This entry originally appeared here in 2008. Five years later and little has changed. So it seemed appropriate to re-run it (with some editing) to remind ourselves that we still have a long ways to go.
We have a long way to go for equality in health care and mental health care amongst different races and ethnicities. In 2001, the U.S. Surgeon General issued a supplement to its ground-breaking 1999 report on mental health. This supplement focused on issues of culture, race and ethnicity and, not surprisingly, found:
- Minorities have less access to, and availability of, mental health services.
- Minorities are less likely to receive needed mental health services.
- Minorities in treatment often receive a poorer quality of mental health care.
- Minorities are underrepresented in mental health research.
On this day we honor a voice for those oppressed, not solely by unjust laws, but also by unjust prejudice that infected much of our country and much of our culture. Today, everyone with a mental illness faces prejudice and discrimination similar to — but distinct from — the prejudices and discrimination that Martin Luther King, Jr. fought so eloquently against.
The supplement also found:
[… T]hat racial and ethnic minorities collectively experience a greater disability burden from mental illness than do whites. This higher level of burden stems from minorities receiving less care and poorer quality of care, rather than from their illnesses being inherently more severe or prevalent in the community.
This finding draws on several lines of evidence. First, mental disorders are highly disabling for all the world’s populations (Murray & Lopez, 1996; Druss et al., 2000). Second, minorities are less likely than whites to receive needed services and more likely to receive poor quality of care. By not receiving effective treatment, they have greater levels of disability in terms of lost workdays and limitations in daily activities. Further, minorities are overrepresented among the Nation’s most vulnerable populations, which have higher rates of mental disorders and more barriers to care. Taken together, these disparate lines of evidence support the finding that minorities suffer a disproportionately high disability burden from unmet mental health needs.
From King himself:
The realist in the area of race relations seeks to reconcile the truths of two opposites while avoiding the extremes of both. So the realist would agree with the optimist that we have come a long, long way. But, he would go on to balance that by agreeing with the pessimist that we have a long, long way to go. And it is this basic theme that I would like to set forth this evening. We have come a long, long way but we have a long, long way to go.
– Martin Luther King, Jr.
A Realistic Look at the Question of Progress in the Area of Race Relations
Address at Freedom Rally (1957)
Sadly — nearly 45 years after his death — I’d have to still agree.
Read the full report: Mental Health: Culture, Race and Ethnicity supplement to the 1999 report on mental health.
Also worth the read: Overview of Cultural Diversity and Mental Health Services (1999).