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Mental Health for All – A Spotlight on the Disparities in Mental Health Care

Image credits/ Xesai

The 10th of October is World Mental Health Awareness Day. This year, the theme set by the World Federation of Mental Health is Mental Health in an Unequal World. At Teva, we’re strongly committed to Inclusion and Diversity (I&D) - it’s key to our business and part of our commitment to our employees and society at large. As October is also Global Inclusion and Diversity (I&D) month, now is a good time to look at the disparities in mental health care – and to investigate ways to address them.

A global view

Mental Health for All info.jpg

Unmet mental health needs can lead to negative personal consequences including job loss, incarceration, institutionalization, substance abuse, violence, self-harm, and suicide. Mental health

issues that remain unmet will likely also have a larger social impact including a rise in poverty and a fall in economic development. [6]

It also adversely affects gender equality, as the responsibility of caring for people with mental health issues disproportionately falls on women and children. [7]

People at a social disadvantage are more likely to have poorer mental health than those with the means to access care readily. They also have less access to support and treatment, leading to a damaging cycle that is hard to break.[8] In fact, 75% - 95% of people with mental health disorders in low and middle income countries have no access to mental health care, and the lack of investment in mental health contributes to the huge gap in treatment, even in high income countries. [9]

A patient’s perspective on the disparities in mental health care

René Brooks is an author, the founder of the site Black Girl, Lost Keys, a mental health advocate and a contributor to Life Effects, Teva’s digital program for patients by patients that offers support and advice. Living with ADHD, depression, and anxiety, René has dedicated her professional life to mentoring, coaching and creating communities for other women of color with neurodiversity and mental health conditions. René’s work often touches on the unique challenges that minority groups face in a system and society that does not accommodate diversity. In an article written for Life Effects about the importance of psychologically safe spaces in healthcare, she writes: “To be understood by your medical professional isn’t a luxury, it’s a necessity.”

Unfortunately, this is not always the case. In a mental health report by the Race Equality Foundation, mental health disparities across different population groups were tracked in terms of prevalence, access, assessment, treatment and recovery.[10] While results show no significant disparity in prevalence among ethnic groups, there are huge gaps in the other four areas.

Barriers to accessing care include different cultural attitudes toward mental health and strained relationships with healthcare practitioners. René believes while much is made of the former, there is often too little focus on the latter.

In ‘Coming Out’ to My Family About ADHD, René writes: “The black community in the United States has historically had a complicated relationship with the medical community. From the Tuskegee Study and issues of informed consent to various experiments on black men and women during slavery, suffice to say that in my culture, there’s a lot of mistrust of the medical community.”

This mistrust often continues through to mental health assessments, and it goes both ways. In a telephone interview, René talks about what she perceives as an imbalance in power: “We talk a lot about mental health being stigmatized in marginalized communities. The impression is that these people are superstitious, overly cautious, or almost backward in their thinking. But we don't talk about how the scrutiny levels are higher when you are part of a marginalized community. The consequences are more severe. You're talking about revealing information to people who share such information with their superiors who can potentially have your children taken away or make recommendations to have you hospitalized against your will.

“Can you trust them to be honest with them about what's happening in your life? Do they trust what you're saying? There's mistrust on both sides. And where there's mistrust, there can't be genuine communication.”

René’s views are reflected in the UK Race Equality study:

“Once in the mental health system, black and minority ethnic people experience further inequalities and discrimination… There is no evidence of direct racial discrimination in assessments, but there is evidence of ethnic bias, including greater uncertainty by clinicians in the diagnosis of emotional problems and depression in [black and minority ethnic] patients. However, mental health services need to be aware and recognize the impact of racism on accessing mental health care and in perpetuating ethnic and racial inequalities." [11]

After assessment, further inequalities persist in treatment.

“Being in spaces where you don’t ‘fit in’ or you feel misunderstood can be incredibly isolating. Sometimes people don’t understand other cultures. That lack of cultural understanding can cause them to minimize, criticize, or mock other people’s customs.”

“You would think that within mental health spaces, this wouldn’t be an issue, given their sensitive nature. But, remember: those spaces are made up of regular people, and therefore regular people problems come in there as well,” writes René in Why Safe Spaces Are so Important for People of Color

According to a factsheet published by the American Psychiatric Association,[12] a “lack of cultural understanding by health care providers may contribute to underdiagnoses and/or misdiagnosis of mental illness in people from racially/ethnically diverse populations.” On top of that, racial minorities “often bear a disproportionately high burden of disability resulting from mental disorders.”

Finally, minority youths are more likely to be sent into the juvenile justice system compared to white youths who are instead referred to specialty primary care.

So, what needs to be done?

To avoid the consequences of a worldwide mental health collapse, a UN policy brief suggests we “apply a whole-of-society approach to promote, protect, and care for mental health.”

At Teva, we recognize that mental health is just as important as physical health. Teva is proud to stand together with the mental health community through awareness, advocacy, and scientific innovation. We are also a leading supplier of medications on the WHO's Essential Medicines List (EML), an index of essential drugs for healthcare needs, including 93% of mental health treatments. As a result, we recognize the importance of integrating mental health care services into primary care services.

René believes that awareness is no longer enough. As she says, it's time to put our money towards actively changing the conversation around mental health.

“I don’t think the problem is awareness. The medical community is well aware that there is a problem here and that something needs to be done to shift it.”

“In my opinion, it's time for them to start taking action. It's time to make sure you're training people. It's time to make sure that you are taking complaints seriously and addressing them.”

“Hire black people. Hire people who look like the communities that you're supposed to be serving.”

Because, as she advocates, “We need more mental health spaces, and we need them now. Every face and every voice must be represented in the struggle to combat the mental health crisis that will arise if we don’t pay attention.”


Find out more

  • At Teva, inclusion and diversity are core values that inform our entire organization. Read more

[1] World Mental Health Day: an opportunity to kick-start a massive scale-up in investment in mental healt https://www.who.int/news/item/27-08-2020-world-mental-health-day-an-opportunity-to-kick-start-a-massive-scale-up-in-investment-in-mental-health

[2] https://apps.who.int/gb/ebwha/pdf_files/EB130/B130_9-en.pdf

[3] Global mental health: five key insights which emerge from the data https://ourworldindata.org/global-mental-health

[4] https://www.who.int/news/item/05-10-2020-covid-19-disrupting-mental-health-services-in-most-countries-who-survey

[5] https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30432-0/fulltext?rss=yes

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935265/

[7] Mental disorders, health inequalities and ethics: A global perspective https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935265/

[8] https://www.centreformentalhealth.org.uk/publications/mental-health-inequalities-factsheet

[9] https://wfmh.global/2021-world-mental-health-global-awareness-campaign-world-mental-health-day-theme/

[10] Mental Health Report https://raceequalityfoundation.org.uk/wp-content/uploads/2020/03/mental-health-report-v5-2.pdf 

[11] https://raceequalityfoundation.org.uk/wp-content/uploads/2020/03/mental-health-report-v5-2.pdf

[12] Mental Health Facts for Diverse Populations https://www.psychiatry.org/psychiatrists/cultural-competency/education/mental-health-facts 

[13] Mental Health Facts for Diverse Populations https://www.psychiatry.org/psychiatrists/cultural-competency/education/mental-health-facts 

OCTOBER 2021 NPS-ALL-NP-00420

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