Healthcare Reform and Mental Health Eliminating Disparities in Care
The need to reform the current healthcare system, including the provision of mental health and substance use services has been an ongoing debate for decades. The Patient Protection and Affordable Care Act (PPACA, H.R.3590) was signed into law on March 23, 2010 by President Obama. Together with the Health Care and Education Reconciliation Act, signed on March 30, 2010 they are known as the Affordable Care Act (ACA). On March 31, 2014, Congress passed the Protecting Access to Medicare Act (H.R.4302) which includes provisions of the Excellence in Mental Health Act. Signed into law on April 1, 2014, the legislation will provide resources to establish a pilot project designed to increase access to mental health and substance use services while improving Medicaid reimbursement for these services. This has important implications for eliminating care for Asian Americans, Native Hawaiians and Pacific Islanders in need of mental health services. Please click here to read more about mental health issues, mental health provisions in healthcare reform, and Excellence in Mental Health Act.
Mental Health of Asian Americans, Native Hawaiians, Pacific Islanders and the Need to Develop New Models of Integrated Care
Asian American, Native Hawaiians and Pacific Islanders are the fastest growing ethnic minority group in the country, yet the availability of culturally and linguistically appropriate mental health care has not kept up with the increase in need. Contrary to the belief that AANHPIs have few, if any problems, many experience serious mental health problems including high rates of depression, post traumatic stress disorder and thoughts of suicide. The stigma associated with mental health, the serious lack of trained bi-lingual, bicultural providers, the lack of affordable insurance and a system that fails to provide equitable resources for mental health services all contribute to an environment that is not conducive to an individual receiving they help they need. Mental health disparities have been highlighted in the President’s New Freedom Commission on Mental Health (2003)9, the Surgeon General’s Report on Culture Race and Ethnicity8 and the Institute of Medicine’s Report on Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.5 and Integrated Care for Asian Americans, Native Hawaiians and Pacific Islander: A Blueprint for Action7
Mental health impacts every aspect of a person’s life including their physical health, their ability to maintain healthy relationships, being able to maintain steady employment or do well in school. Many AANHPIs have experienced trauma brought on by war, colonization, and adjusting to live in the US. They experience isolation brought on by language and cultural barriers, intergenerational conflict, anti-immigrant bias, lack of adequate employment, pressures to excel in school and the impact of reduced services brought about by cuts in funding for direct services. For many, their mental health problems may go underreported or undetected as they frequently seek help from primary care physicians and healthcare workers who are not trained to recognize mental health disorders.10 A major challenge facing advocates and policy makers is the lack of accurate data11,12 which takes into consideration differences in ethnicity, language, place of birth, generational status, historical trauma, and other critical variables that impact mental health/health outcomes for AANHPIs.
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Affordable Care Act Update