SACRAMENTO, Calif.--()--The following is an opinion editorial provided by Dr. Oscar Wright, CEO of United Advocates for Children and Families (UACF):
California is in the midst of a cultural crisis expressed in two dimensions of compassion: prevention and early intervention vs. treatment for the mentally ill. The former suffers silently without a diagnosis and the latter suffers severely, with a diagnosis. Why must we choose one over another? And what does culture have to do with mental health issues, in particular Proposition 63?
An example of how cultural nuances can set an issue ablaze with misinterpretations and faulty assumptions is the latest debate and dialogue on the allegation that Mental Health Services Act funds (Proposition 63) have been spent frivolously on wellness programs with no relationship to mental illness. A recent Associated Press report chides gardening and sweat lodges as fiscal boondoggles outside the box. But whose box are we outside of? The notion is that those funds could have been better spent on individuals experiencing severe mental illness. Honestly, I get it! However, I would contend that it would be less than humane, fiscally short-sighted and culturally insensitive to address this issue in less than a fair and equitable manner. In this case, we don't need a rush to judgment, but rather a stampede to sensitivity.
First, understand that we are all ‘captives of culture.’ Culture plays an incredibly important role in the cause and reasoning of mental health. Cultural beliefs can shape the way people identify stress and the way they seek help. All of us are programmed by ‘cultural software’ that determines our behavior and attitudes.
Recent studies clearly indicate that cultural barriers prevent access to care for many underserved communities; barriers such as:
Mistrust and fear of treatment,
Alternative ideas about what constitutes illness and health,
Language barriers and ineffective communication,
Access barriers, such as inadequate insurance coverage,
Stigma and shame,
A lack of diversity in the mental health workforce.
Consider the following statistics on some of our most vulnerable communities:
Latinos are twice as likely to seek treatment for mental disorders in other settings such as general health care or the clergy, than in mental health specialty settings. Forty-three percent of the total Medi-Cal population is Hispanic/Latino, while 13% of those receiving mental health are Hispanic/Latino.
During 2007-2008, less than 1% of California's nearly 2.2 million African Americans used Department of Mental Health services. Thirteen percent of the total Medi-Cal population is African American, while 14 % of those receiving mental health services are African American.
Asian Americans have the lowest utilization rate for mental health services among all populations. Seven percent of the total Medi-Cal population is Asian, while 8% of those receiving mental health services are Asian.
Native Americans: A recent study suggests that mental health dollars should be spent on practices like 'coming of age' ceremonies for young people. It says these create a sense of wellness and balance that can prevent drug abuse, suicide, and related mental health problems
By 2025, 35% of U.S. population will be members of ethnic minority groups. Ethnic minority children will be 48% of all children residing in the U.S. In the early 1990's, most immigrants came from Europe and Canada; now they come from Latin America and Asia; different strokes for different folks! We don’t have a melting pot, it’s a salad bowl!
From a cultural context, perhaps we can better understand why funds were spent to develop gardens for Hmong community and sweat houses for Native Americans. Outreach strategies simply must factor in cultural considerations.
In California, when we talk mental health…..culture counts!
I’d like to hear from readers at: firstname.lastname@example.org.
Dr. Oscar Wright is the CEO of United Advocates for Children and Families (UACF), a statewide nonprofit that provides support to families, children and youth experiencing mental illness.