Dear Colleagues

The US Surgeon General has just released a report on access and quality of
mental health care services for ethinc minorities in the United States. I
have attached below an except of the press release accompanying the report.

The full report

MENTAL HEALTH: CULTURE, RACE, AND ETHNICITY: A Supplement to Mental Health:
A Report of the Surgeon General can  be downloaded free of charge from

http://www.surgeongeneral.gov/library/mentalhealth/cre/default.asp

David McDaid
LSE Health and Social Care


Edit of Press Release

Sunday, August 26, 2001

CULTURE COUNTS IN MENTAL HEALTH SERVICES AND RESEARCH FINDS NEW SURGEON
GENERAL REPORT

Striking disparities in access, quality and availability of mental health
services exist for racial and ethnic minority Americans, according to the
new report of the Surgeon General released today, Mental Health: Culture,
Race and Ethnicity.

The report, a supplement to the 1999 first-ever Surgeon General's report on
mental health, highlights the role culture and society play in mental
health, mental illness,  and the types of mental health services people
seek. It finds that, although effective, well-documented treatments for
mental illnesses are available, racial and ethnic minorities are less likely
to receive quality care than the general population. Overall, one in three
Americans who need mental health services currently receives care. A
critical consequence of this disparity is that racial and ethnic minority
communities bear a disproportionately high burden of disability from
untreated or inadequately treated mental health problems and mental
illnesses.

"While mental disorders may touch all Americans either directly or
indirectly, all do not have equal access to treatment and services. The
failure to address these inequities is being played out in human and
economic terms across the nation - on our streets, in homeless shelters,
public health institutions, prisons and jails," said U.S. Surgeon General
Dr. David Satcher. "The revolution in science that has led to effective
treatments for mental illnesses needs to benefit every American of every
race, ethnicity and culture. Everyone in need must have access to
high-quality, effective and affordable mental health services. Critically,
culture counts. That means we need to embrace the nation's diversity in the
conduct of research, in the education and training of our mental health
service providers and in the delivery of services."

Dr. Satcher observed that culture, broadly defined as a common set of
beliefs, norms and values, influences many aspects of mental illness and
mental health. It influences, for better or for worse, how patients
communicate and manifest their symptoms, how they cope, the range of their
family and community supports, and their willingness to seek treatment
However, a history of racism, discrimination and economic impoverishment can
combine with mistrust and fear to deter minorities from using services and
receiving appropriate care.

The cultures of clinicians and the service system itself further influence
diagnosis and treatment. Providers need to know how to build upon the
cultural strengths of the people in their care. After all, while not the
sole determinants, cultural and social influences do play important roles in
mental health, mental illness and service use, when added to biological,
psychological and environmental factors.

The volume focuses on the four most recognized racial and ethnic minority
groups in the United States: African Americans, American Indians and Alaska
Natives, Asian Americans and Pacific Islanders, and Hispanic Americans.
Within each of the categories are many distinct ethnic subgroups, such as
Mexican Americans and the Navajo Nation. The report describes the historical
context and mental health issues of specific subgroups. However, because
data are limited, the primary focus is on findings for the broader racial
and ethnic categories.

The 200-page report not only articulates the foundation for understanding
the relationships among culture, society, mental health, mental illness, and
services, but also provides information about these issues as they affect
each of the four major racial and ethnic minority groups. For example, the
report highlights that:

The report concludes by proposing broad courses of action to improve the
quality of mental health care available to racial and ethnic minority
populations. They include continuing to build the science base, improving
access to treatment, reducing barriers to and improving the quality of
mental health services, and supporting culturally relevant capacity
development and leadership opportunity.