Mental health treatment for minorities substandard

Speaking of race, I stumbled upon Ephphatha, a blog from an African American woman looking to raise awareness of mental health in the African American community.

She linked to two News & Notes series on npr that focus on the lack of appropriate care to Blacks in the mental health community. This gets me thinking: If Blacks, how much more so other racial/ethnic minorities, e.g. Hispanics, Asians, Native Americans, Indians, etc. Is it really true that Caucasians a.k.a. white Americans receive better mental health treatment than other races and ethnicities?

It appears so
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Article Analysis – “Breaking it down: Mental health and the African community”

Liz Spikol linked to this article back in December and as a Black American with West Indian heritage (and by default, African and French), I couldn’t resist commenting.

Author Morenike Fasuyi blasts the United Kingdom’s mental health system as being less than inadequate for Africans. I don’t doubt it.

I do wonder about Fasuyi’s seemingly sheer hatred for anyone of European descent (in America, we’d refer to them as “white” or “Caucasian”). The article seethes with anger.

“The general consensus suggests that African people have to work twice as hard as their european counterparts in every aspect of our social, cultural and economical existence in order to make ends meet.”

This also is the case for Black Americans.

Fasuyi explains how she’s been diagnosed with bipolar disorder but says her disorder is mainly triggered by things related to Africa: “slavery, politics, oppression.” Her turning point was on May 1, 2004 when “it was as if [her] ancestors called” upon her and “removed the scales from her eyes.” She refers to Karl Marx when speaking about “groups” – Africans – who are oppressed and eventually rise up and lead a revolution. In addition, she believes the numbers 7 and 9 relate to the African people and that 2007 could be the year when “division within the African community” would be “homogenized[d]… to effect change.”

As a Black American, I know that African people truly value their ancestors and even practice ancestry worship. This is where I believe she is coming from. To any other nationality, Fasuyi is crazy (no pun intended). It wouldn’t surprise me if her mental health status file read, “bipolar disorder with psychosis.” Not knowing about African ancestry worship can make any doctor of non-African nationality misdiagnose Fasuyi. To be able to accurately help her, she must be accurately understood.

She asked for an African psychiatrist who might have a cultural understanding of where she was coming from. She mentions this was a slow process since “there [were] hardly any.” She also asked for an African social worker but was given “an insensitive male european (sic) social worker who adversely affected my health with his actions, racist remarks and incompetence.”

She takes a nice jab at Big Pharma and pharma reps, too:

“Maintaining you within the system keeps consultants in their jobs and increases the profit of the pharmaceutical industry, which has a turnover of billions.”

Zyprexa; Cymbalta, anyone?

Read the rest of this entry »

Loose Screws Mental Health News

Liz Spikol linked to this and I can’t believe I missed it: Poorer mental health for black Caribbeans.

“The longer Caribbean immigrants who are black stay in the United States, the poorer their mental health, according to a study.

Prior research has shown that black Caribbean immigrants differ from African-Americans in various measures of physical health, but little research has been done on differences in mental health.

‘What we found was that ethnicity matters a lot in the black population in the United States for mental health risk,’ [lead author David R.] Williams said.”

This is certainly a study that should yield interesting results. As a first-generation African-American with West Indian parents, I can definitely see the higher risks of mental health problems in my own family. Not only is it an ethnic problem, but it also is rooted in genetic causes. My maternal line has no history of mental illness (the DSM threw out homosexuality a while ago), but my paternal line has many cases of mental illness – almost all of them developed after immigrating to the U.S. From what I understand, my grandmother suffered from some kind of mental illness and out of her eight children, three of them developed mental illness, including my father.

I’m mainly interested to see what kind of effect this could have on first-, second-, and third-generation blacks of Caribbean ancestry and what correlations result from immigrant relatives who developed mental illnesses in the U.S.

Before leaving office, Gov. George Pataki signed a bill into law that requires commercial insurance policies to pay for mental health care just like care for physical illnesses. (Pataki has been slightly redeemed in the sight of a former New Yorker who suffered under his reign.)  Since this is news from Dec. 23, you might have to pay $4.99 to read the article, but as of Jan. 9, the article is still available for free. Read a few excerpts below:

“Most commercial policies already cover mental health treatment, which the governor said had helped allay his concerns about cost, and so do government programs like Medicare and Medicaid.

Business organizations – whose members pay for most health insurance – and insurance companies generally oppose these kinds of mandates. But they did not work against the mental health bill this year, after small employers were exempted and after coverage that would have mandated treatment for alcohol and drug addiction was taken out of the bill.

An employer with fewer than 50 workers could opt out, but the insurer would be required to offer a policy that covered mental illness. The law pledges that the state will develop a method to help small businesses pay for that coverage if they choose to buy it.

There were at least 17 other states that mandated some kind of mental health coverage, but not full parity with other health benefits.”

I'm glad that the state has offered to help small businesses pay for mental health coverage if employers choose to provide it. It would be difficult for a small business to pay for health insurance – let alone mental health! – for 50 employees or less. However, it's an important investment in employees that small businesses and large corporations can't afford to overlook.

As for treatment for substance abuse, the state is doing a major disservice to employees who struggle with these issues. More employees are likely to suffer from some kind of substance abuse problem and the lack of coverage for treatment is a step backwards. During my mental health treatment, I've noticed that mental health problems sometimes accompany substance abuse. If a patient can't obtain substance abuse coverage, then the entire problem isn't solved. I can only hope that an amendment mandating substance abuse coverage is added to the bill in the future.

The American Foundation for Suicide Prevention provides their take on the bill:

"The law requires insurance companies to cover 30 inpatient and 20 outpatient days of treatment for mental illness. Companies must fully cover "biologically-based mental illnesses" including major depression, obsessive compulsive disorder, anorexia and binge eating. Timothy's Law would also require coverage for children with attention deficit disorder, disruptive behavior disorders or disorders that include suicidal symptoms. The measure is expected to increase premiums about 3 percent and no more than 10 percent, while providing a much wider array of mental health services.

Timothy's Law took effect on New Year's Day and will last for three years. The Legislature will make a decision about continuing the law in 2009. New York is the 38th state to enact mental health parity."