Focus serious attention on eliminating disparities in mental health care for minority groups
The Alliance for Latino Behavioral Health Workforce Development, a strategic partnership of the leading national Latino behavioral health professional organizations, and other key leaders in the Latino health and behavioral health professions, and workforce development, and the National Resource Center for Hispanic Mental Health (NRCHMH), a private non profit organization spearheading the development and operations of the Alliance strongly recommend the following:
1) Adding a new strategic initiative on the elimination of disparities in the availability of, access to and the provision of culturally and linguistically competent mental health care to individuals from racial and ethnic minority populations, especially those with Limited English Proficiency -- we must enforce and monitor Title VI of the Civil Rights Act of 1964 and Executive Order 13166 - to other under served and largely marginalized populations. Disparities in access and quality of care have been well documented and continue to grow for some populations sch as Latinos, the nation's largest ethnic minority group. Given the rapid growth of minority populations, it is imperative to focus attention to the elimination of disparities and improving the delivery of culturally and linguistically competence mental health care.
2) While the plan mentions embedding the elimination of behavioral health disparities across all of the initiatives, we unfortunately feel that the draft fails to achieve this goal. Overall the plan fails to fully integrate cultural competence and the elimination of disparities in each of the proposed initiatives. We recommend revising each priority area to guarantee the inclusion of goals and action steps that reflect SAMHSA’s commitment to cultural competence and the elimination of disparities. These goals, objectives and action steps need to be clearly spelled out.
3) The Alliance and the NRCHMH applauds and supports increasing SAMHSA’s diversity scope to include individuals from the lesbian, gay, bisexual and transgender community. Research indicates significant barriers to treatment and quality of care issues that members of this community face when coming in contact with the behavioral health system so we welcome this new focus and SAMHSA’s leadership on LGBT mental health.
4) The Affordable Care Act provides opportunities and a variety of provisions focused on addressing disparities and cultural competence issues. The Alliance and NRCHMH recommends taking a close look at these provisions in order to take advantage of potential opportunities.
5) We recommend developing provisions to guarantee language access to services for Limited English Proficient individuals. Lack of such services only foster additional disparities in access to care.
6) The Alliance and NRCHMH welcome the creation of the Office of Behavioral Health Equity. This new office should be identified as the lead on a new strategic initiative on cultural competence and the elimination of disparities. While we recognize the intent of addressing cultural competence and disparities through the drafted eight initiatives, our experience shows that unless we create a specific goal and initiative for this, there is clear danger that this may not be achieved. Quite frankly, our country cannot afford to take such risk. Additionally, adding a cultural competence and disparities initiative will provide the impetus needed for this new office to grow. This would allow resources (staff, funding, etc.) to be allocated to this office.
We also strongly believe that SAMSHA must continue to address behavioral health workforce issues and be a leader in trainings, organizational and provider development, leadership capacity and more. We must address the critical shortage of behavioral health professional and leaders from racial and ethnic minority communities.
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Jimi Kelley commented
Thank you, Henry, for pushing forward with this. We know that most of the highest rates of disparities in health/mental health belong to minority communities. It is disgraceful that SAMHSA would seek to back out of their support for the needs of under-served populations by disguising disinterest with "embedded terminology".
It is a simple mathematical fact: if one addresses disparities in under-served populations, barriers to treatment, and prevention programs, disparities will reduce. These are the sources of Evidence Based Practice.
I agree with the recommendation for language developments for those with limited English proficiencies.
Gilberto Pérez Jr. commented
Funding Human Services Academy's such as Mental Health America Los Angeles address workforce preparation in the here and now, but more importantly focus on the future workforce. Glad to see your Alliance is stimulating the conversation with SAMHSA and others. Adelante. You have my support.
Ambrose Rodriguez commented
This is the most important issue facing the behavioral health system. The issue is an economic, human rights and social justice issue. Please reference Presidents Bush's commission report.
Molly C commented
Henry Acosta commented
The origin comment was posted by Henry Acosta, MA, MSW, LSW, Executive Director, National Resource Center for Hispanic Mental Health, and Chair, Alliance for Latino Behavioral Health Workforce Development
For more information on both, please visit www.nrchmh.org
Henry Acosta commented
Thank you RBG --- for far too long individuals from racial and ethnic minority groups and other marginalized populations have suffered disparities in access to and the provision of quality care in many human services. These disparities may be resulting in the over representation of individuals from these communities in high need vulnerable populations such as the homeless, the uninsured, the poor, the poorly educated, and those involved with the child welfare or juvenile justice systems. Thank you supporting this comment. Best wishes and continued sucess.
We are all Americans,parity in mental health services for all.