Mental Health and Ethnic Minority Children and Youth: Need, Access, Quality From: “Mental Health: Culture, Race, and Ethnicity A Supplement to Mental Health: A Report of the Surgeon General” Lonnie R. Snowden Professor of Social Welfare Director, Center for Mental Health Services Research

Demographics and Areas of Special Need Native Americans:.5% of California population; 42% rural; high rates of substance abuse, especially alcohol abuse. Latinos: 32% of California population; 38% non U.S. born; high rates of depressive symptoms and substance abuse. Asian Americans: 12% of California population; 60% non U.S. born; high rates of anxiety symptoms among some immigrant youth and PTSD among refugees. African Americans: 7% of California population; heavily urban; symptoms of conduct disorder and depression, substance abuse.

Family and Community Poverty: Family and community, income and assets High and low social capital: Ethnic enclaves and poverty communities Family, friends, and religious figures as source of help Functional status: family, peers, schools, police

Promoting Access Unmet need and burden Insurance: Medical and private coverage; the problem of differential response High need populations: child welfare, juvenile justice, social service recipients, the homeless

Improving Quality Belief systems, idiom of distress Practice guidelines and issues of translation The need to improve functional status Therapeutic alliance and trust Large gains from small investments: toward a life course, societal perspective