Mental Health Concerns in our Communities of Color

After connecting dots, it looks like our problem is getting worse. Here’s what we can do to keep it at bay.

Last week I alluded to what this week’s post would be about – mental health in our communities of color. And especially in light of two articles I saw this past week, I’m staying true to my word.

The first from Morning Consult is something we are going to need to keep an eye on: How an end to the Covid-induced eviction moratorium will impact Americans’ mental health, particularly the mental health of communities of color. 

Morning Consult found that compared to the 4% of white Americans, 6% of Black Americans and 9% of Hispanic/Latinx Americans received an eviction notice last month. Six percent, 9%, and 15%, respectively, didn’t pay rent last month but must repay it in the future, and another 5%, 7%, and 13% didn’t pay their rent/mortgage last month even though they didn’t have permission to do so.

A person’s (in)ability to put a roof over their head naturally has an impact on their mental health – and compared to white Americans, it has been more difficult for members of Black/Brown communities to put a roof over their head for decades. Last year, the gap between white American homeowners and Black American homeowners was larger than it was nearly 50 years prior. And today, that gap is still significant: There's a roughly 30-percentage-point homeownership gap between white Americans and Black Americans, as well as the roughly 20--percentage-point homeownership gap between white Americans and Hispanic/Latinx Americans.

Housing isn't just another everyday stressor that can be easily brushed off. Neither is finances, which often determine whether someone can or cannot buy a house. Both are major stressors that take a toll on individual well-being. 

That’s exactly what the authors wrote in the second article I want to call out, an opinion piece in The Baltimore Sun about the connection between poverty and overdose deaths. As Alexandra S. Wimberly, an assistant professor at the University of Maryland School of Social Work, and Shawna Murray-Browne, a licensed clinical social worker and community healer with Kindred Wellness LLC, explain:

“Why are poverty and marginalization related to worse substance use outcomes? In a nutshell, restricted access to basic needs puts tremendous stress on a person, and chronic and severe stress are major factors in developing substance use disorders. With financial hardship comes other stressors, like housing instability, environmental toxin exposure and less health care access. This is an even greater hardship for people of color, who endure systemic racism and may live in areas of concentrated disinvestment (high poverty, more policing, worse public services, less access to quality substance use treatment).”

MENTAL HEALTH FACTS

There is a ton of data out there on mental health and substance use in communities of color. Below, I have highlighted a few data points with an emphasis on substance misuse to show how an eviction moratorium could have a hugely negative impact on communities of color; however, it’s important to note that substance use disorders and mental health concerns often present together (despite our system many times treating them as separate). So, while the emphasis is on drug overdoses below, it’s critical we approach the problem more comprehensively and see mental health and addiction as intertwined issues – just like our minds/bodies.

Well Being Trust and Trust for America’s Health’s Pain in the Nation report found that over the years, drug-induced deaths among communities of color have increased. Between 2016 and 2019, Black Americans saw a 42% increase in the rate of drug-induced deaths; Hispanic/Latinx Americans a 33% increase; Asian Americans a 30% increase; and American Indians a 23% increase. By comparison, drug-induced deaths among whites only increased by 5% increase over those three years.

Just looking at 2018 data versus 2019 data, communities of color saw a substantial increase in year-over-year drug-induced deaths.

While white Americans only saw a 2% increase in drug-induced deaths in 2019, Hispanic/Latinx Americans and Black Americans saw a 15% increase, American Indians an 11% increase, and Asian Americans a 10% increase. With that, the 2019 drug deaths rate for Black Americans surpassed that of white Americans for the first time since 2005.

As grim a picture as this paints for our communities of color, it’s important to remember that since this data was collected, a pandemic has wreaked havoc on our nation – and especially these individuals. Communities of color were found to have higher rates of Covid-19 cases, hospitalizations and deaths for Covid-19, which has understandably increased fear, anxiety, stress and sadness among members of each group.

SOLUTIONS TO IMPROVE MINORITY MENTAL HEALTH

Come the next Pain in the Nation report, we shouldn’t be surprised to see that the mental health of Black/Brown communities suffered greatly in 2020. What we should do, however, is spend time right now getting ahead of the curve and talking about ways that we can start improving it.

First, addressing racism at systemic and structural levels is critical, as it's the only way to ensure equitable health and well-being for all. Embracing approaches included in the recently released report from Well Being Trust and PolicyLink – Advancing Well-Being by Transcending the Barriers of Whiteness – and applying equity in all we do will ultimately lead to better health and well-being outcomes for all.  

Second, we should protect and increase access to telehealth. For many people, telehealth has done wonders to reduce barriers to care considering nearly 50% of Americans have to drive more than one-hour round trip to mental health treatment locations, and even if they do that, odds are, the person treating them wouldn’t be someone with whom they share racial/ethnic similarities: Only 16% of active psychologists are from communities of color. Telehealth expands treatments options and gives individuals choice in from whom they receive mental health and substance use care – if they can access it.

Like any intervention for mental health, we have to make sure that telehealth also doesn’t further disparities, as some data seem to indicate. Assuring that communities of color have access to broadband and even devices they can use for telehealth would be a good place to start.

Other standout solutions, as described in our Pain in the Nation report, involve:

· Promoting diversity and culturally appropriate care in the health care system by Congress increasing the number of mental health and substance use practitioners from communities of color though more support for programs SAMHSA’s Minority Fellowship and the HRSA’s Behavioral Health Workforce Education and Training grants; and

· Adopting trauma-informed and culturally competent policies and practices for youth-serving programs and agencies by Congress maintaining federal support for programs that disseminate technical assistance and training for trauma, like the National Child Traumatic Stress Network.

The numbers don’t lie and the connections between housing, finances and mental health couldn’t be more clear: If we don’t act now, from the close of this Minority Mental Health Awareness Month forward, we could see an ongoing catastrophic wave of disparities continue to crash over America’s communities of color.

Now, let’s do everything in our power to keep that tide at bay.