Tackling Mental Health Issues from the Ground Up

By So Yoon Sim

According to National Institute of Mental Health, one in four adults in the United States — approximately 61.5 million Americans — experience mental illness, and one in 17 — about 13.6 million — live with a serious mental illnesses such as schizophrenia, major depression or bipolar disorder. However, approximately 60 percent of adults, and almost one-half of youth ages 8 to 15 with a mental illness received no mental health services in the previous year.

As a Research and Policy Fellow, I had the chance to participate in a Mental Health Workgroup, launched by the Maternal Infant Community Health Collaborative (COMADRES) in January, representing my placement organization Grameen PrimaCare. Different health care providers that serve immigrant populations in Queens, New York City, joined this workgroup to identify gaps and barriers and develop innovative strategies to tackle mental health issues in the community.

In New York City, mental and emotional wellness has been under-prioritized in medical and social support services. Nearly 40 percent of adult New Yorkers with serious mental illness did not receive mental health treatment in the past year. Furthermore, barriers to mental health care and low utilization rate among ethnic minorities create substantial disparities in health outcomes across different populations and communities. In Queens, which has the highest percentage of immigrants of all the boroughs in New York, the patient to mental health provider ratio is 897 to 1, in comparison to New York City’s ratio of 510 to 1, and among all U.S. counties the top performing 10% ratio is 521 to 1. In terms of service utilization, African American and Hispanic Americans used mental health services at about one-half the rate of whites in the past year and Asian Americans at about one-third the rate.

At our biweekly meetings, we first discussed challenges and the root causes of the mental health issues. In addition to genetic or biological causes or substance use that is not adequately addressed, we identified other contributing factors that are specific to the immigrant populations we serve. Multiple stressors that cause mental health issues include, poverty, work environment, social isolation, a crowded home, trauma and stress during the immigration process, domestic violence, and the general climate of fear and mistrust, among others. All participating providers also expressed the importance of culturally and linguistically appropriate services, which will help improve the adherence to medication and follow-up appointments and reduce the stigma attached to mental illness.

What we aim to achieve through this workgroup is to increase the overall community awareness of mental health issues by setting up an effective referral system among providers and organizing educational sessions and mental health fairs at public schools, which provide mental health screenings for children and also serve as a social space for immigrant parents. As in other public health issues, our major focus will be prevention: increasing community prevention efforts and creating more opportunities for community cohesion and support to reduce isolation.

Still, more work should be done to reduce treatment gaps and expand access to mental health services. In January, shortly after we launched our mental health workgroup, NYC First lady Chirlane McCray announced a partnership that will create a roadmap for a more inclusive mental health system in New York City, of which a comprehensive layout is still being drafted. McCray in The Root:

I recently had the privilege of announcing that the city will invest $78.3 million annually to provide counselors and treatment to the most vulnerable New Yorkers, including children, families living in homeless shelters and the survivors of domestic violence. Our goal is to create a truly inclusive mental-health system that can serve as a model. This investment is just the first step.

On June 29, 2015, our workgroup attended one of the five borough town hall meetings hosted by Queens Borough President Melinda Katz, which McCray and commissioners of the New York City Department of Health and Mental Hygiene attended. During the public session, I presented the major findings about stressors that affect the immigrant populations we serve, introduced our mental health workgroup’s initiatives, and expressed the needs for the city government’s collaboration with community partners such as our selves.

So Yoon Sim was a 2014–2015 Global Health Corps fellow at Grameen PrimaCare in New York City. All GHC fellows, partners and supporters are united in a common belief: health is a human right. There is a role for everyone in the movement for health equity. Join the movement today.