A recent report from KFF, a foundation that provides health policy analysis, found that mental health issues are on the rise among people of color in the United States and that there are disparities in mental health treatment.
The report found that suicides and drug overdoses have increased during the COVID-19 pandemic, and these deadly effects of mental health and substance abuse disorders disproportionately affect people of color in the United States.
New Mexico has slightly higher rates of anxiety and depression, according to KFF. Drug overdoses have skyrocketed during the pandemic, putting the state above the national average.
New Mexico’s drug overdose rate nearly doubled between 2019, the year before the pandemic, and 2022, the second year of the public health emergency, with 1,052 drug overdose deaths in 2022 compared to 599 in 2019.
Deaths by suicide have been on the rise in both the United States and New Mexico since at least 2011. However, New Mexico’s suicide death rate is higher than the national average, with 525 people dying by suicide in New Mexico in 2022. Of those 525, 409 were men.
According to a KFF report, people of color, young people, and people living in rural areas have the highest suicide death rates in the United States.
“We’re pleased to be able to provide this to our patients,” said state Sen. Jerry Ortiz y Pino (D-Albuquerque), chairman of the Senate Health and Public Affairs Committee. NM Political Report In the behavioral health field, there are “shortages everywhere.”
He said some treatment facilities are operating at below capacity due to a lack of staffing, and that there aren’t enough behavioral therapists, adding that in addition to the overall shortage, New Mexico also has a shortage of culturally competent therapists.
The KFF report found that people of color are more likely to struggle to find therapists who understand their experiences.
Ortiz y Pino said one solution to the shortage of culturally competent behavioral health therapists would be for the state to create its own educational pipeline to bring in behavioral health therapists from New Mexico communities.
She also said she would like to see the licensing process expedited for those who have graduated but are waiting to get licensed. She also said a measure would be to simplify the process for therapists to get licensed in other states so they can start practicing right away when they move to New Mexico. Currently, therapists who get licensed in other states must wait months before they can practice because of the lengthy processing time, Ortiz y Pino said.
He said another strategy is to increase Medicaid reimbursement rates so behavioral health therapists can “make a living here.” Nearly half the state’s population is on Medicaid.
“How can we increase services? At the end of the day, we need more facilities and more programs to meet the needs of people with severe mental illness. I think we need day care programs,” Ortiz y Pino said.
Ortiz y Pino said one idea he’s trying to promote is a day treatment program where people who need treatment could live at home but spend every day at a treatment facility. Ortiz y Pino said the program would reduce costs. Providing a treatment facility with night staff, security, food and beds would increase overhead but not improve the effectiveness of treatment, Ortiz said.
KFF concluded that the top reason people who reported needing mental health treatment didn’t receive it was because of high cost, which can be an especially big barrier for communities of color.
Deidre Yellowhair (Diné), a research assistant professor in UNM’s Department of Community Behavioral Health, said COVID-19 has “really highlighted the need for infrastructure and resources to get people the services they really need.”
“When we switched to telemedicine [during the pandemic]”Some of the patients who needed it most didn’t have the infrastructure in place to support telehealth services,” she said.
Another barrier to receiving mental health treatment is unfair or negative treatment. KFF reports that people of color are more likely to experience unfair or negative treatment, which means they don’t return to their therapist or seek out a new one.
Thomas Anthony Chavez, an assistant professor in the Department of Community Behavioral Health at the University of New Mexico, said the problem starts with how mental health is studied. He said research subjects are primarily white, studying the mental health of other white people, which institutionalizes bias. Chavez said this can lead to comparing people of color to white people’s understanding of mental health and mythologizing people of color.
“In that respect, what we know about people of color is pretty new in the literature right now,” Chavez said.
He said the fact that the treatment process is focused on white, middle-class communities can lead to the possibility that for people of color, treatment can become “more of an assimilation process than a therapeutic process.”
“For those who are referred to behavioral health counselors or therapists, the values may not align or may not align well. That’s because every cultural group has their own way of dealing with mental illness. This is not something new to these cultural groups. They may have traditional practices. We need to take that into consideration,” he said.
Chavez said some people are hesitant to seek help from the health care system because of distrust and “racism is structurally perpetuated or continues through every system and is institutionalized in every system.”
In addition to her role as a research assistant professor at the University of New Mexico, Yellowhair also serves as project director for a program that provides training and knowledge on historical trauma and its impact on Native parenting and suicide rates. She said that given the culture, traditions and language of communities of color, people of color “can be stigmatized and pathologized when in fact it is a cultural difference in values and worldviews.”
Yellowhair cited the fact that multigenerational housing, where aunts, uncles and grandparents live under the same roof, is common in many tribal communities, which he said could be seen as “a lack of individuation or a lack of independence.”
“But from a cultural perspective, having a multigenerational household is really a protective factor,” Yellowhair said.
Yellowhair also said historical trauma affects the way an individual processes things and influences how they interact with different systems.
“Looking back at the history of the United States since colonization, historical policies and events have shaped the way communities of color interact with the justice, education and health care systems. In health care, people of color and their experiences are not used as a measure of health; rather, the white population is often used to measure what is normal,” Yellowhair said.
Chavez said people of color are more likely to come from more collectivist societies, for which “family is an essential mode of existence.”
“For people of color, definitions of self can vary widely and can be interdependent. Definitions of family vary widely and family structures vary widely across cultures. Family can be a powerful source of resilience,” Chavez said.
Yellowhair said a “multi-systemic cultural change” is needed, including more people of color on licensing boards, professional organizations and in the industry itself.
Yellowhair said there are more than 570 federally recognized tribes in the U.S., but only about 200 Native American psychologists. To change that, she said, multisystemic change is needed to ensure Native Americans have “culturally safe spaces” to earn their degrees and find institutions to work with.
Chavez said that as a researcher, it can also be difficult to get funding to study issues relevant to communities of color, for example, because “treatment interventions are rarely funded.”
“But these are important practices for the Hispanic and Latino community. It’s a part of life and it’s something that has kept them strong for generations,” Chavez said.
Yellowhair said institutions need to “make space to embrace Indigenous traditional knowledge and accept it as knowledge.”
“Instead of a top-down approach, we need a grassroots effort to put resources into communities and build more mental health services. It feels very hierarchical. It’s ingrained in our language. We need a grassroots understanding to provide services that meet their needs, rather than saying, ‘Here’s a box, this is what health looks like, fit yourself into this box,'” Yellowhair said.
