Too few Californians have access to mental health care, and the problem exacerbates inequities in the state.
Low-income residents and people of color end up bearing the brunt of this health inequity.
Take, for instance, the impact of poverty on mental health. While mental health and substance abuse issues cross lines of wealth and social status, poverty and economic distress can have a significant impact on mental well-being. In fact, neuroscience research suggests that the chronic stress often linked with poverty can have negative lifelong consequences in brain and nervous system development.
Individuals and families experiencing economic instability are at greater risk for stress-related illnesses impacting one’s full participation and quality of life. This risk especially holds true for communities of color and other vulnerable communities, who have been denied opportunities to build wealth toward middle class or higher economic standing.
Without this in mind, we would miss how poverty might lead to greater psychological distress from the compounded impacts of toxic stress and lack of access to care. Lacking an intersectional approach, we would miss the challenges that Latinos and Africans Americans in California face due to historical wealth gaps.
So, what can be done to improve mental health with equity in mind?
For starters, equity calls for investments that directly address the structural inequalities that influence not only mental health and substance use, but overall health and well-being. It calls for us to address how intersecting identities and needs operate to determine well-being and how our health-care system either improves outcomes or makes conditions worse.
To begin improving mental health and substance use outcomes for all Californians, the California Pan-Ethnic Health Network (CPEHN) has outlined specific goals and practices to transform our mental health-care delivery system with equity with mind.
First, we need to prioritize economic investments and educational opportunities in low-income communities.
Education provides people with greater access to better jobs and helps them become more adept at acquiring resources and social support systems, all of which lead to improved health.
Economic development can also advance equity by reinvesting in community, strengthening local assets and offering diverse career pathways. Together, along with other socio-economic strategies, we begin to unwind the structural barriers that drive health disparities.
Next, we must ensure that every Californian has health-care coverage and access to care. More importantly, that care must be culturally responsive and meet the needs of underserved populations.
This means supporting community-based research to develop better practices for reaching underserved populations and practices for evaluating the care individuals receive. It means people receive care in the way they need, at the time they need it and in a language they can understand.
Finally, we need to integrate mental health as a key component of our overall health and well-being, moving beyond the traditional medical model of care. For many, care should be viewed in the context of family and community, not only of a diagnosis. This means both addressing a patient’s social needs—such as housing, employment and transportation—and including the family, culture and community in a care plan.
Health equity hinges on acknowledging structural and systemic inequalities, along with efforts to expand equitable access to care, resources and opportunities. Rather than continue to operate according to the status quo, we must advocate for communities of color and underserved communities to be the focus of policy efforts.
Together, we can bridge the gaps in physical and mental health care to improve the quality of life for all.
Kimberly Chen is the government affairs manager for the California Pan-Ethnic Health Network.