During the 2008 session, Senate Joint Resolution 46 was introduced by Senator Henry L. Marsh, III directing the Joint Commission on Health Care (JCHC) “to continue its study of the mental health needs and treatment of young minority adults in the Commonwealth." This study is a continuation of the study requested by Senate Joint Resolution 25 (Senator Marsh) during the 2004 legislative session.

Overall, rates of mental illness are similar across racial and ethnic groups; however significant differences between minorities and Whites exist in access to and quality of treatment, help seeking and help utilization, negative experiences within the system, and pervasiveness of stigma. Results of a 2005 study by the Central Virginia Health Planning Agency indicate that, in central Virginia, younger adults, minorities, and individuals with lower incomes are less likely to receive treatment than Whites. The most common responses among minorities to the question of why services were not received are “insurance was not accepted," “could not afford treatment," and “did not know how to get help/refused to get help."

State-level data for Virginia shows that Whites are more likely to receive outpatient treatment in the private sector, whereas Blacks are more likely to receive treatment at a hospital or through a community services board. While 19.9 percent of the state’s population is Black, 27 percent of all hospital admissions for mental health issues are African American. Outpatient treatment in the community is generally preferred and considered to be a better model for treatment than institutionalization, and the over-representation of African Americans among hospital admissions in Virginia mirrors the national pattern of this health disparity.

A review of the minority mental health literature indicates that the following factors influence the decision to receive treatment: fear associated with stigma and/or being deported or turned down for citizenship, embarrassment, language barriers, lack of trust, poor mental health literacy, negative experiences, lack of insurance, confidentiality concerns, and cultural beliefs emphasizing community care over formal treatment. The implications of deciding not to seek professional help include increased risk of death, acute episodes, chronic conditions, risk of misdiagnosis, inpatient treatment, and use of courts; and a decrease in access, availability, and quality of care.

Finally, based on the 2007 study findings, JCHC voted “to request by letter from the JCHC Chairman for the State Council of Higher Education for Virginia (SCHEV) to examine the issue of requiring cultural competence training as part of college curriculum for health profession majors." SCHEV surveyed Virginia’s public and private institutions of higher education which offer health profession programs. A workgroup was convened by SCHEV to discuss the survey results which indicated that most institutions offer some type of cultural competency training with the most common practice being embedding the material in existing classes. Consequently, the workgroup suggested that a formal mandate regarding cultural competency in health profession curricula does not appear to be needed. However, workgroup members unanimously agreed that “improving the pipeline of minority students for their programs is an essential element for ensuring cultural competence and reducing health disparities." The report submitted by SCHEV will be included in JCHC’s final study.

Although the presentation for this study was distributed, it was not presented to the Behavioral Health Care subcommittee due to time constraints; therefore no policy options have been adopted at this time. A report will be presented in 2009 and a written document will be submitted to the General Assembly and the Governor for publication as a Senate document.