CHAPTER 7

A Vision for the Future

Introduction

The extensive evidence reviewed in this supplemental report to Mental Health: A Report of the Surgeon General (1999) supports the conclusion that mental illnesses are serious and disabling disorders affecting all populations, regardless of race or ethnicity. This Supplement also concludes that culture and social context influence mental health, mental illness, and mental health services in America. Despite the existence of effective treatments, disparities lie in the availability, accessibility, and quality of mental health services for racial and ethnic minorities. As a result, these populations bear a disproportionately high disability burden from mental disorders. This Supplement underscores the recommendation of the original Surgeon General’s Report on Mental Health: People should seek help if they have a mental health problem or if they think they have symptoms of a mental disorder. In addition, the literature reviewed herein suggests that mental health researchers, policymakers, and service providers must be more responsive to the social contexts, cultural values, and historical experiences of all Americans, including racial and ethnic minorities.

Lack of information regarding the mental health needs of many racial and ethnic minorities is also a critical disparity. Too often, the best available research on racial and ethnic minorities consists of small studies that cannot be generalized to today’s increasingly diverse communities. While the research reported in this Supplement is the best science available, it represents a science base that is incomplete.

To better address the dynamic impact of culture, race, and ethnicity on mental health and mental illness, more research is needed on how to prevent and treat mental illness and to enhance the mental health of all racial and ethnic groups. Following an extensive consultation process with public health experts, service providers, and consumers, the Surgeon General released Healthy People 2010 in early 2000 as a challenge to the Nation to address disparities in health care access and outcomes. For the first time, among the 10 “leading indicators” of the Nation’s health on which progress will be regularly monitored is one mental health goal: increasing treatment of depression for underserved minority groups. This national agenda encourages the field to strive toward the highest possible quality of health care and health outcomes, with equally high standards of care across groups.

A public health approach to reducing mental health disparities will require a national commitment, bringing together the best of the public and private sectors, individuals and communities, Federal, State, and local governments, universities, foundations, mental health researchers, advocates, health service providers, consumers, and their families. Through active partnership, these stakeholders can generate the knowledge and resources necessary to improve mental health services for racial and ethnic minorities in this country. This chapter highlights promising courses of action that can be used to reach the ambitious goals of reducing barriers and promoting equal access to effective mental health services for all persons who need them.