental health treatment in the U.S. Here are some general statistics everyone should know and understand:

• 22.8% of adults in the U.S. had a diagnosable mental illness in 2021
• 5.5% adults in the U.S. had a serious mental illness in 2021
• Ove 50% of mental health conditions appear before age 14, while 75% appear by age 24
• 46% of people who die by suicide have a diagnosed mental illness
• Suicide was the 11th leading cause of death in the U.S. in 2021
• On average, there’s an 11-year gap between onset of symptoms and seeking treatment for a mental health disorder
• Barriers to mental health include the cost, prejudice, discrimination, and overall structural inequity (see below)
• Only 47.2% of people diagnosed with any mental illness receive the treatment they need

Let’s look at the first and last bullet points side-by side.

Each year, 22.8% in the U.S. have a mental health disorder that meets clinical criteria, but only 47.2% receive treatment for that mental health disorder. Those figures tell us that in 2021, with a total of 57.8 million people diagnosed with a mental health disorder, over 27 million people did not receive the professional support and care they needed.

That’s why we need mental health awareness month overall. Now let’s look at why we need something like Minority Mental Health Awareness Month – starting with the significant barriers to care members of minority populations face every day.

Minority Mental Health: What Are Barriers to Care?

Barriers to care refers to factors that restrict access to mental health treatment by members of minority groups. Evidence published in MMHAM Toolkit shows that minority groups experience the following barriers to care with disproportionate frequency, compared to members of majority demographic groups.

Barriers to Care: Minority Groups in the U.S

• Structural inequity in health care system
• Cost
• Lack of insurance
• Inadequate insurance
• Stigma around mental illness
• Stigma around mental illness treatment
• Inadequate diversity/representation in mental health care and mental health care providers
• Inadequate cultural competence in mental health care and among mental health care providers
• Language barriers
• Generational trauma resulting in distrust in the health care system
• Inadequate funding in public social safety net programs, i.e. Medicare, Medicaid

In addition, the Agency for Healthcare Research and Quality (AHRQ) published a report in 2017 called the “2017 National Healthcare Quality and Disparities Report,” which reached the following conclusions. In the U.S., members of minority demographic groups:

• Have less access to mental health services than members of majority groups
• Use community mental health services less frequently than members of majority groups
• Use emergency departments as basic health care more frequently than members of majority groups
• Receive lower-quality care, overall, than members of majority groups

That’s why we need MMHAM. Members of minority groups in the U.S. simply don’t experience equity in health care or mental health care. The long-term goal is what the Centers for Disease Control (CDC) called mental health equity. The CDC defines this as follows:

“Mental health equity is the state in which everyone has a fair and just opportunity to reach their highest level of mental health and emotional well-being.”

With the concept of mental health equity front of mind, let’s take a look at the latest data on mental health among minorities in the U.S.

Minority Mental Health: Facts and Figures

The following information is available in two easy-to-find locations online. The first is the 2021 NSDUH, which we mention above. The second is the resource page for MMHAM maintained by the U.S. Department of Health and Human Services Office of Minority Health (OMH).

First, we’ll share the overall prevalence of mental illness for the main demographic groups in the U.S.

Any Mental Illness/Serious Mental Illness: 2021

Two or More Races:

• AMI: 34.9%
• SMI: 8.2%

American Native:

• AMI: 26.6%
• SMI: 9.3%

Asian:

• AMI: 16.4%
• SMI: 2.8%

Black:

• AMI: 21.4%
• SMI: 4.3%

Hispanic/Latino:

• AMI: 20.7%
• SMI: 5.1%

Native Hawaiian/Pacific Islander:

• AMI: 18.1%
• SMI: 6.3%

White:

• AMI: 23.9%
• SMI: 6.1%

Please notice two things about these statistics: the rates of AMI an SMI among people of two or more races and American Natives. For AMI, multiracial people experience rates that are close to 50 percent higher than most single-race demographic groups. For SMI, multiracial people experience rates that are 25-75 percent higher than most single-race demographic groups. Also, for AMI, American Natives experience rates that are 30-35 percent higher than most demographic groups. For SMI, American Natives show the highest rate of all demographic groups, with rates are between 50 and 350 percent greater than other demographic groups.

Next, let’s look at rates of depression and depression treatment. In the NSDUH, major depressive disorder is a proxy metric for a clinical diagnosis of major depressive disorder (MDD).

Depression and Depression Treatment Among Minority Groups: Facts and Figures

These statistics are also available online from the 2021 NSDUH and the U.S. Office of Minority Health (OMH). Here’s the data:

Major Depressive Episode (MDE), MDE with Severe Impairment, Treatment

Two or More Races:

• MDE: 13.9%
  • Received treatment: 60.7%
• MDE with Severe Impairment: 9.9%
  • Received treatment: (data not available)

American Indian or Alaska Native:

• MDE: 11.2%
  • Received treatment: (data n/a)
• MDE with Severe Impairment: 7.7%
  • Received treatment: (data n/a)

Asian:

• MDE: 13.8%
  • Received treatment: (data n/a)
• MDE with Severe Impairment: 10.0%
  • Received treatment: (data n/a)

Black or African American:

• MDE: 6.7%
  • Received treatment: 51%
• MDE with Severe Impairment: 4.6%
  • Received treatment: 52.5%

Hispanic/Latino:

• MDE: 7.9%
  • Received treatment: 58.5%
• MDE with Severe Impairment: 5.4%
  • Received treatment: 59.7%

Native Hawaiian/Pacific Islander:

• MDE: 5.1%
  • Received treatment: (data n/a)
• MDE with Severe Impairment: 4.7%
  • Received treatment: (data n/a)

White

• MDE: 8.9%
  • Received treatment: 64%
• MDE with Severe Impairment: 6.1%
  • Received treatment: 68.6%

From this set of data, please also note the information on multiracial people. For people of two or more races, these figures show rates of major depressive (MDE) 55 percent higher than White people, 108 percent higher than Black people, and 75 percent higher than Hispanic people. These figures also show rates of MDE with Severe Impairment among multiracial people that are 65% higher than White people, 118 percent higher than Black people, and 85 percent higher than Hispanic people.

We’ll also make another point about this data set. When we look at the treatment rates, we may be tempted to think that rates near or over 60 percent – as we see above – are good news we should be satisfied with.  We may think, “those rates are actually pretty good.”

This is where our unconscious stigma against and misunderstanding of mental health shows itself clearly. Those treatment rates are not good enough. The fact most of us likely think they’re acceptable reveals that we have a long, long way to go, with regards to understanding the needs of people who need mental health treatment. Think of it like this: if only 70 percent – the highest number we see above – of people with diabetes, hypertension, heart disease, or cancer received treatment, it would likely be an enormous public scandal and we’d probably declare a public health emergency.

Celebrating Culture, Connection, and Community: How We Can All Support Minority Mental Health Awareness Month

If we’re bring honest, we need to recalibrate our goals and expectations and consider the need for better health for members of minority demographic groups year-round, not just during the month of July. Therefore, when we offer the two lists below, please consider raising awareness not only this month for MMHAM, but year ‘round.

The first thing we all need to do is understand and address inequities in the social determinants of health (SDOH), which include:

• Economic stability
• Education access and quality
• Healthcare access and quality
• Neighborhood and built environment
• Social and community context

Those are nationwide, structural forces that we need to remediate in order to bring full equity to mental health care for minority demographic groups. With regards to specific actions we can all take to raise awareness about minority mental health, the organizers at MHA compiled a brief list, which we share below. For a full examination of what public, private, and other organizations can do to raise awareness for MMHAM, please download their full toolkit here.

Mental Health America: How to Be an Advocate for Minority Mental Health Awareness Month

Members of any community can advocate for:

1. Increased access to essential resources. These include:

• Physical and mental health programs
• Functional, accessible community infrastructure
• WiFi
• Healthy food sources

2. Culturally competent social services.
3. Culturally competent mental healthcare providers
4. Educational opportunities at all levels
5. Decreased us vs. them policing and surveillance. The community policing model is associated with:

• Decreased police and community violence
• Stronger feelings of safety
• Enhanced trust between communities and public officials

We’ll close with a quote from the MMHAM toolkit, which is a reminder that you don’t have to be a member of a minority community to care about, support, or advocate for better minority mental health:

“There is power in numbers, and there is always a need for solidarity from allies who are willing to uplift and give space to those within the communities they support. When allies show support and solidarity in public and action-oriented ways, they can…promote wellness, increase social power, and improve cross-cultural unity.”