Finding and scheduling healthcare appointments can be challenging for anyone, especially in low-income neighborhoods, with additional barriers present for mental health services.
Language barriers may impede communication with healthcare practitioners, leading to them misinterpreting symptoms or being unaware of available treatments (DIXONWOODS2005). Furthermore, practical issues like inflexible clinic hours or needing childcare arrangements may impede access.
Social Determinants of Health
Environments where people live, learn, work and play have a tremendous effect on health – known as social determinants of health – including quality food and housing, education, neighborhood and community safety, access to healthcare and jobs.
These factors are determined by public policies and social norms which act together to reinforce and support each other, influencing opportunities distribution in ways which impact an individual’s ability to maintain a healthy lifestyle, in turn impacting mental health.
Although clinical interventions are necessary, it’s essential that we address the root causes of issues on a population level as well. This means adapting public policies so they are more health promoting, shifting social norms so we prioritize everyone’s wellbeing, and using what’s known as social prescribing (also called “social prescribing”) to increase patient engagement and treatment adherence in underserved communities while decreasing mental illness or substance use disorders.
Access to Health Insurance
Finding mental healthcare requires more than simply finding someone to talk to; it also involves finding services that are affordable and straightforward to use. Many who seek mental healthcare face costs barriers.
Studies have demonstrated how financial strain – such as unemployment or poverty – can have serious repercussions for mental health, making symptoms harder to control. Thankfully, there are solutions available to assist people facing these challenges.
Payers can help ensure all communities have access to mental health care by investing in recruitment, training, and education of behavioral health practitioners that reflect the population they serve. This requires developing a broad pipeline for behavioral health practitioners as well as expanding programs offering loan repayment assistance and scholarships.
Rural communities face unique difficulties accessing mental healthcare, since the nearest clinician could be hundreds of miles away. Payers can help address this gap by teaming up with digital mental health vendors to reimburse telehealth services in these regions.
Cultural Competence
Cultural competence refers to a set of behaviors, attitudes and policies in an agency or system which allow its staff to effectively collaborate across cultures. This means respecting both beliefs, language use, interpersonal styles and attitudes of families receiving services as well as those providing those services on both sides of the table.
Enhancing cultural competence can be achieved through seeking out training opportunities and forging partnerships with organizations already employing such strategies. There are also federally funded technical assistance centers dedicated to this topic that provide access to pertinent data.
One way to build cultural competency is to intentionally engage in dialogues with people of diverse backgrounds in your community. This could involve simple things such as finding out which race/ethnic group lives nearby, or more advanced measures such as using various cultural assessment tools and books. When engaging in these dialogues, make sure you listen for the message behind their words; doing this shows compassion towards your conversation partner.
Peer Support
Peer support programs enable individuals to take control of their lives and can save money by decreasing reliance on more formal mental health, medical and social services. But these initiatives must be properly supported.
Training and an environment which recognizes the significance of peer role models and their cultural sensitivity when conducting recovery work are required for effective rehabilitation work. Rehabilitation work does not mean fixing someone who has been severely hurt; rather it means nurturing what has been gained from experiencing trauma while identifying their qualities and assets to highlight even small achievements.
People living with mental health conditions and homelessness play a pivotal role in MHCC’s Opening Minds project, either as fully paid peers on service teams, or peer researchers helping collect data for analysis. Furthermore, they provide invaluable leadership advocacy efforts on behalf of vulnerable populations.