Background: Mental health insurance laws are intended to improve access to needed treatments and prevent discrimination in coverage for mental health conditions and other medical conditions.
Objectives: The aim was to estimate the impact of these policies on mental health treatment utilization in a nationally representative longitudinal sample of youth followed through adulthood.
Methods: We used data from the 1997 National Longitudinal Survey of Youth and the Mental Health Insurance Laws data set.
The mental health system is often not readily accessible, culturally responsive, or a reliable source of effective interventions for society's most vulnerable populations. Modern-era studies estimate the number of persons diagnosed with serious mental illness in correctional facilities is more than 3 times the amount in hospitals. Understanding mass incarceration and the criminalization of mental illness is imperative to address mental health inequities.
View Article and Find Full Text PDFObjective: The purpose of this secondary data analysis was to describe racial-ethnic disparities in receipt of depression treatment and treatment modality among adult Medicaid beneficiaries with depression from a nationally representative sample-28 states and the District of Columbia-of Medicaid beneficiaries (N=599,421).
Methods: Medicaid claims data were extracted from the full 2008-2009 Medicaid Analytic Extract file. The primary outcome was type of depression treatment: medication only, therapy only, medication and therapy, and no treatment.
Screening for depression is paramount to identify patients with depression and link them to care, yet only 29% of patients in the primary care center (PCC) were screened for depression in 2016. A baseline survey identified provider barriers to depression screening, including lack of time, support staff, and referral resources. The purpose of this project was to increase depression screening in the PCC using the Patient Health Questionnaire (PHQ-2/9).
View Article and Find Full Text PDFRacial/ethnic disparities have long persisted in the United States despite concerted health system efforts to improve access and quality of care among African Americans and Latinos. Cultural competence in the health care setting has been recognized as an important feature of high-quality health care delivery for decades and will continue to be paramount as the society in which we live becomes increasingly culturally diverse. Unfortunately, there is limited empirical evidence of patient health benefits of a culturally competent health care workforce in integrated care, its feasibility of implementation, and sustainability strategies.
View Article and Find Full Text PDFPeople with serious mental illness are more likely to be arrested multiple times for the same crime, spend more time in jail before adjudication, serve longer sentences, and have higher recidivism rates than those without mental illness. Several conceptual foundations, such as the sequential intercept model and the risk-needs-responsivity model, have been developed to help communities address the overrepresentation of people with mental illness in the criminal justice system. The Stepping Up Initiative is a national effort to enlist counties to commit to reduce the number of people with mental illness in their jails.
View Article and Find Full Text PDFIntroduction: Addressing the multifaceted health and mental health needs of ethnically and culturally diverse individuals is a challenge within the current health care system. Integrated care provides a promising approach to improve mental health treatment-seeking disparities; however, adaptation of care models to impact African Americans is lacking. Although resources to support engagement of diverse populations in depression care exist, little has been developed to tailor patient preferences in accessing and engaging mental health services that are integrated into primary care.
View Article and Find Full Text PDFThe Campus and Community HIV and Addiction Prevention (CCHAP) project was a collaborative effort between three academic institutions and a community-based organization to conduct rapid HIV testing, assess substance use behaviors, and provide education on HIV risk behaviors for African Americans, 18-24, attending historically Black colleges and universities (HBCUs) and within the surrounding community. As a result of this partnership 2,385 participants received a rapid HIV test, with testing split almost equally between the campus and the community. The positivity rate was .
View Article and Find Full Text PDFHealth is a human right. Equity in health implies that ideally everyone should have a fair opportunity to attain their full health potential and, more pragmatically, that no one should be disadvantaged from achieving this potential. Addressing the multi-faceted health needs of ethnically and culturally diverse individuals in the United States is a complex issue that requires inventive strategies to reduce risk factors and buttress protective factors to promote greater well-being among individuals, families, and communities.
View Article and Find Full Text PDFJ Health Care Poor Underserved
April 2018
Day-reporting centers (DRCs) provide programming for probationers with a history of non-compliant behavior related to substance abuse, who are overrepresented among justice-involved men and women. While evaluations of DRCs demonstrate some effectiveness, results are mixed and less is known about predictors of program success. This evaluation compared indicators of program success between adult offenders with a substance use disorder (n = 144) and those with co-morbid mental illness (n = 113) at three DRCs.
View Article and Find Full Text PDFInt J Environ Res Public Health
December 2015
St. Lucia is an island nation in the Eastern Caribbean, with a population of 179,000 people, where chronic health conditions, such as hypertension and diabetes, are significant. The purpose of this pilot study is to create a model for community health education, tracking, and monitoring of these health conditions, research training, and policy interventions in St.
View Article and Find Full Text PDFDespite widespread support for removing barriers to the use of electronic health records (EHRs) in behavioral health care, adoption of EHRs in behavioral health settings lags behind adoption in other areas of health care. The authors discuss barriers to use of EHRs among behavioral health care practitioners, suggest solutions to overcome these barriers, and describe the potential benefits of EHRs to reduce behavioral health care disparities. Thoughtful and comprehensive strategies will be needed to design EHR systems that address concerns about policy, practice, costs, and stigma and that protect patients' privacy and confidentiality.
View Article and Find Full Text PDFDespite decades of research, recognition and treatment of mental illness and its comorbidities still remain a significant public health problem in the United States. Ethnic minorities are identified as a population that is vulnerable to mental health disparities and face unique challenges pertaining to mental health care. Psychiatric illness is associated with great physical, emotional, functional, and societal burden.
View Article and Find Full Text PDFThe social determinants unique to African-American men's health contribute to limited access and utilization of health and mental health care services and can have a deleterious effect on their overall health and well-being. There is a need to examine the complex issues concerning African-American men's help-seeking behaviors relative to mental health concerns. Current research estimates that African-American men are approximately 30% more likely to report having a mental illness compared to non-Hispanic Whites and are less likely to receive proper diagnosis and treatment.
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