A person’s beliefs, norms, values and language affect how people perceive and experience mental health conditions. Cultural differences can influence whether or not an individual seeks help, the type of help that is sought, and what treatments might work best.
During National Minority Mental Health Awareness Month in July, the Divisions of Behavioral Health and Public Health at Nebraska DHHS join partners at the federal, state, local, tribal, and territorial levels to promote culturally competent care – the behaviors, attitudes and skills that allow a health care provider to work effectively with different cultural groups.
Diverse communities face many barriers such as higher levels of stigma, misinformation about mental health and language that prevent them from receiving care. However, when a mental health professional does take into account cultural needs and differences, outcomes can be significantly improved.
“Mental health problems affect millions of families, yet we have too often struggled to have an open and honest conversation about these issues,” said Sheri Dawson, director of the Division of Behavioral Health. “Misperceptions, fears of social consequences, discomfort associated with talking about these issues with others, and discrimination all tend to keep people silent. If they get help, most people with mental illnesses can and do recover and lead happy, productive and full lives.”
According to statistics presented by Kimberly L. Nelson, regional administrator for the Substance Abuse and Mental Health Services Administration (SAMHSA) at the Addressing Health Disparities: Focus on Mental Health and Violence conference at Creighton University on April 27:
- 27.5% of American Indians in Nebraska reported having an anxiety disorder, compared to 9.8% of Caucasians.
- Almost 15% of African-Americans in Nebraska had an anxiety disorder.
- Almost 40% of Native Americans in Nebraska had been diagnosed with a depressive disorder.
- Approximately 13% of both African-Americans and Hispanics had been diagnosed with a depressive disorder.
- Nebraska’s Hispanic population experienced the highest percentage of people who had serious psychological distress, at 8.2%, compared to 2% of Caucasians.
- Almost 3.5% of African-Americans experienced serious psychological distress, as did 2.5% of Caucasians.
The Agency for Healthcare Research and Quality (AHRQ) reports that racial and ethnic minority groups in the U.S. are less likely to have access to mental health services, less likely to use community mental health services, more likely to use emergency departments, more likely to be uninsured, and more likely to receive lower-quality care.
However, there is hope and there is help in Nebraska. The Division of Behavioral Health contracts with the Tribal Authorities in Nebraska and funds the Nebraska Family Helpline, (888) 886-8660. As well, many community and cultural centers – including the Lincoln Asian Center and the Nebraska Urban Indian Health Coalition in Lincoln and the Latino Center of the Midlands in Omaha – offer mental health services for specialized populations.
The Division of Public Health offers online and in-person trainings on cultural and linguistically appropriate services (CLAS) and offers a wide variety of resources online, including an assessment that organizations can take to determine how well they are doing in regards to the standards. For more information, please see http://dhhs.ne.gov/Pages/HDHE-
At the federal level, a new e-learning program by the DHHS Office of Minority Health has just launched. It is accredited and an excellent resource for behavioral health providers. For more information, please see https://www.
The Behavioral Health Education Center of Nebraska (BHECN) is doing pilot studies implementing Screening Brief Intervention Referral to Treatment (SBIRT) into rural integrated health care settings, including one at Plum Creek Lexington Clinic in Lexington, Nebraska. This clinic is located in a diverse rural town with many Hispanic and African immigrants. The study is implementing SBIRT training and collecting feasibility data from an integrated primary care clinic, conducting focus groups to identify barriers to SBIRT implementation and identify potential solutions, and assess the behavioral health burden on adolescent and adult rural populations in Nebraska.
An upcoming BHECN pilot study will offer SBIRT services in agricultural work settings, rather than clinics. About 12 screening events are planned over an 18-month period.