Report on Mental Health Disparities and Alignment with Sustainable Development Goals

Introduction: Advocacy and National Recognition

Efforts to address mental health disparities within communities of color have been significantly influenced by advocates like the late Bebe Moore Campbell, a novelist and journalist who highlighted the intersection of racism and mental health. Her co-founding of a National Alliance on Mental Illness (NAMI) chapter in a predominantly African-American community and her broader advocacy work laid the groundwork for addressing challenges now central to the United Nations’ Sustainable Development Goals (SDGs). In recognition of these critical issues, the U.S. House of Representatives designated July as Bebe Moore Campbell National Minority Mental Health Awareness Month in 2008.

Systemic Barriers to Mental Health Equity

Statistical Disparities and SDG 3 (Good Health and Well-being)

Data from the Food and Drug Administration (FDA) highlights significant disparities that impede the achievement of SDG 3: Good Health and Well-being, particularly Target 3.4, which aims to promote mental health. These disparities demonstrate unequal access to and utilization of mental health services among minority populations.

• In 2020, fewer than 50% of African-American adults with mental health issues received care.
• In 2018, Asian Americans were 60% less likely to receive mental health treatment compared to non-Hispanic Whites.

These statistics underscore the urgent need for targeted interventions to ensure equitable health outcomes for all.

Socio-Cultural Challenges and SDG 10 (Reduced Inequalities)

According to Dr. Yeside Ojo, a psychiatric and family nurse practitioner, minority communities face distinct obstacles that directly relate to SDG 10: Reduced Inequalities. These challenges stem from systemic and cultural factors that create barriers to care.

• Stigma: Seeking mental health assistance is often viewed as a sign of weakness rather than strength.
• Lack of Culturally Competent Care: A shortage of healthcare providers who understand the unique cultural and environmental contexts of minority patients.
• Historical Mistrust: Past governmental abuses, such as the Tuskegee experiment and the sterilization of Puerto Rican women, have fostered a deep-seated mistrust in the healthcare system, impacting modern healthcare decisions. This undermines progress toward SDG 16: Peace, Justice and Strong Institutions, which calls for effective and inclusive institutions.
• Cultural Norms: Strong family traditions may encourage internalizing problems rather than seeking external professional help.

Addressing Inequalities Through Targeted Interventions

The Role of Culturally Competent Care Providers

Organizations like the Black Physicians and Healthcare Network (BPHN) are a critical resource for advancing health equity. As Program Director Robin Little explains, BPHN provides a vital service by connecting Black and Brown residents with healthcare providers who share similar backgrounds and understand their life experiences. This model is a practical strategy for achieving the goals of SDG 10 by creating more inclusive and effective health services that build trust and improve outcomes.

Overcoming Economic and Logistical Hurdles

Access to care is frequently obstructed by economic and logistical factors, which are directly linked to broader issues of poverty and inequality addressed in SDG 1: No Poverty and SDG 3: Good Health and Well-being.

• Insurance Gaps: Approximately 10% of Black Americans lack health insurance, compared to 5.2% of non-Hispanic Whites. High out-of-pocket costs for mental health services present a further barrier.
• Access to Transportation: Lack of reliable transportation can prevent individuals from attending appointments.
• Work Flexibility: Inflexible work schedules can make it difficult to access care during standard business hours.

BPHN actively works to close these gaps by offering financial assistance for out-of-pocket costs and providing transportation, demonstrating a holistic approach to ensuring mental health is treated with the same importance as physical health.

Evolving Perspectives and Future Directions

Shifting Public Discourse and Reducing Stigma

Progress is being made in altering the public perception of mental health. This includes a conscious shift in terminology, such as using “mental health conditions” instead of “mental illness,” to soften the language and reduce stigma. Furthermore, when prominent figures like Serena Williams, Simon Biles, and Naomi Osaka speak openly about their mental health struggles, it helps normalize the conversation, making it easier for the general public to seek help. These developments contribute to creating a more supportive societal framework for achieving SDG 3.

Gender-Specific Considerations (SDG 5)

Dr. Ojo notes that men and women often approach mental health differently, a factor relevant to SDG 5: Gender Equality. Men tend to downplay their symptoms, while women are generally more open to verbalizing their struggles and seeking support. Recognizing these differences is essential for developing tailored outreach and support strategies that effectively reach all genders.

Recommendations for Progress

To continue advancing mental health equity, experts recommend a multi-pronged approach focused on empowerment and systemic change.

1. Promote Early and Open Conversation: Normalizing discussions about mental health within families and communities is critical to reducing stigma.
2. Ensure Access to Culturally Competent Care: Expanding the availability of providers who can offer care that is respectful of and responsive to cultural health beliefs and practices.
3. Encourage Self-Advocacy: It is vital for individuals to learn how to advocate for themselves and speak up when they are struggling to ensure they receive necessary support.

Resources such as BPHN, the Chinese Culture and Community Service Center (CCACC), and Montgomery County’s public health websites are essential components of the institutional support system required to achieve these goals and uphold the principles of the Sustainable Development Goals.

Analysis of SDGs, Targets, and Indicators

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  The article’s central theme is mental health, a critical component of overall health and well-being. It discusses the challenges in accessing mental healthcare, the stigma associated with it, and the importance of promoting mental well-being, especially within minority communities. The entire discussion revolves around ensuring healthy lives and promoting well-being for all.

• SDG 10: Reduced Inequalities

  The article explicitly focuses on the disparities and inequalities faced by communities of color in the context of mental health. It highlights how “ethnic minorities at a different pace” are affected due to “distinct obstacles, including stigma,” “lack of culturally competent care,” and “limited access to quality mental health care resources.” It also points out racial disparities in health insurance coverage and access to treatment, directly addressing the goal of reducing inequalities within and among countries.

• SDG 5: Gender Equality

  The article touches upon gender-specific differences in addressing mental health. It notes that “men and women often deal with the issue differently,” with men tending to “downplay their mental health” while “women are more open and more likely to seek help.” This connects to the goal of achieving gender equality by highlighting different health-seeking behaviors and needs between genders that require tailored approaches.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. The article’s entire focus is on promoting mental health, changing the language from “mental illness” to “mental health conditions,” encouraging people to seek help, and reducing stigma, all of which are essential actions to promote mental well-being.
   • Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services… The article directly addresses barriers to this target by mentioning “a lack of health insurance,” “less access to treatment,” “high out-of-pocket costs,” and the need for “access to culturally competent providers.”

2. SDG 10: Reduced Inequalities

   • Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of… race, ethnicity… The article supports this target by highlighting the work of Bebe Moore Campbell, who “fearlessly challenged the status quo, shedding light on the unique struggles faced by people of color and advocating for their voices to be heard.” It also discusses the importance of organizations like BPHN, which empower Black and Brown residents.
   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory… practices… The article points to the legacy of discriminatory practices like the “Tuskegee experiment on African-American men, and the sterilization of Puerto Rican women” as a source of “longstanding mistrust of the healthcare system.” It also discusses current systemic issues like “poverty, racism, and systemic oppression” that lead to unequal health outcomes like higher rates of PTSD.

3. SDG 5: Gender Equality

   • Target 5.c: Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels. The article’s observation that “men tend to downplay their mental health” while “women are more open and more likely to seek help” implies the need for gender-sensitive health policies and awareness campaigns that address these different approaches to health-seeking behavior.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For SDG 3 (Good Health and Well-being)

   • Indicator for Target 3.8 (Access to care): The article provides direct statistics that can serve as indicators. For example, “In 2020, fewer than one in every two African-American adults got care for mental health.” Another is, “In 2018, Asian Americans were 60 percent less likely to receive mental health treatment than non-Hispanic Whites.”
   • Indicator for Target 3.8 (Health insurance): The article states, “about 10 percent of Black Americans lack health insurance compared to 5.2 percent of non-Hispanic Whites,” which is a direct measure of health coverage disparity.
   • Indicator for Target 3.8 (Financial barriers): The mention of “High out-of-pocket costs” as a problem implies the indicator of household expenditure on health as a share of income.

2. For SDG 10 (Reduced Inequalities)

   • Indicator for Target 10.3 (Discrimination and unequal access): The article implies an indicator related to the availability of culturally appropriate services by noting the “lack of culturally competent care” as a key obstacle. The existence and reach of organizations like BPHN, which provide “health providers that look like them,” can be a measure of progress.
   • Indicator for Target 10.3 (Unequal outcomes): The article mentions that issues like poverty and racism “can contribute to higher rates of post-traumatic stress disorder (PTSD) in these communities,” suggesting that the prevalence of specific mental health conditions by race/ethnicity can be used as an indicator of inequality of outcome.

3. For SDG 5 (Gender Equality)

   • Indicator for Target 5.c (Gender differences in health behavior): The article’s statement that “women are more open and more likely to seek help” than men implies an indicator based on the rate of seeking mental health services, disaggregated by gender. This can be measured through healthcare utilization data or population surveys.

4. Table of SDGs, Targets, and Indicators

Source: mymcmedia.org