Disparities in Mental-health Care for African Americans

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Lonnie Snowden

Since the Supplement to the U.S. Surgeon General’s Report Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General, several events have occurred. These, say Lonnie R. Snowden, have established a national commitment to understanding African American-White American treatment disparities, their consequences, and opportunities for their reduction.

Snowden’s article, “Health and Mental Health Policies’ Role in Better Understanding and closing African-American-White American Disparities in Treatment Access and Quality of Care” appeared in the October 2012 Special Edition of American Psychologist.

The Surgeon General has done a 10-year follow-up study to examine disparities in mental health care provided to African Americans, and this was an extension of an initial study dating back to 1985. Snowden documents key elements of the Surgeon General’s findings.

The U.S. Congress itself requested an assessment of treatment disparities beyond ability to pay and insurance coverage—factors including bias, discrimination, and stereotyping and ways to eliminate them. One area includes understanding why African Americans receive mental health services disproportionately in emergency rooms rather than clinics and offices.

The importance of co-morbidities is addressed. These include diabetes, heart disease, prostate and breast cancer, HIV/AIDS, and infant mortality. Since these problems may be priorities, affirming the need for treatment of mental health issues is suggested. Snowden notes:

“The results affirm a conclusion that has also been reported elsewhere: that African Americans’ untreated mental illness is appreciably more untreated than mental illness suffered by White Americans, and that African Americans’ psychiatric hospitalization rates are higher than those of White Americans. As I show later, when I consider the burden of disease borne by African Americans, African Americans’ treatment quality is lower than that of White Americans.”

Snowden believes that President Obama’s Patient Protection and Affordable Care Act will bring about a dramatic transformation of the American Health care system in the future. However, these changes might not be enough to eliminate access disparities because African Americans are disproportionately unlikely to comply with a mandate requiring them to purchase insurance coverage. Even with these difficulties in mind, the author concludes:

“What began with the publication of the Supplement under an African American surgeon general can reach its greatest fulfillment under a U.S. President who is African American. These historic figures have presented us with historic opportunities to improve African Americans’ mental health and for widescale betterment of African American communities.”

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