MENTAL HEALTH CARE FOR ASIAN AMERICANS AND PACIFIC ISLANDERS STEVEN P. SHON, M.D.

DISPARITIES IN MENTAL HEALTH CARE FOR RACIAL AND ETHNIC MINORITIES Minorities have less access to, and availability of, mental health services Minorities are less likely to receive needed mental health services Minorities in treatment often receive a poorer quality of mental health care Minorities are underrepresented in mental health research Mental Health: Culture, Race, and Ethnicity, a Supplement to the Surgeon General’s Report on Mental Health

ASIAN AMERICANS AND PACIFIC ISLANDERS Fastest growing racial group in U.S. 4% of U.S. population Projected in 2020 to be 6% of U.S. population (20 million people) Over 60% of AA/PI are foreign born 43 different ethnic groups Over 100 different languages and dialects 54% live in West, 17% in the South, 18% in the Northwest, and 11% in the Midwest 44% age 25 or older have college or professional degrees (28% of whites) but almost two-thirds of Cambodians, Hmong, and Laotians have not completed high school

CULTURE CONFLICT Culture of MH Treatment System vs Culture of AA/PI Communities The greater the congruency the more likely treatment will succeed. Question: Which circle should move for congruency? MH System AA/PI Consumer

BARRIERS TO TREATMENT Cultural Dissonance System; Individual staff (lack of bicultural staff) Communication Language (lack of bilingual providers); Communication style (indirect, non verbal) Stigma and Shame Shame is a powerful cultural influence Lack of Integration with Other Caregivers Primary care; Traditional caregivers Lack of Research Evidence base; Validation of models Cultural Competency Implementation Shift organizational culture; systemic plan; training; resource commitment; monitoring

VISION FOR THE FUTURE Continue to Expand Science Base Improve Access to Treatment Reduce Barriers to Treatment Improve Quality of Care Support Capacity Development Promote Mental Health Ch. 7, Mental Health: Culture, Race, and Ethnicity

PRIORITIES FOR ASIAN AMERICANS AND PACIFIC ISLANDERS Organize Existing and Future Knowledge Aggregate knowledge (clearinghouse) Develop guidelines and tools (assessment, treatment, etc) Develop training models and curricula Disseminate Knowledge Through A Systematic Process Distribute products (tools, curricula, etc) Provide technical assistance and training Create uniform expectations

PRIORITIES FOR ASIAN AMERICANS AND PACIFIC ISLANDERS Develop New Knowledge Research Evaluation of outcomes Develop Capacity – Cultural Competent Staff And Systems of Care AA/PI professionals AA/PI paraprofessionals Ethnic specific services Non AA/PI MH staff – clinical and administrative Partner With AA/PI Communities