How mental health funding helps providers fight disparities

Health systems, federal agencies and private sector companies are looking to community partnerships and federal grants to tackle persistent disparities in mental health treatment and access.

Demand for and use of mental healthcare services increased slightly across adults in all demographics in the last decade, according to the American Psychiatric Association. But in the past three years, 50% of white adults reported receiving mental health services compared with 39% of Black adults and 36% of Hispanic adults, according to May data from a KFF survey. Continued disparities between patients of different backgrounds have led New York City Health + Hospitals, the Substance Abuse and Mental Health Services Administration, Jefferson Center for Mental Health, and Headspace to launch provider training and community engagement efforts to shrink gaps in mental healthcare utilization.

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There are many reasons why people of color are less likely to seek and receive mental healthcare, from cultural stigma and a lack of diverse providers to high costs and geographical barriers, said Dawn Tyus, director and principal investigator of the African American Behavioral Health Center of Excellence at Morehouse School of Medicine in Atlanta. Among adults seeking mental healthcare, Asian, Hispanic and Black adults are more likely to report difficulty finding a provider that understands their background and experiences compared to their white counterparts, according to data from KFF.

Here are some tactics organizations are using to increase access to mental healthcare across demographics.

SAMHSA's center of excellence funding

The African American Behavioral Health Center of Excellence, founded in 2020 and funded by SAMHSA, is focused on making it easier for Black patients to access care. The center aims to do this by educating mental health professionals on how to provide sensitive, informed and culturally competent treatment, Tyus said.

After assessing the knowledge gaps of various primary care physicians, psychiatrists and psychologists, the center developed targeted curricula, courses and webinars for mental health providers on how institutional racism, generational trauma and social determinants impact Black mental health. Providing these resources for mental health professionals has made more individuals better suited to meet the care needs of patients from different racial backgrounds, Tyus said.

Eliminating disparities must be a group effort that integrates all corners of a community, Tyus said. The African American Behavioral Health Center of Excellence regularly works with faith-based entities, historically Black colleges and universities and recovery organizations to create more holistic mental health support services for Black populations, she said.

Jefferson Center for Mental Health's community outreach

Broader community involvement is key at Jefferson Center for Mental Health, in Lakewood, Colorado, where nearly one-fourth of the patient population identifies as Hispanic.

Jefferson Center’s bilingual community engagement coordinator, paid for by a SAMHSA grant, helped connect more Hispanic patients to mental health services, tackle language barriers and break through issues of trust. The coordinator regularly meets with local leaders, gathers community members for suicide prevention trainings and coordinates resource fairs where individuals can learn more about their mental health options, said Amanda Daniel, manager of diversity, equity and inclusion at the center.

“It’s about hearing from the community what they want, going where they are instead of making them come to us,” Daniel said.”

Finding and retaining bicultural, bilingual therapists has also been critical in getting Jefferson Center’s Spanish-speaking patients timely access to mental healthcare and allowing the center to take on more patients, she said.

“It's one thing to attract clinicians of color, it's another thing to keep them and to have the infrastructure to make them feel supported and not tokenized,” Daniel said.

NYC Health + Hospitals' training programs

NYC Health + Hospitals recently rolled out a behavioral health blueprint, includings a three-year plan to maximize patient capacity by increasing its mental health staff. The health system's initiative, funded in part by $41 million from New York State’s Behavioral Health Centers of Excellence program, will include a social work training academy, a psychiatric physician assistant career pathway program and loan repayment for behavioral health staff.

The 11-hospital system provides behavioral health services to 76,000 patients every year, most of whom are from underserved populations and have complex psychiatric and social needs, said Dr. Omar Fattal, deputy chief medical officer and system chief of behavioral health at NYC Health + Hospitals. Many patients of color in the city struggle to access mental healthcare in part due to the lack of available providers, he said.

The health system plans to place community health workers in different behavioral health treatment settings, as well, Fattal said.

Aside from broadening its workforce, the health system has already implemented a number of strategies like a 24/7 on-demand virtual behavioral health platform and a extended stay care unit to reduce barriers to care for certain patient demographics, Fattal said.

Headspace's partnership with Hartford, Connecticut

Headspace, a digital mental health platform known for its self-guided meditation and mindfulness app, entered a multi-year partnership last year with Hartford, Connecticut to give anyone who lives, works or goes to school in the city free access to the company's digital tools. The goal is reducing community violence and fostering prosocial behavior among young people, according to Wizdom Powell, chief purpose officer at Headspace.

The advantage of an app like Headspace, which was created in 2010 and has 70 million users in 200 countries, is its ability to bring psychiatry, psychotherapy and coaching services to people regardless of their physical proximity to a mental health provider, Powell said.

But in Hartford, the company coupled its app with in-person education and culturally responsive content guides that help individuals navigate their care, Powell said. The majority of the city's population is composed of people of color.

By investing in communities and allowing its clinicians to practice both globally and locally, Headspace is able to make a greater impact on reducing mental healthcare disparities, she said.

The company also launched direct-to-consumer mental health coaching services in April to ease populations who might be wary of traditional mental healthcare or have less experience with it into such services, said Powell.