To improve minority mental health, research must put patients first

To improve minority mental health, research must put patients first
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As physicians, we care for patients with acute and chronic diseases every day, doing whatever we can to help them achieve the best health outcomes possible and live long, productive lives. But as leaders of the two largest physician organizations dedicated to health advocacy for racial minority populations in the United States, we know that far too many of the patients our members treat will have less access to the care they need, and see poorer outcomes, than non-minorities.

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We see these disparities across all conditions, but one of our greatest challenges is in helping patients in minority communities live with serious mental illness. One in six U.S. adults has an illness like depression, bipolar disorder, or anxiety disorder, but African Americans are 10 percent more likely, and Latinos 40 percent more likely, to experience serious psychological distress than non-Hispanic whites. And those minority populations are only half as likely to receive needed treatment or counseling as non-Hispanic whites. Statistics are even worse for American Indians and Alaska Natives.

 

Compounding this problem, people with serious mental illnesses die on average 10 to 20 years earlier than others. A primary reason for this is preventable medical conditions, like those linked to obesity and smoking. People with serious mental illnesses often don’t get the care they need to address these comorbid conditions, making a difficult situation far worse. 

So how do we make a dent in these discouraging statistics? It will require a multi-pronged approach.

We must urgently address the stigma associated with mental illness, still taboo in minority communities. We can do this with more funding for culturally and linguistically appropriate educational programs, including in our schools, awareness campaigns, preventive care, and treatment and support services, including those delivered through the community health centers so vital to many in minority communities.

We need to invest more in research specifically focused on improving minority mental health care and outcomes. This includes ensuring that relevant clinical trials are accessible to our communities, which isn't always the case. And it means supporting the kind of studies that engage patients and others in our communities from start to finish. This makes it more likely researchers will ask the right questions, focus on outcomes that matter most to patients, and produce useful results that can help them make better health care decisions. This is especially important in studies looking at improving care and outcomes for people living both with mental illness and other chronic physical conditions.

These are no small challenges, but we’re optimistic that there is broad public support for dealing with these issues aggressively. A recent survey commissioned by Research!America, for example, found 74 percent of respondents said it was either very or somewhat important for the federal government to fund research on social determinants of health — things like education, housing, income, access to healthy food and health care — to address health disparities. And 73 percent said it was very or somewhat important to conduct research to address the disproportionate impact many serious health problems — such as diabetes, heart disease, and infant mortality — have among minorities or people with lower incomes.

To provide leadership for these efforts, our organizations recently joined with three others: the Association of American Indian Physicians, Association of Black Cardiologists, and National Council of Asian Pacific Islander Physicians, to form The Minority Physicians’ Alliance.

Each of our organizations will continue to work in our own capacities as we always have, because we know it will take expert attention for each under-served community to achieve health equity — but it will also require collective expertise and the reduction of existing siloes. We will continue to home in on issues that cross over our communities in order to maximize impact. We can't do it all, but we welcome all physicians and health care providers to further this mission by amplifying our collective voice.

Dr. Elena Rios is president and CEO of the National Hispanic Medical Association.

Dr. Doris Browne is president of the National Medical Association.