RACE AND RECOVERY: DISPARITIES IN BEHAVIORAL HEALTH TREATMENT
• August 2020 •
From Juan Navarro, Executive Director
Los Angeles Centers for Alcohol and Drug Abuse
Race and Recovery: Disparities in Behavioral Health Treatment
The impact of addiction and mental illness is felt across all demographic groups, but the promise of recovery is less widespread.
· 88.7% of African Americans diagnosed with a substance use disorder (SUD) did not receive addiction treatment;
· 90% of 3.3 million Latinos with a SUD did not receive treatment, and 67% of 6.9 million Latinos with a mental illness received no treatment;
· Asian Americans are 51% less likely to take advantage of mental health services than white Americans; and
· Blacks, Latinos, and American Indians are less likely than whites to complete addiction treatment.
People of color make up 40% of admissions to publicly-funded substance abuse treatment programs, but they are at particularly high risk for poor outcomes. Why?
We know that income plays a big role. Racial and ethnic groups make up a greater percentage of the poor, and low-income families have reduced access to effective, evidence-based behavioral health programs. Structural racism and discrimination in the healthcare system (at times unintended) are other significant barriers experienced by people of color. So is the cultural and self-stigma attached to accessing alcohol, drug, and mental health treatment. The disproportionate number of Black and Brown people who are incarcerated in America also plays a part. While the criminal justice system has potential as an important pathway into treatment, most jails and prisons lack treatment slots.
These are all long-standing treatment barriers — L.A. CADA was established 49 years ago to provide greater access to treatment for disadvantaged populations. We have developed evidence-based services specific to Latino adults and youth, African Americans, LGBTQ+ individuals, incarcerated adults, and other groups that face treatment barriers. Yet so much more remains to be done. Working to overcome racial and ethnic treatment barriers is our agency mission. It’s also a privilege to be entrusted with this critical work.
Learn about: mental health and racism
“I was an out-of-control addict most of my life. I lost my marriage and my children around it. I lost my freedom all the times I ended up in jail and prison. I lost my health for not taking medicine I was supposed to. I lost my home; I lost all my possessions. So, any normal person would ask, why you keep using? Because going into rehab means I really am a crazy b***h addict. In my family, that’s what it means. You don’t go into rehab unless you coo-coo – a whack-job, you know? Staying out of rehab was the last piece of dignity I could hang on to, you know? But then one night I saw one of my old friends, the one always ready for the next partizzle. Just like me. But, no more – she was clean now. It made me think, if she could do it, maybe I could too. Today, I have six months clean and sober — and a job. Now I understand that the mental stuff is just like other diseases – you can recover. Last month, I even helped my cousin get into a program for his depression. This is what rehab can do!”
SPOTLIGHT – THE EVIDENCE IS IN:
CLAS National Standards
In 2000, the U.S. Office of Minority Health developed National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. It’s a set of 15 action steps we can use to advance health equity, improve service quality, and eliminate cultural healthcare disparities. With the publication of Unequal Treatment by the Institute of Medicine in 2003, culturally and linguistically appropriate services were finally recognized as an important way to help address persistent disparities faced by our nation’s diverse communities. In 2013, CLAS National Standards were enhanced to address the importance of cultural and linguistic competency at every point of healthcare contact.
Today, CLAS is the gold standard of care for competent, respectful healthcare delivery. This evidence-based practice is guided by a principle standard: Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs. It’s not always possible to implement CLAS National Standards all at once, but L.A. CADA has found that working toward full use of these action steps is the way forward to surmount barriers that separate people from needed behavioral health treatment.
Read more about: CLAS National Standards