How does environmental discrimination affect mental health?
It’s important to think of environmental health on multiple levels. The World Health Organization defines health as “a state of complete physical mental and social well being, not merely the absence of disease or infirmity” (in Lee, 2002). One aspect of environmental injustice is that there is a lack of political control within communities of color to garner the resources necessary to ensure that community needs are addressed. These needs run beyond the realm of just physical safety and health. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241156/pdf/ehp110s-000141.pdf
“Environmental justice is based upon the idea that the health of the members of a community, both individually and collectively, is a product of physical, social, cultural, and spiritual factors…Environmental justice represents a new vision borne of a community-driven process in which the core is a transformative public discourse on what constitutes truly healthy, livable, sustainable, and vital communities. It has given birth to a new definition of the environment as “the place where we live, where we work, and where we play” (Guana in Lee, 2002). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241156/pdf/ehp110s-000141.pdf
“The two key social dynamics that systematically create environmental inequality are (a) the functioning of the market economy and (b) institutionalized racism” (Brulle and Pellow, 2005) http://www.pages.drexel.edu/~brullerj/Annual%20Review%20of%20Public%20Health%20Brulle-Pellow.pdf
What is the problem?
“Historically, mental health research has been based on Caucasian and European based populations, and did not incorporate understanding of racial and ethnic groups and their beliefs, traditions and value systems. Culturally competent care is crucial to improving utilization of services and effectiveness of treatment for these communities.”
--From the American Psychiatric Institute More Info on African Americans
“For example, one out of three African Americans who need mental health care receives it. Compared to the general population, African Americans are more likely to stop treatment early and are less likely to receive follow-up care.”
--From the American Psychiatric Institute More Info on African Americans
"Asian Americans are less likely to seek help for their emotional or mental health problems than whites, according to preliminary data from the National Latino and Asian American Study (NLAAS), conducted from May 2002 though December 2003-the first national study to examine the rates of mental illness and treatment use among a national sampling of three major Asian-American groups." --From the American Psychological Institute Asian American Mental Health
"Because many Indian families contend with poverty and unemployment, however, a disproportionate number are uninsured or underinsured (Brown, Ojeda, Wyn, & Levan, 2000) and are therefore unable to afford quality mental health services requiring nonfederal thirdparty payment. In any case, it remains exceedingly unlikely that the vast majority of these “mainstream” services—even when actually accessible to Native people—are capable of providing “culturally sensitive” assessment and treatment (i.e., services thatare intentionally formulated to assist Indian clients).
--From Professional Psychology Research & Practice Native American Mental Health
What is being done? Some national actions:
Mental Health agencies in Chula Vista, CA have reached out to the Latino community with a Fotonovella public health project. See the video clip below:
Health Through Action is a project of the The Asian & Pacific Islander American Health Forum (APIAHF). This organization works to influence policy, mobilize communities, and strengthen programs and organizations to improve the health of Asian Americans, Native Hawaiians, and Pacific Islanders. This video is from a Health Through Action research assistant, describing the work she is doing in sharing individuals' stories in an effort to break the stigma against mental illness in the Asian American community.
An example of a targeted public health campaign to raise awareness about suicide within the Asian American community. This was a Public Service Announcement that aired on national TV:
What are some local resources?
ConsejoMental Health agencies in Chula Vista, CA have reached out to the Latino community with a Fotonovella public health project. See the video clip below:
Health Through Action is a project of the The Asian & Pacific Islander American Health Forum (APIAHF). This organization works to influence policy, mobilize communities, and strengthen programs and organizations to improve the health of Asian Americans, Native Hawaiians, and Pacific Islanders. This video is from a Health Through Action research assistant, describing the work she is doing in sharing individuals' stories in an effort to break the stigma against mental illness in the Asian American community.
An example of a targeted public health campaign to raise awareness about suicide within the Asian American community. This was a Public Service Announcement that aired on national TV:
The Need for Cultural Competence
There has been growing attention to the fact that health care providers—including those in mental and behavioral health—need specific training to address growing diversity, persistent disparities, and to promote health and mental health equity. The National Center for Cultural Competence at Georgetown University provides a wealth of resources, two of which are linked below. The NCCA can be found at http://nccc.georgetown.edu/
Checklist for cultural competence in behavioral health: http://nccc.georgetown.edu/documents/ChecklistBehavioralHealth.pdf
One Spanish-speaking family’s experiences dealing with a child’s mental health challenges, and the community-based agency that assisted them:
En espanol: http://nccc.georgetown.edu/documents/Buda.pdf
Providing Effective Mental Health Services
When many people think about mental health treatment, we often envision one-on-one sessions with an individual lying on a couch talking with a psychiatrist or people locked up in institutions. But the reality today is that both models are outdated. There are fewer large facilities, and innovative approaches are far more community based.
The Group Health Research Institute is a leader in innovative approaches to treating mental illness, with an emphasis on patient-centered care.
Here are examples of new approaches that they have developed:
• Flexible psychotherapy programs delivered by telephone
• Depression programs tailored to patients with co-occurring health conditions (diabetes, heart disease, obesity)
• Using new communication technologies (Internet, e-mail) to make care for depression and bipolar disorder more convenient
• Integrating peer support with professional treatment for mood disorders
• Broadening the focus of mental health treatment from symptom management to recovery
• Activating mental health patients to be more knowledgeable and assertive consumers
Clearly our challenge is to bring these innovations to communities of color, where often people with mental illness go undiagnosed until it is too late.
When many people think about mental health treatment, we often envision one-on-one sessions with an individual lying on a couch talking with a psychiatrist or people locked up in institutions. But the reality today is that both models are outdated. There are fewer large facilities, and innovative approaches are far more community based.
The Group Health Research Institute is a leader in innovative approaches to treating mental illness, with an emphasis on patient-centered care.
Here are examples of new approaches that they have developed:
• Flexible psychotherapy programs delivered by telephone
• Depression programs tailored to patients with co-occurring health conditions (diabetes, heart disease, obesity)
• Using new communication technologies (Internet, e-mail) to make care for depression and bipolar disorder more convenient
• Integrating peer support with professional treatment for mood disorders
• Broadening the focus of mental health treatment from symptom management to recovery
• Activating mental health patients to be more knowledgeable and assertive consumers
Clearly our challenge is to bring these innovations to communities of color, where often people with mental illness go undiagnosed until it is too late.
What are some local resources?
Located in Seattle, Kent and Federal Way (with offices also in Yakima, Bellevue, Kennewick, and Tacoma). Offers culturally-competent counseling and referrals for behavioral health, substance abuse and domestic violence, tailored for the Latino community
SeaMar
Clinics and programs throughout Seattle, Des Moines and Burien (and other locations in Western Washington). Provides comprehensive health and human services, specializing in services for Latinos.
Asian and Pacific Islander Women and Family Safety Center
Located in downtown Seattle. Dedicated to organizing, educating and providing services on domestic violence, sexual assault and human trafficking to Asian and Pacific Islander community members.
Academic Sources:
Brulle, R.J. and D.N. Pellow. (2005). “Environmental justice: Human health and environmental
inequalities.” Annual Reviews in Advance, 17, 1-22.
Gone, J.P. (2004). “Mental health services for Native Americans in 21st century United States.”
American Psychological Society, 35, 10-18.
Lee, C. (2002). “Environmental justice: Building a unified vision of health and the
environment.” Environmental Health Perspectives, 110, 141-144.
