Across mental health outcomes, youth of color often have less access to mental health services and poorer quality mental health services than their White peers. Diagnoses of specific disorders are also unequal. Given a specific set of behaviors, youth of color tend to be diagnosed with conduct disorder or oppositional defiance disorder while their White peers are more often diagnosed with Attention Deficit Hyperactive Disorder (ADHD) for those same behaviors. Latinx families and youth are also at a higher risk for negative mental health outcomes than White families, as they face issues such as higher levels of stress, unstable housing, community violence, discrimination, lower socioeconomic status, and higher prevalence of substance use.
Our research group at UC Santa Barbara, led by Dr. Jill Sharkey, along with Santa Barbara County Department of Behavioral Wellness (BeWell), was interested in understanding if these same outcomes were taking place in Santa Barbara County and figuring out what could be done to address them. Thanks to funding through the RED (Racial and Ethnic Disparities) Grant, we have been able to explore the inequality in the juvenile justice system and work to decrease the overrepresentation of youth of color in the system.
Working with the Community
We partnered with BeWell and numerous other community based mental health organizations to recruit mostly Latinx youth, their parents, and mental health treatment providers (staff) to participate in small focus groups in English and Spanish to understand their opinions of mental health and their experiences with mental health services in Santa Barbara County. Previous research highlighted certain obstacles associated with accessing and receiving mental health services such as insurance coverage, language barriers, segregation leading to service shortages, discrimination and biases (incorrect diagnoses and limited treatment options), and stigma. From our meetings with these groups, ten themes emerged:
- Positive Experiences
- Limited Awareness of Services
- Need for Education about Mental Health
- Limited Resources and Procedural Barriers Impeding Access
- Language Barriers
- Cultural (In)Senstivity
- Need for Peer Interaction or Peer Helpers
- Safety in Therapeutic Setting
- Ideal of Integrated Services
What Does This All Mean?
These findings were not necessarily a surprise to the researchers. This is unfortunate because it shows that institutional barriers to mental health treatment still exist and are not easy to fix. We need to reexamine how we address mental health and we need to pay special attention to the roles of cultural competence and responsivity within mental health.
During the course of the focus groups, families, youth, and staff suggested a variety of ways to address these problems. They suggested more culturally competent training around implicit bias, conducting psychoeducation about what exactly mental health is, and engaging in more outreach in different settings. Especially notable was the feedback from youth. They suggested numerous outreach ideas within school systems, such as having a mental health peer, video campaigns, speakers to talk about their mental health experiences, flyers explaining different services, and many more. A particularly creative solution was an integrated health facility to combine arts and crafts, food, and an adult or knowledgeable peer to talk to, all within a nurturing, safe environment.
This got me thinking. Why don’t we have more mental health outreach in schools? We have school guidance counselors, school psychologists, and other individuals all looking out for youth and their wellbeing. Schools can also serve as the first point of contact for youth and their families regarding different health care systems. This could make schools great places to conduct outreach and provide youth and their parents with information about healthcare options. Ultimately it comes down to time and resources. Do school personnel have the time to add this extra piece to their daily jobs? Should it be seen as something extra or should psychoeducation around mental health and resources be inherent to school systems?
For those of us working with young people, we need to keep the following thoughts in mind: what are we doing to ensure our students have the appropriate knowledge and access to health resources, and what more can we do?
Note: Although this blog post was written by Sruthi, this data collection phase and writing of the official 2017 RED Mental Health had many more authors and student contributors including Dr. Sharkey, Luke Janes, Kelly Edyburn, Alissa Der Sarkissian, and numerous undergrad volunteers. Thank you to everyone involved!
About the Author
Sruthi Swami is a 4th year doctoral candidate in the Department of Counseling, Clinical, and School Psychology within the Gevirtz Graduate School of Education. Her primary research interests include racism and discrimination in school settings, academic motivation, and understanding systemic barriers that impede access to education and mental health. Sruthi can be reached at email@example.com.