First, unprecedented increases in public awareness and advocacy about mental health, well‐being and illness, albeit concentrated in the Global North, have raised political pressure on institutions and governments to act to address the global burden of psychiatric morbidity2. These last two decades have simultaneously witnessed at least two seismic transformations in the mental health landscape. Arguably, the last two decades have brought about some progress in our biomedical understanding of psychiatric disorders, while investigating the importance of psychosocial factors in causing mental disorder has remained a peripheral focus for scientific discovery and clinical psychiatry. Such determinants are therefore not randomly or benignly distributed within or between populations, but are manifested by systems and institutions of power that often produce and reproduce intergenerational inequities in people’s opportunities to realize safe, secure, prosperous and healthy lives. Finally, we provide seven key recommendations, framed around social justice, which constitute a roadmap for action in research, policy and public health.
Black and African American Mental Health Considerations
Organizational and financial rearrangements and improvements in training of the mental health workforce are needed steps to overcome these barriers. With the government promise to fund and sustain it, ECHO will help to expand professional development, improve clinician performance, and provide best practice care in underserved areas and successful integration of physical and behavioral health. Patients and providers uniformly report high levels of satisfaction with videoconferencing, and there is good evidence for the clinical equivalency of psychiatric and psychological treatments delivered via videoconferencing, compared with face-to-face delivery (78).
Heightened mental health concerns among People of Color
In this review, we have highlighted the major social determinants that generate and sustain intergenerational inequalities in risk and maintenance of mental health problems and disorders. Interventions that support stable, secure and cohesive communities in the wider social environment may also help buffer children from the impact of social adversity on mental health281. Second, since many psychiatric disorders exhibit such social gradients, universal, selective or indicated primary prevention strategies would not only promote more equitable mental health, but also achieve substantial gains in improving the mental health of whole populations. For example, there is evidence that people from socioeconomically disadvantaged, migrant and ethnoracial minoritized backgrounds are under‐represented in services for early detection of psychosis397, 398, 399, as well as in child and adolescent mental health services400. Others have highlighted the importance of building up cultural competence amongst health care professionals as a vital intervention to reducing mental health inequities for LGBTQ+ people187. While these studies lend some support to the effectiveness of culturally‐agnostic interventions, there is also evidence that culturally‐adapted mental health interventions offer more benefits in some ethnoracial minoritized groups over non‐adapted treatments or treatment‐as‐usual390, 391.
A 2015 survey found that 48% of white adults with mental illness utilized any mental health services in the previous year. Disparities in the utilization of mental health services could be partly responsible for these differences in outcomes. As more counselors such as Cindy and Rey are empowered to incorporate their interests and backgrounds into their practice, the mental health field becomes better equipped to serve people from all walks of life.
- Marginalized communities face unique challenges that significantly elevate their risk of suicide.
- Normalizing the reactions and offering guidance about what to expect with symptoms over time, as well as when and where to get assistance if needed, helps people feel calm and increases self-reliance.
- In LMIC settings, the reasons for this may be self‐evident, since limited resources may mean political prioritization of other vital issues.
- Secondary and tertiary family interventions can also lead to reductions in parental stress and depression, and improvements in parenting behaviours422, 425, which may be particularly relevant to interrupting intergenerational transmission of familial risks for mental health problems424.
- In contrast, there is more consistent evidence of increased rates of psychotic symptoms and disorders in ethnoracial minoritized groups, particularly amongst groups perceived as more socioculturally distant from the racial or ethnic majority population in HICs144, 152.
Combined with societal stigma surrounding mental illness, this atmosphere results in lower service utilization rates among marginalized https://www.naadac.org/cultural-humility-resources populations. Individuals from low-income backgrounds often lack health insurance or have inadequate coverage, contributing to their reluctance to seek help. Structural racism plays a significant role, contributing to underdiagnosis and lower quality of care.
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