KHN: Race, Ethnicity Affect Kids’ Access To Mental Health Care, Study Finds

By Shefali Luthra
Nubia Flores Miranda works part time at Family Paths, a counseling and mental health organization in Oakland, Calif. Miranda, a psychology major at San Francisco State University, said she became interested in a career in mental health after she started experiencing depression and anxiety her freshman year in high school. (Heidi de Marco/KHN)

Nubia Flores Miranda works part time at Family Paths, a counseling and mental health organization in Oakland, Calif. Miranda, a psychology major at San Francisco State University, said she became interested in a career in mental health after she started experiencing depression and anxiety her freshman year in high school. (Heidi de Marco/KHN)

One in five Americans is estimated to have a mental health condition at any given time. But getting treatment remains difficult — and it’s worse for children, especially those who identify as black or Hispanic.

That’s the major finding in research published Friday in the International Journal of Health Services. The study examines how often young adults and children were able to get needed mental health services, based on whether they were black, Hispanic or white. Using a nationally representative sample of federally collected survey data compiled between 2006 and 2012, researchers sought to determine how often people reported poor mental health and either saw a specialist or had a general practitioner bill for mental health services.

“No one is necessarily bigoted — and yet we have a system that creates the kind of discrimination we see in the paper,” said Steffie Woolhandler, a professor at City University of New York School of Public Health, and one of the study’s authors. “Kids are getting half as much mental health treatment — and they have the same level of mental health problems.”

Young people in general aren’t likely to see mental health specialists. But the numbers fell further when racial and ethnic backgrounds were factored in. About 5.7 percent of white children and young adults were likely to see a mental health specialist in a given year, compared with about 2.3 percent for black or Hispanic young people.

Put another way: Even when controlling for someone’s mental health status, insurance and income, black and Hispanic children saw someone for treatment far less often than did their white counterparts — about 130 fewer visits per thousand subjects. Black young adults visited a mental health specialist about 280 fewer visits per thousand; Hispanics had 244 fewer visits per thousand.

But the data indicate that mental illness incidence rates are generally consistent across racial groups, according to the study. Of adults between the ages of 18 and 34, between 4 and 5 percent indicated having fair or poor mental health, regardless of racial background. For children, white and black subjects were reported to need care at about the same rate — between 11 percent and 12 percent — compared with about 7 percent of Hispanic children.

The paper outlines a few possible reasons for this disconnect. Different communities may attach greater stigma about mental health care, or they may place less trust in the doctors available. Plus, there is a shortage of child psychiatrists across the country, and black and Hispanic families often live in the most underserved areas.

“There are problems of access all around,” said Harold Pincus, vice chair of psychiatry at Columbia University’s College of Physicians and Surgeons. “We have to change the way we do things.”

The findings suggest that lawmakers have focused on trying to improve access to mental health care, but “we can’t rest on our laurels,” said Pincus, who wasn’t affiliated with the study. He also noted that treating white children’s level of access as the golden standard is probably unwise, since research suggests they also receive inadequate care.

One of the study’s clear messages, argued Woolhandler, is that racial minorities received markedly less care — regardless of socioeconomic or health status. The gap suggests a targeted intervention is needed.

The study highlights a need to ensure doctors know how to counsel patients of different racial backgrounds and will do so, said Benjamin Le Cook, an assistant professor of psychiatry at Harvard Medical School, who was also not affiliated with the study. Ending racial and cultural disparities in access to care is a more pressing concern than erasing the stigmas about mental illness in minority communities, he said.

That’s especially relevant given minorities are less likely to be treated by doctors of their ethnicity. In addition, research suggests that mental health specialists sometimes discriminate based on race when seeing patients.

“It has to do with experiences people in the community have had that haven’t matched their expectations or aligned with problems they’re having,” LeCook said. “Cultural stigma is a factor, but not the main one.”

Beyond better training, more funds are needed for resources like community health centers, which often serve black and Hispanic patients, Woolhandler said.

“I see these great people trying to work in community mental health, but they need more resources to do their job,” she said.

But, the research doesn’t account for other areas where minorities may access mental health services, Pincus noted. Churches and social service agencies, for instance, may be filling some of the void and wouldn’t be accounted for by the survey data.

Researchers and policymakers should explore those sectors, he said, to see if they could be better leveraged to help people get connected to care they’ll actually trust. As experts try to bolster the mental health system — both to improve access across the board and also to close race-based gaps — they need to use a multipronged approach, pulling in different kinds of caregivers than those who might normally treat mental illness.

“There’s all kinds of ways by which the mental health system doesn’t play a role in helping people,” he said. “Family and community supports, social services — they’re all part of the picture.”

Story shared from:

Safe Space Personal Story: Gadget

This a brief history of how I battled with PTSD and came to understanding so much more about myself, my family, as well as just life in general. 

When I was 14 years old I was a very rotten kid. I was into drugs, smoking and drinking a lot. It was to the point of where I was grabbing anything and everything to feel different from how I was feeling normally.  If I wasn’t drunk or high on something, I wasn’t happy. I had begun smoking and experimenting with pills and pot at the age of 14 and I’m not talking about just some casual usage; there were more hard things involved that no one should see a kid using.

At around the age of 16 or 17 (can’t quite remember) my body started to suddenly fail me. Something just kinda clicked over and I had to go to the emergency room, my heart rate was up, my blood pressure was up and; I felt so sick to my stomach and basically I had panicked. Something was not right. From that night I couldn’t handle doing drugs very much. I would try and smoke or drink or do things but it all made the pain just so much worse. After that night that pain never stopped.

For close to two years after that night I struggled daily, to eat, to sleep, to get out of bed. I couldn’t go to school. I felt sick all the time and there was nothing I could do to make me feel better it seemed. I lost about 50 pounds I think about going through that period. I was not healthy and I did not look healthy either. There were lots of tests and doctors I had seen, nothing conclusive ever, which is the most frustrating thing to have a camera at one point shoved down your throat to find nothing. I had nothing to explain why i felt the way i did and a box full of prescriptions. I had been so beaten, so depressed and suicidal feeling to take my pain away. It was my own personal hell that I was stuck in. I could only do one thing and that was to look inside to my mind, and to face these demons. 

I started to make baby steps one by one. I started with getting a routine down in my daily life,
I would eat the same exact thing every day. Do the same activities every day. I monotonized my life to a single routine every day. It relaxed the brain and my emotions in a way. I knew what to expect every day. Once I got used to that, over months of doing this routine, I started to branch out and introduce different things like going out and seeing my friends, trying to eat other foods. Often meeting a lot of pain and anxiety. It was from there I started to look more and more inside at these demons that would come to surface. I realized finally something may be wrong mentally. I set out to find help through therapy and psychology. During this time I had basically made a complete 180 on what kind of person I was. I became compassionate and empathetic towards my family and other people (remind you I was a terrible person before who cared about nothing haha). I did chores, I got back into school and I finished my high school diploma, ON TIME. This was while working two jobs paying for my own summer school to catch up, and helping my mother with bills and what not to keep a roof over us. 

After some weeks of therapy i was then diagnosed with C-PTSD, Acute Anxiety Disorder, severe depression, and OCD tendencies. It felt like I finally had an explanation. It was liberating so to say. Growing up as a child my family had this constant arguing and fighting with violence. So many bad memories that my mind to this day is hard to handle. Basically I had this learned behavior to always be looking for danger, always be on this constant edge of aggression and stress. I never realized all of those memories was what was making me sick. I call these my demons because that’s how I envision it. Me fighting those demons. 

So I went on with therapy. I learned to calm my mind in times of being triggered. I learned how to recognize my emotions as they happened. I finally started to heal once I moved out into something of my own. For me it was an environmental problem being around my family would cause so much stress for me.  I couldn’t heal unless I put myself at a distance I realized. 

They say it takes 5 years for your neural network to reprogram itself essentially. It was tough for me to heal. A lot of sleepless nights and anxiety and more pain. But every year I would look back at how my progress was and there was progress. For example at times I could never lay on my stomach. One day I realized I could and it was a strange elating experience, I know simple, but it was a blissful feeling to be able to lay on my stomach as I had not been able to for years. 

So that’s kinda the story in a shortened and kinda minced up way… What I want to relay to people struggling with this problem is that NEVER give up. Never let your emotions take you those dark places and if you do, forgive yourself and don’t be embarrassed. You had been beaten down at one point in your life by whatever situation you were in and now you need to heal. People should respect that. They are the wounds you’re healing. You are stronger than you realize, you can take more pain than you can imagine, you can face those demons. Know this that if you feel weak facing them, they are simply the past and not the future or the present and therefore can do no extra harm. Take care of your mind and body. If you need a day, take a day to heal. This illness or condition is not very much different from having say a broken leg or being ill. Its simply something that takes much longer to heal and therefore should be looked at as an illness or injury not as if you're being lazy or dramatic or emotional. Your brain is literally malfunctioning and needs this time to heal! 

My advice is go to therapy or get help in some way if you think or even suspect your mental state is not okay in some way and really make the effort to heal. I made that decision to get help and heal years ago and now I am living my life finally. I have a wife, I own my own home. I can eat food! I enjoy things and almost best of all what was a huge milestone for me: I don’t take any medicine anymore as of only a few months ago from writing this. I went from having a box filled with medications to taking nothing now. You can heal, you can make it. Just keep looking forward and keep fighting.

July is Minority Mental Health Awareness Month

We all know that mental health issues affect the youth in our community but there are added barriers when it comes to access and quality of mental health services for minority children, who are more likely to receive inferior care.
July is Minority Mental Health Awareness Month and this July we will discuss some of the issues minority children deal with when in need of mental health care.

Here is some more information on Minority Mental Health Issues from the Dept. of of Health and Human services; Office of Minority Health. CLICK HERE

You can also like us on facebook to learn more about this issue and how it affects our community! CRMHF FACEBOOK

What treatments are available for children with PTSD?

What can we do to treat PTSD in children? Dr. Joan Kaufman of the Department of Psychiatry at Yale University explains the four stages of trauma-focused cognitive behavior therapy, an evidence-based intervention for children who have impairing reactions to traumatic events.
One key insight, she says, is that caregivers and children must work together, and that clear communication and understanding can make all the difference.

June is PTSD Awareness Month

In the past little was known about PTSD in children. Today, we know that trauma and abuse can cause chidlren to suffer with PTSD. In the United States, Child Protective Services receives reports on the abuse or neglect of about 5.5 million children in a year. Some of those children will inevitably suffer from the affects of that trauma. 

Following trauma, most children will have some symptoms. They may be fearful of strangers or become needy toward their parents. They might also have sleep problems/nightmares or become more irritable, aggressive, or reckless. Young children may lose skills they once had, such as potty training. They might go back to earlier habits, like sucking their thumb. Although most children have symptoms following trauma, only a few will go on to get PTSD. 

Early trauma affects the nervous system which is shaped by experiences. Stress and trauma, especially over a period of time, can lead to changes in parts of the brain. This can have long-term effects on physical, mental, and emotional growth. What's more, the impact of early abuse often extends into later childhood, teen, and even adult years.


It is important to help children deal with trauma as they probably will have little to no coping mechanisms to help them. Pediatricians and other child health care providers can give support, education, safety planning, and information about treatment. Also child and family social services can help caregivers with many issues. There is help out there for children who may have PTSD issues.


Columbia River Mental Health Services offers mental health and substance use treatment to adults and children.

Washington State Department of Social and Health Services 

Cinco de Mayo Gala & Fundraiser, Celebrating Columbia River Mental Health Services 75 year anniversary!

This years Gala and Fundraiser was a huge success! Hundreds of people from the community came out to celebrate Columbia River's 75 year anniversary and support the Foundation's work within the community.

There was delicious Mexican food & entertainment, including pianist Jim Fischer and Ballet Papalotl. Plus silent & live auctions, as well as a themed selfie station!

The foundation was also celebrating the roll out of the Foundation's Hopes and Dreams Grant Program. This gala helped us raise money to assist the social & emotional needs of children & families with children as well as helping to meet the mental health needs of others in our community. 

A huge thank you to all the sponsors, community leaders, and attendees who supported this event with their time and money. The Foundation is forever grateful!

Vancouver City Council proclaims May 2017 “Mental Health Awareness Month”

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On Monday April 17th, Anne McEnerny-Ogle proclaimed May “Mental Health Awareness Month” in the name of Columbia River Mental Health Services to help celebrate our 75 years of work within our community and to highlight the Mental health issues in Clark County. 

Thank you Vancouver City Council for helping us to bring more attention to mental health needs in our community!

First Annual Awards Ceremony & Luncheon Fundraiser SUCCESS!

On September 22nd 2016 the Columbia River Mental Health Foundation held its first annual Awards Ceremony & Luncheon Fundraiser at the downtown Vancouver Hilton. Hundreds of community leaders and advocates attended to help us raise funds to support the important work we are striving to do within our community.

Sharon Wise, speaking about resiliency.

Sharon Wise, speaking about resiliency.

The featured speaker was Sharon D. Wise, a nationally renowned speaker & author on behavioral health issues. Ms. Wise spoke about how adverse events in childhood effect an individual’s ability to thrive & succeed in adulthood. Her life story and the way she conveyed her message was inspiring! 

Foundation Board President Deanna Pauli-Hammond & CRMHS CEO Craig Pridemore presenting awards.

Foundation Board President Deanna Pauli-Hammond & CRMHS CEO Craig Pridemore presenting awards.

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The luncheon established two annual community awards:  The Behavioral Health Community Service Award for an individual or group who has made a significant contribution to the behavioral health community over a number of years; and The Behavioral Health Business Champion Award for a business that has made a significant contribution to the behavioral health community in the past year. This years honorees were Joan Caley and DeWils Custom Cabinetry

We also had many event sponsors, which helped us make this luncheon a huge success. Thank you to everyone who participated, all who donated both time and money. With your generosity we will be able to do more within our community to help those who are struggling. Lives change here!