July 1 marked the second annual observation of No Shame Day—an event that promotes awareness of mental illness in the black community. No Shame Day is just one of many events taking place during National Minority Mental Health Awareness Month to promote mental well-being among minority populations, who comprise a vibrant and growing segment of the country’s population.

Such activities strive to address gaps in the mental health system, which as a whole is not keeping pace with the diverse needs of these ethnic and racial minorities—especially the needs of children. Not only does the current system underserve these communities, but it often fails to recognize cultural considerations, which can lead to inadequate care.

Disparities in Mental Health Care for Minority Children

To learn more about this important month, I spoke with MaJosé Carrasco, director of the Multicultural Action Center at the National Alliance on Mental Illness (NAMI), who says, “The system provides poor care for everyone, but the care offered is even worse for minorities.”

Data illustrate the racial and ethnic disparities in children’s mental health care:

• The percentage of black and Latino youth who use mental health care services is less than half that of white children (4­–5% and 10%, respectively)
• 88% of Latino children with mental health issues have unmet needs
• More than 25% of African American youth exposed to violence have been shown to be at high risk for post-traumatic stress disorder
• Adolescent Native Americans experience the highest rates of suicide of any population in the United States—at least three to five times the national average
• In the Asian American youth population, suicide ideation and suicide rates continue to increase

These disparities do not arise from a greater prevalence or severity of illnesses in these populations—rather, they stem from the reality that minorities receive “less care and poorer quality of care,” as stated in a report from the President’s New Freedom Commission on Mental Health.

Barriers to Minority Children’s Mental Health Care

What accounts for these troubling disparities in minority children’s mental health? The answers are complex, to say the least.

Many minority children face a variety of barriers in accessing specialist care. Lower numbers of local specialists, transportation issues, and a lack of a regular health care provider are among the common obstacles to obtaining mental health services. One of the most pressing challenges for minority children is a lack of insurance coverage, says NAMI’s Carrasco, adding, “Fortunately, the Affordable Care Act will help address this barrier.”

The problem of misdiagnosis also prevents minority children from receiving the mental health care they need. For example, African American children with autism are often initially misdiagnosed, and they face an average diagnosis delay of 18 months compared to their white peers. African American children are also more likely to be over-diagnosed for schizophrenia and under-diagnosed for depression. Similarly, Latino youth with mental illness are often misdiagnosed as having “anger problems.”

Furthermore, it remains unclear if symptoms for mental health disorders such as autism are the same across racial groups. As the report from the President’s New Freedom Commission on Mental Health states, “Misunderstanding and misinterpreting behaviors have led to tragic consequences, including inappropriately placing minorities in the criminal and juvenile justice systems.”

The Need for Cultural Competency in Mental Health Care

When minority children are able to access mental health care professionals, these providers often fail to provide culturally competent services—services that are responsive to the cultural concerns and needs of racial and ethnic minority groups, including their language, histories, traditions, beliefs, and values.

Carrasco elaborates: “Many providers don’t understand the cultures of minority kids, and they don’t incorporate those cultural differences into the treatment plan—many times it’s simply a lack of knowledge.” The under-representation of racial and ethnic minorities and bilingual professionals in the mental health workforce exacerbates the shortage of culturally competent care. 

Racism and provider bias also play a factor in mental health care disparities: 15% of African Americans, 13% of Latinos, and 11% of Asian Americans say that there have been times when they believed they would have received better care if they had been of a different race or ethnicity. Not having access to language interpreters also prevents effective communication: Among non-English speakers who requested translation during a health-care visit, fewer than half (48%) received an interpreter.

Children of immigrants often face a unique set of stressful circumstances, including the responsibility of acting as linguistic and cultural interpreters between the new country and their parents. “These immigrant youth are dealing with two cultures, which can create a lot of immigration-related stress,” says Carrasco. “Many times, the children are left to navigate for the parents . . . adapting to the culture, creating a balance between the parents’ home culture and the new one, serving as translators.”

How Minority Mental Health Awareness Month Came to Be

One activist recognized the importance of these cultural nuances regarding mental health awareness in minority populations: African American writer Bebe Moore Campbell advocated for mental health education and support among families and individuals in diverse communities. Before passing away in 2006, Campbell had the idea to create a month devoted to “providing awareness, supporting families, and eliminating stigma” in minority communities regarding mental health issues. In 2008, the U.S. House of Representatives named July as National Minority Mental Health Awareness Month, a month devoted to enhancing public awareness of mental illness among minorities, in Campbell’s honor.

“Stigma is high in many communities—especially in communities of color,” says Carrasco. “We need to become advocates, and that’s why National Minority Mental Health Awareness Month is important to address the lack of information in many communities.” Carrasco also emphasizes the paramount role of parents in taking steps to improve children’s mental health: “We want to get parents involved as the strongest advocates for their kids so that they can navigate the mental health systems . . . and become savvy and outspoken.”

How You Can Get Involved

If you or your organization would like to help raise awareness for minority mental health this month, NAMI offers a toolkit with activity planning worksheets, tips for sharing your story, a sample press release, Twitter hashtag suggestions, promotional posters, and more. “NAMI has many resources so that grantees don’t have to start from scratch,” says Carrasco.

In addition, parents, community members, and mental health advocates can find a list of activities that take place around the country to honor Minority Mental Health Awareness Month—including a record-breaking Soul Train dance in Harlem, New York. Moreover, NAMI’s Multicultural Action Center website provides resources about mental health care in multicultural settings—including research, steps for outreach, translation guidelines, and more.

On July 17 NAMI and the National Network to Eliminate Disparities in Behavioral Health (NNED) will host “Our Strength and Support: Celebrating National Minority Mental Health Awareness Month.” During this webinar, a panel of presenters will share perspectives on mental health in minority communities, emphasizing the strengths of diverse cultures to support individuals touched by mental illness.

As Carrasco notes, all communities can promote minority mental health awareness: “Whether the effort is big or small—an event, a blog, a newsletter—everyone has a way to call more attention to the month.”

Your Turn

What mental health disparities exist among the children in your community? Is your community planning to honor National Minority Mental Health Awareness Month? If so, how? Please leave your comments below.*

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