As the COVID pandemic has retreated, many folks are left with lingering feelings of trauma, particularly in minority communities that were impacted more than others. Many people lost loved ones during the past few years and others are coping with the lingering health impacts of having had COVID or caring for those who did. The pandemic exposed glaring health disparities in which racial and ethnic minority patients had less access to high-quality health care, more severe illness, and higher numbers of severe COVID.
Beyond healthcare and within a society that has structural racism, the pandemic caused far-reaching impacts from a disease that upended employment, income, insurance coverage, childcare, transportation, and family structure. The long-term impacts of the trauma people experienced, and are still experiencing, is something that will influence minority mental health for years to come.
During Minority Mental Health Awareness Month, nurses can help spread information about the importance of good mental health by discussing it with patients. They can offer resources, talk about how mental health changes physical health, and normalize discussions around emotions and trauma.
Because nurses educate patients, they can call attention to symptoms that patients might associate with mental health struggles including
new or marked sadness or crying
changes in eating (too little or too much)
changes in sleep patterns (difficulty falling asleep or getting out of bed)
lack of interest in hobbies, relationships, work
thoughts of suicide
They can also verbalize symptoms that aren’t always recognized as symptoms of something like depression or anxiety including
anger and rage
increased substance use and abuse
new or increased compulsive actions (checking locks, food patterns)
Talking about minority mental health with nurses encourages patients to recognize their feelings, be attentive to changes, and understand that they aren’t alone. These efforts might not always seem significant, but nurses can keep in mind that their conversation about mental health might be the only time a patient discusses their concerns. Some minority communities have such a barrier to openly discussing mental health that it is a subject that is just never brought up.
When nurses identify symptoms, highlight resources, make connections for therapy or medication providers, and show support, patients feel seen and heard. Emphasizing that mental health is a physical condition and that effective treatment is available is a beacon of hope for people who are feeling like they aren’t sure what to do. Nurses can make a meaningful difference to patients with a caring conversation about minority mental health and some resources to get started.
The recent news of elite Olympic athletes prioritizing their mental health and their own physical wellness over their sport has focused a national spotlight on the complexities and the prevalence of mental health struggles. And while seeing people who are suffering from mental health issues is difficult, the athletes’ public struggles have opened a door that allows healthcare providers to raise the issue with patients and loved ones.
In some minority communities, mental health struggles remain taboo to discuss openly. People who are experiencing symptoms of illness such as depression, anxiety, or obsessive-compulsive disorder, or even life-threatening suicidal thoughts face a stigma that prevents them from even seeking care. When the issues are discussed, access to affordable and high-quality mental health providers can be a barrier to getting help, as can lack of insurance and any language barriers.
According to the OMH, mental health is a serious and common health issue with approximately 18 percent of the entire U.S. population having a diagnosable mental illness within any given year. Of that percentage, only 43 percent of people who need mental health care receive treatment or counseling. For minority mental health needs, the numbers are even more concerning. While 48 percent of whites receive care, only 31 percent of Blacks and Hispanics do. And statistics for Asians were even lower at just 22 percent receiving needed mental health services. Disparities in mental health care can lead to lack of treatment or ineffective treatment.
For most people, mental health treatment is effective and improves their quality of life. Whether people choose medication (psychiatric nurse practitioners are especially), talk therapy, or a combination of both, getting help can make symptoms abate significantly. In more transient cases of mental illness, for example depressive symptoms caused by a major life change, treatment can get someone back to feeling like their old selves and can improve their resiliency moving forward.
These care disparities have lasting impact. According to the American Psychiatric Association minority and white populations have similar rates of mental illness, with white populations being slightly higher in some instances. But when Black and Hispanic people have depression, for example, the effects are more persistent. And systemic racism plays a role in proper care. The report states that “Racial/ethnic minority youth with behavioral health issues are more readily referred to the juvenile justice system than to specialty primary care, compared with white youth.” If mental health needs aren’t addressed and youth don’t receive proper care, that can lead to a disciplinary cycle that impedes educational and employment opportunities.
As a healthcare provider, keeping conversations about minority mental health open and ongoing with patients and having easily accessible resources available can make all the difference to helping patients get the care they need. From understanding the different types of mental health professionals and what they do to addressing medications or alternative therapies in a comprehensive treatment approach can help patients understand the range of help available. And with a recent uptick in the availability and acceptance of virtual therapy appointments, accessing care is somewhat easier for people.
Raising awareness and broaching the topic about minority mental health is important to removing the stigma and helping people move toward care that works for them.
July is Minority Mental Health Awareness Month and this year’s focus is particularly relevant. Minority populations have had significant stressors this year. The coronavirus pandemic, the national focus on race and systemic racism, and the economic fallout from an unstable economy have created a storm of emotions and concerns.
In 2017, 10.5% (3.5 million) of young adults age 18 to 25 had serious thoughts of suicide including 8.3% of non-Hispanic blacks and 9.2% of Hispanics.
In 2017, 7.5% (2.5 million) of young adults age 18 to 25 had a serious mental illness including 7.6% of non-Hispanic Asians, 5.7% of Hispanics and 4.6% of non-Hispanic blacks.
Feelings of anxiety and other signs of stress may become more pronounced during a global pandemic.
People in some racial and ethnic minority groups may respond more strongly to the stress of a pandemic or crisis.
Because of the vast gaps in health equity and access, many minority populations have trouble finding high-quality mental health care providers and/or a means of getting to a provider to receive care. The pandemic has created a unique situation that can actually be a benefit for some people who have trouble finding good care or getting to an office. Because so many healthcare appointments are now virtual, that could remove one barrier to receiving care, but is wholly dependent on access to reliable technology to be able to connect virtually.
Increased access also depends on changing much deeper levels of the healthcare system. Many mental health providers are overwhelmed with the increased demand for their services during the pandemic. And many providers choose to skirt the often tedious and time consuming insurance process and have opted not to accept insurance and are private pay only. Those two issues can actually create even steeper burdens for those already marginalized by the healthcare system.
MentalHealth.gov offers resources to help families, individuals, educators, and faith and community leaders to begin conversations around mental health among minority populations. Talking about mental health in a normalized and compassionate way can help reduce some of the stigma around mental health issues. People who feel like they can ask for help are often able to then take the steps to get the help they need. If they feel like they are not alone and they are not the only ones who might be struggling, then they will find that getting help is less of a burden. If they feel supported by their community, they feel less need to hide or even deny what they are feeling and experiencing.
Although July calls attention to minority mental health, the issue is one that needs constant attention, but particularly during this time of tremendous and chronic upheaval.
Mental illness is a major health condition affecting millions of American families. With no regard to education, age, class, family, ethnicity, or gender, mental illness can impact anyone’s life and often has widespread effects.
July is Minority Mental Health Awareness Month and helps spread the word about the higher risk of mental illness in minorities own lives and the real barriers minorities face to receiving timely, high-quality, and accessible care.
According to the Substance Abuse and Mental Health Services Association (SAMHSA), rates of mental illness impact minority communities in greater numbers. Culturally, many minority communities have a greater stigma associated with mental illness, so people have a hard time speaking up or admitting they need help. If they do decide to get help, the barriers for finding high-quality, accessible, and affordable care can be insurmountable.
As a result, nurses might routinely see patients who have symptoms of mental illness but won’t address it. Most of these conditions are treatable with the right help, so it’s important to let patients know about available resources or even that what they are feeling is a true biological illness, not something that they can just get over or take care of on their own.
The American Psychiatric Association and the Mayo Clinic offer these indicators that might signal something more serious than a passing phase. Experiencing one or two of these symptoms isn’t necessarily a cause for alarm, but if symptoms are interfering with someone’s ability to perform their normal functions, take care of themselves, work capably, or hold meaningful relationships, then they need to get help.
What are some signs and symptoms to look for?
Feeling sad, down, or hopeless
Excessive anger or an inability to cope with stress
Anxiety, feelings of guilt
Withdrawing from social activities, friends, family
An inability to keep up with grades or normal work quality
Sleeping too much or an inability to sleep
Eating too much or too little
Extreme mood changes – highs and lows that are beyond average
Increased or troublesome use of drugs and alcohol
Feelings of being disconnected or experiencing delusions
Thoughts of suicide
Many people experience sadness or mood changes throughout their lives. A bad day at work can make you grouchy, and family problems can make you sad and anxious. But lingering problems with these feelings and those that impact daily life need attention.
Be on the lookout for any of these symptoms in your patients and listen to the ways they might express them. If they are in danger of harming themselves or someone else, immediate help is necessary, so call 911 or get your emergency team to respond immediately.
Above all, reassure your patients that, like any other medical illness, mental illness is something that is treatable and nothing they are at fault for. A little compassion can make a huge impact.
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