Case study A: Diego (anatomy and physiology) Case Information: Diego

I have been privileged to serve in the nursing profession for 20 years. Currently, I practice as a dual board-certified Family and Psychiatric Mental Health Nurse Practitioner. In addition to my professional practice, I am pursuing a Doctor of Nursing Practice (DNP) at Chamberlain University, driven by my commitment to positively influence healthcare outcomes and advance national mental health goals. Throughout my career, I have witnessed firsthand the profound effects of poor mental health, particularly within minority communities, and more specifically, among African Americans (AA) in New York City (NYC). My growing concern centers on the persistent healthcare disparities and the inadequate access to quality, culturally adaptive care in these and other minority communities. Substantial evidence underscores the ongoing challenges related to equity and access to mental health services for minorities. Research indicates that African Americans and non-Hispanic Whites are affected by mental health illnesses at similar rates. However, African Americans are significantly less likely to receive appropriate treatment and management for mental health conditions (U.S. Department of Health and Human Services [HHS], 2024; National Institutes of Health [NIH], n.d.). Within New York City, African Americans represent 12.8% of the population, yet among those who require mental health services, only one-third receive them (City of New York Office of the Mayor, 2015; New York State Office of Mental Health [OMH], n.d.). One policy that directly addresses the mental health challenges faced by minority communities is H.Res.639 – Supporting the goals and ideals of “Minority Mental Health Awareness Month.” This resolution recognizes the disproportionate impact of mental health conditions on minority populations and communities, highlighting the need for focused attention and resources (Library of Congress, 2023). Without sufficient support for this policy, the existing disparities in mental health care are likely to persist, resulting in poorer outcomes for minority populations. For instance, African Americans report higher rates of chronic depression and associated disability compared to their White counterparts (Centers for Disease Control and Prevention [CDC], 2023). In NYC, a greater number of African Americans are diagnosed with severe mental health disorders such as schizophrenia, and they experience higher levels of psychological distress (City of New York Health, 2024). Your ongoing efforts to address mental health issues, particularly among the seriously mentally ill homeless population and through initiatives like the 11-Point Mental Health Legislative Agenda, have been commendable. These actions have significantly raised awareness within the NYC community. As someone who is deeply involved in the daily assessment, education, and management of mental health patients, I have seen how genetics, cultural beliefs, and social determinants of health interact to perpetuate disparities. This experience allows me to confidently inform you about the specific issues affecting minority populations. Unfortunately, it is all too common to encounter patients who opt for medical treatment while refusing psychiatric care due to poor knowledge, lack of insight, and financial constraints. It is imperative that we engage minority patients in mental health care long before they reach a point of crisis or become chronically disabled. Supporting “Minority Mental Health Awareness Month” would enhance outcomes for various stakeholders, including patients, providers, and policymakers. For example, primary care initiatives that incorporate culturally adapted education and screening have proven successful in raising awareness and increasing help-seeking behavior in these communities (Bamgbade et al., 2024; Randle et al., 2019). Such efforts can lead to improved access to quality, culturally sensitive care, better mental health outcomes, reduced disparities, decreased disability, and a lower economic burden. Organizations such as the African American Behavioral Health Center of Excellence (AABH CoE), the National Alliance on Mental Illness (NAMI), and the Substance Abuse and Mental Health Services Administration (SAMHSA) are all supportive of this resolution. Given your office’s history of successfully implementing similar initiatives, I recommend that you support H.Res.639. By committing the necessary budgetary resources, you can ensure the successful delivery of accessible, essential, and sustainable mental health services for vulnerable populations. Good mental health contributes to the overall well-being of individuals, families, and communities, reducing the negative impact on physical health, family and social relationships, job functionality, financial security, and other life domains (HHS, 2024; National Institute of Mental Health [NIMH], 2023). Supporting H.Res.639 would align all stakeholders in a shared vision of improved mental health for these marginalized groups.

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