Senate Joint Resolution 25 of the 2004 Session of the General Assembly directed the Joint Commission on Health Care (JCHC) to conduct a two-year study of “the mental health needs and treatment of young minority adults in the Commonwealth." A study workgroup, convened by JCHC staff, met during 2004 and 2005. The workgroup developed a work plan and determined that completion of the study would require an additional one to two years in order to address adequately the study issues. The study was completed in 2007. This is the final JCHC report in response to SJR 25 (2004).
The results of the study indicate that while the rates of mental illness are similar for racial/ethnic groups, minorities are more likely to be in high-need sub-populations (like the homeless or incarcerated) whose rates of mental illness are higher and much less likely to be treated. Key disparities for racial and ethnic minorities include a lack of access to quality services, lower levels of help seeking and help utilization, language barriers and lack of cultural competence among practitioners, negative experiences within the mental health system, the pervasiveness of stigma, and a lack of inclusion of minorities in research and clinical trials.
These disparities, at least in part, can be alleviated by increasing the level of cultural competency of all practitioners and addressing workforce issues including practitioner shortages in underserved areas and the lack of racial/ethnic minority health practitioners. The Virginia Department of Health is making improvements in the area of cultural competence through the Culturally and Linguistically Appropriate Health Services (CLAS) Act Initiative; however, cultural competency training needs to be recognized as an important component of all practitioners’ training and knowledge. Currently students majoring in the health care professions are not required to demonstrate competency in cross-cultural knowledge or in culturally appropriate care in order to graduate from Virginia’s colleges and universities.
To address workforce shortages, various programs provide incentives for health care practitioners to serve in under-served regions of the State but only one program focuses specifically on the mental health field (child psychology/psychiatry internships). Moreover, no program is dedicated solely to increasing the number of racial and ethnic minority mental health care providers. (1*) This is a critical shortage that needs to be addressed in order to reduce disparities in minority employment opportunities and to provide more culturally appropriate care for minority populations.
Based on the study findings, JCHC voted to request by Chairman’s letter that the State Council of Higher Education for Virginia (SCHEV) examine the issue of requiring cultural competence training as part of college curriculum for health profession majors.
On behalf of the Joint Commission and staff, I would like to thank the numerous individuals who assisted in this study, including representatives of community health centers, community services boards, free clinics, indigent defense attorneys, the Psychiatric Society of Virginia, Hampton University, Virginia Commonwealth University, and such State agencies as the Department of Health and the Department of Mental Health, Mental Retardation and Substance Abuse Services.
(*1) With the possible exception of the Virginia College of Osteopathic Medicine where students are trained to treat the individual as a whole and, therefore, have at least basic mental health knowledge. It is likely that some students choose to specialize in the mental health field.