Name: Monica Ferreira
From: Wesport, Massachusetts
Saving the Underserved: Mental Health, Addiction, and Culture
Saving the Underserved: Mental Health, Addiction, and Culture
Addiction by definition is a mental health issue. According to the American Psychiatric Association, addiction if a severe version of substance use disorder (SUD). SUD is complex a condition in which there is uncontrolled use of a substance despite harmful consequences. People who have SUD have an intense need to use certain substances such as alcohol or drugs to the point that their daily functioning becomes impaired. The most severe forms of substance use disorders are often called addictions, where a person feels compelled to use the substance in order to carry out a normal life. In order to treat this matter on both the individual and societal level, we must tackle the issue of mental health by raising awareness and providing access to services.
Introduction: Addiction, Mental Health, and Culture
I frequently notice that underserved communities are those that are impacted them most from a failed system, especially those from underrepresented cultures. Racial and ethnic disparities have been repeatedly linked to lack of access to mental health care and cultural bias amongst services. Lack of mental health care has severe repercussions that are far-reaching throughout the community (Brown, Ojeda, Wyn, & Levan, 2000). It is my opinion that serving the mental health needs of the public is the best way to curb substance use disorders and addiction. While this may be true, I have been in contact with many families who were firmly set in their beliefs that mental illnesses should simply be ignored. Different cultures have different meanings of mental illnesses which influence whether people seek help or not, what type of help they seek, what types of social supports they have, and how much stigma is attached to mental illness (Office of the Surgeon General, US. 2001).
The stigma around mental health in many cultures is largely attributed to distrust from systematic racism and discrimination (Williams, Yu, Jackson, & Anderson, 1997). According to the office of the United States Surgeon General, cultural meanings of illness have real consequences, and mistrust of the system and fear of mistreatment due to assumptions about their background often causes many people to avoid proper addiction treatment. However, it is important that these mental illnesses are not be left untreated, doing so causes a significant impact to one’s quality of life and can create secondary health effects (Office of Surgeon General, US. 2001). Addiction is a mental illness in which secondary health effects are much more prominent.
In addition to physical repercussions, addiction has been linked to negative behavioral and emotional changes such as violence, social issues, impaired control, and increased risk taking (American Psychiatric Association, 2021). These effects not only effect the individual with the addiction but their friends, family, and other social connections as well. By treating addiction and other mental health issues, quality of life will increase while physical, social, and emotional effects will be mitigated. To accomplish this, we must challenge and reform the current mental health system.
Mental Health Education
The first step in changing the system is to raise awareness on the importance of caring for your mental health. It is important to make educational materials more accessible to ethnically diverse communities who communicate in non-English languages as mental health information is severely lacking (Corrigan, & Penn 1999). To resolve this issue, we must provide education and have open conversations in order to normalize discussing and treating addiction. This should be completed by providing infographics and flyers, hosting discussion panels, and providing advertising for mental health addiction services. Each of these services should be held in both English and non-English languages in order to reach a wider demographic. This will provide numerous people with the groundwork to understand addiction as well as provide them with the means to seek proper treatment. Importantly, it also will also send the powerful message that they are not alone, that someone cares, and that there is hope to heal and move on.
Cultural misunderstandings between the client and clinician or cultural bias can often deter minorities from seeking appropriate care (Ramirez, 1991). This is why the next step in reforming the system is to focus on providing mental health professionals with the education to become culturally competent. Cultural competency is very important, especially in the mental health field. It is imperative that those involved in a client’s addiction treatment recognize and are open to the fact that just as individuals and families are different, so are cultural practices and beliefs (Ramirez, 1991. Corrigan, & Penn, 1999. U.S. Center for Mental Health Services, 2000). This will create an open environment to foster an unbiased and culturally-sensitive relationship between client and clinician, where the clinician can learn about the client’s cultural experiences and treat accordingly. Practicing this therapeutic approach will result in a better understanding between client and clinician and will lead to a more successful treatment of the individual’s addiction.
Reform through Affordability and Insurance
Affordability and insurance coverage of mental health services is a great area of concern in regards to minorities (Brown, Ojeda, Wyn, & Levan, 2000). Common mental illnesses such as depression, anxiety, and addiction can be extraordinarily incapacitating, yet many people do not have access to affordable treatment. While low-income adults may be covered under Medicaid and the Affordable Care Act, many people under insurance still pay a large stipend for services. Minorities experience a “disproportionate burden” when seeking mental health care where ‘the lack of health insurance diminishes their utilization of preventative services’ (Brown et al. 2000). This is why I believe that a program should be created to exchange mental health services of low-income clients for student loan repayment offered by the United States government and other major loan holders. This would provide clinicians with an incentive to work within underserved communities while providing clients with a low-cost or free mental health service to treat their addictions.
There are unquestionably a lot of problems with the current mental health system. From racism and bias, lack of understanding and awareness, to access and affordability issues, there is a lot that needs to be changed. In order to transform this broken system, we must speak up for those who don’t have a means to do so themselves and work together. The only way to do this is through a few straightforward steps; awareness, education, and implementation. It will undoubtably take years of hard work in order to truly make a significant change. Nevertheless, every minute of work will contribute to the betterment of mental health throughout our country.
It is obvious that we must work together to create true change. It is critically important to provide education and raise awareness for addiction and other mental health issues and services, especially amongst underrepresented communities. Mental health professionals must be mindful of the diverse field of cultures and beliefs in order to have a successful therapeutic outcome free from bias and misunderstanding. Lastly, we must implement accessible mental health services to those that most need them, providing coverage for clients and incentives for professionals. I am absolutely sure that with these steps in place we will create a healthier, more understanding, and accepting society and save many lives from the addiction crisis.
American Psychiatric Association What Is a Substance Use Disorder? What Is Addiction? (2021). https://www.psychiatry.org/patients-families/addiction
Brown, E. R., Ojeda, V. D., Wyn, R., & Levan, R. (2000) Racial and ethnic disparities in access to health insurance and health care., Los Angeles UCLA Center for Health Policy Research and The Henry J. Kaiser Family Foundation.
Corrigan, P. W., & Penn, D. L. Lessons from social psychology on discrediting psychiatric stigma., 54, American Psychologist (1999):765–776 [PubMed]
Office of the Surgeon General (US); Center for Mental Health Services (US); National Institute of Mental Health (US). Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2001 Aug. Chapter 2 Culture Counts: The Influence of Culture and Society on Mental Health. [NCBI]
Ramirez, M. (1991) Psychotherapy and counseling with minorities: A cognitive approach to individual and cultural differences., New York Pergamon Press.
U.S. Center for Mental Health Services. (2000) Cultural competence standards in managed care mental health services: Four underserved/underrepresented racial/ethnic groups., Rockville, MD.
Williams, D. R., Yu, Y., Jackson, J. S., & Anderson, N.B. Racial Differences in Physical and Mental Health: Socio-Economic Status, Stress and Discrimination., 2, Journal of Health Psychology (1997):335–351. [PubMed]