At NIMH’s Mental Health Disparities Team Speakers Series are (from l) Dr. James Jackson, NIMH deputy director Dr. Richard Nakamura, Dr. Margarita Alegria, Dr. David Takeuchi and NIMH director Dr. Thomas Insel.
Many diverse groups in the U.S. do not receive equitable
care by the current health and mental health systems. Inequalities in care can be attributed in part to poor inclusion and engagement of these groups in the development and implementation of interventions. This can further compound feelings
of stigma associated with mental disorders and reluctance to seek care.
Recognizing the need for comprehensive epidemiological
data on mental illness within diverse populations,
NIMH launched in 2000 the Collaborative Psychiatric Epidemiological Studies (CPES). It now provides the first national data with sufficient power to investigate cultural and ethnic influences on mental
disorders among African-American, Latino and Asian-American groups.
“These studies provide a gold mine of information,”
said NIMH director Dr. Thomas Insel, “which can help us to identify the needs and strengths of diverse groups and use this information to create and enhance more personalized interventions for mental illnesses.”
Study findings were presented at NIMH’s Mental
Health Disparities Team Speakers Series, which recently featured presentations by Dr. Margarita
Alegria of Harvard, Dr. James S. Jackson of the University of Michigan and Dr. David Takeuchi of the University of Washington.
“We are not all alike,” said Jackson, contrasting stereotypical views that tend to categorize diverse ethnic groups under broad homogenous labels. His study showed that labels, at least in terms of mental
health outcomes, are often misrepresented. For example, African-American men had greater social stability and lower rates of diagnosed mental disorders
than men of Afro-Caribbean ancestry. However,
African-American women experience a higher rate of mental health problems than their Afro-Caribbean counterparts. These findings, according to Jackson, illustrate the complex nature of racial and cultural identity and mental health.
Takeuchi noted that the U.S. has a significantly higher rate of mental disorders compared to other nations, including Brazil, Canada and Mexico. His study showed that assimilation into American culture
greatly increased risk within Asian-American immigrant populations as well. Asian-American immigrants who arrived in the U.S. at an early age were more likely to develop mental health problems than those who arrived later in life, and U.S.-born children of immigrants experienced a rate of mental disorders similar to that of the general population.
Alegria stressed the need for new approaches that reach “beyond the clinic
walls.” Her investigation
found that despite the availability of potentially effective
treatments, most Latino groups did not have adequate access to care. This factor correlated
with a significant
under-diagnosis of mental disorders within these communities.
The findings from CPES provide an array of information about the mental health needs and strengths in the U.S. Future NIMH research will build on these findings and find ways to better personalize clinical care, which in turn can contribute to improving equality in mental health care.