May 25, 2021  |  Blog

Mental Health Equity Is Health Equity

“Mental Health Awareness Equity Month”

By: Madhuri Jha, LCSW, MPH (she/her/hers) – Director, Kennedy-Satcher Center for Mental Health Equity

One year into the COVID-19 pandemic, it is again Mental Health Awareness Month. This pandemic has exposed systemic fractures in healthcare, where already disenfranchised populations now face an unstable resource base to meet their needs. National attention to urgent issues like police brutality and anti-Asian rhetoric have generated an era where social justice is a prioritized talking point for leaders across disciplines. “Equity” has become a buzz word — a word that carries power, if approached thoughtfully and consciously.  While I may be the new Director of the Kennedy-Satcher Center for Mental Health Equity (KSCMHE), I will always consider myself a clinician first. We are healers of the human experience. We carry our patients through confronting adversity, restoring agency, and achieving survivorship – a unique responsibility that requires us to ensure our own wellness is sustained. It is undeniable that right now practitioners and patients are experiencing an extreme collective trauma simultaneously, and we are deep in a complicated mental health crisis. This month, I am compelled to think about what we advocate for and how we message it.

Even before COVID-19, the prevalence of mental illness was increasing. Now, we are seeing these figures skyrocket. According to the Mental Health America, individuals living with schizophrenia are ten times more likely to contract the virus, and three times more likely to die from it.  Youth mental health has worsened, illuminating the system’s inability to support children during this period of remote learning. A recent CDC study showed that due to implications associated with COVID-19, respondents reported increase in symptoms of anxiety or depression, increase in substance use, heightened stress-response, and some reported having serious thoughts of suicide in the past 30 days.  The referenced rates are nearly double what the field would have expected before the pandemic. The National Institute for Mental Health estimates that there are more people of Asian, Black, Latinx, and Native descent seeking culturally-sensitive mental health resources than ever before — a reflection of how historic racial and ethnic injustice is now virally on display through media.

I was the Director of an Assertive Community Treatment team in New York City during COVID-19. My unit was responsible for providing intensive mobile psychiatric services to individuals with serious mental illness. Mental health resources were slashed to account for the waves of COVID-19 cases. Psychiatry services were classified like elective surgeries, and psychiatric units were reduced in bed capacity to create space for COVID overflow. We saw an increase in psychiatric decompensation, criminal arrest, and homelessness. We sadly lost many patients living with co-morbid issues, such as substance use or chronic illness, because the system could not meet multiple needs at once. Mental health clinicians, like all healthcare providers, were not trained to work in such unfamiliar conditions or combat this much systemic duress. This crisis forced our system to become cross-sectional for the first time, and a steep learning curve in the field has exposed trickle-down consequences of the economic burden of the pandemic and the way consumers access mental healthcare.

KSCMHE seizes this opportunity to re-think our own community engagement and commit to developing a new vision for what equitable behavioral health care truly means in a post-COVID world. Deficiencies in mental health data are a result of poor reporting amongst patients and a long-standing lack of innovation in how information is accessed. We must acknowledge the persistent mistrust that historically marginalized people have in our healthcare system, and ensure that data collection and programming are inclusive, affirming, and participatory. Our field must leverage the political and social momentum during the COVID-19 era by prioritizing input from patients and interdisciplinary providers on the front-line. We must demand that our environments and policies adopt a trauma-informed approach, a treatment lens which assumes that an individual is more than likely to have a history of trauma, and advocate that it be applied to all facets of integrated healthcare. Our messaging must recognize a history of oppression in our field itself, with specific attention to the evolution of mental health diagnosis and mental hygiene law.  In my own role, I aim to be cross-cutting in how my center closely investigates systems like criminal justice, education, housing, child welfare, among others — environments where many historically traumatized groups, and many of my own patients, have received a mental health diagnosis for the first time.

As the problem has evolved, our messaging needs to as well. Mental health equity is health equity. When the stakes are so high, “awareness” is no longer a strong enough message. I ask you to join me in re-naming it “Mental Health Equity Month.” The time is now to repair and build the foundation for an equitable mental health system that can carry entire populations through sustained recovery during periods of crisis and beyond.

About the author/for immediate inquiry: Madhuri Jha, LCSW, MPH is the newly appointed Director of the Kennedy-Satcher Center for Mental Health Equity – an entity of the Satcher Health Leadership Institute at the Morehouse School of Medicine. She has over a decade of service devoted to being a clinical practitioner, consultant, and leader in the public mental health and health equity field. For immediate inquiries about the author or the work being done at KSCMHE contact Mahia Valle at mvalle@msm.edu.