Featured expert in video discussion:
Anisha Gangotra, Health Advocate & Dance Instructor
Anisha Gangotra is a UK-based health advocate and patient leader who has lived with ulcerative colitis since 2008 and mental health issues including PTSD, depression and anxiety following a traumatic, high-speed car accident in 2011. She’s works in the mental health profession specialising in mental health and employment and in her spare time, she’s an Inclusive Dance and Zumba instructor, bringing the joy of dance to people with chronic health conditions, disabilities and mental health issues. She was a finalist in the 9th Annual WEGO Health Awards 2020, a HLTH VRTL conference event which recognises patient advocates who are leading the way in online health communities across the globe. She’s passionate about sharing her story and using her experience to work with multiple stakeholders so we can challenge society’s views of those living with invisible conditions, improve infrastructure to better support us, shape the future of healthcare by the people who use it, and continue to dance whilst doing it!
Mental Health In Underserved Communities
As the economic effect of Covid 19 around the world continues to rise, the impact it causes on the mental health of individuals continues to rise too. For instance, we should worry about the frontline health care providers whose jobs require them to put their life on the line while they save other lives. So, they battle with anxiety, trauma, and post-traumatic stress.
Reports from the global family violence also state that many violence victims and witnesses who are locked down with their abuser will need mental health support. Add this to the list of possible mental effects of social isolation, grief, and health anxiety.
Yet even when everything was normal, and there was no pandemic, a large proportion of individuals facing mental health issues around the globe and needing medical attention never get it. Mental health is so expensive, and many treatment providers do not take insurance and want patients to pay out of their pockets. Also, the social stigma around it makes it even more complicated.
Research has shown that the mental health road for people living in underserved communities and poverty seems to be a steep climb. Apart from the fact they also battle with mental health, the mental health treatment available to them is very limited, and they even struggle before they can get the little help they get.
Mental Health and Minorities
The most extensive US-based psychiatric study stated in research that individuals that fall under the lowest socioeconomic status are three times more likely to have a mental disorder than individuals in the highest status.
Although individuals’ environment, characteristics, and family situation can also contribute to mental health issues, research shows that the discrimination and segregation present in society may play a higher role in mental health than imagined.
The poor, underserved communities and minorities usually lack the resources they need to maintain essential community healthcare services. So, this means they don’t have access to mental healthcare when needed. However, even when resources are made available to these communities, the cultural and social stigmas attached to mental health in these communities might stop individuals from seeking proper help when needed.
Unfortunately, even when a person from a minority group can reach out for mental health care, studies shows that the probability of getting proper and efficient treatment is lower than that of people in higher statuses.
Mental Health and the Elderly
Alongside the physical, health, and financial care that the elderly population need, many of them also need mental health care. However, the diagnosis of these mental issues might be slow because they often manifest in different ways like fatigue and weight loss and might be easily dismissed as one of those issues that come with aging. So, this may result in delayed or inappropriate treatment.
Poor mental health among older people can be often overlooked or not taken seriously. Research even shows that up to 85% of older people with depression do not receive any help from the National Health Service (Stapleton 2020).
Older people are also susceptible to grief, even more than young ones but the availability for treating this problem varies based on country, with most countries having limited services.
Mental Health and Primary Care; How Primary Care Network Can Help
The most effective way to meet the mental health needs of the global population is to integrate mental health in general healthcare at the primary care level.
In the Mental Health Gap Action Program(MhGAP), World Health Organization (WHO) stated that there is a treatment gap that can only be bridged by enlightening and training frontline health workers about mental health. This will empower them to be able to identify, diagnose, and provide treatment for mental problems.
The MhGAP has also created some intervention guidelines that will enable non-mental healthcare workers to identify and manage mental health issues like bipolar disorders, depression, epilepsy, dementia, self-harm, behavioral and developmental disorders in adolescents and children, psychosis, and other medically unexplained or emotional conditions.
The program also has a prime package that is aimed at reducing the mental health treatment gap for low-to-middle income earners in various countries. A detailed evaluation process follows this, and there have been field trials in five countries; Nepal, Ethiopia, India, South Africa, and Uganda. Three of the field trials (Nepal, Ethiopia, and India) were made up of mostly rural communities.
The findings from the field trials are also promising and have helped highlight the problems that may be encountered when integrating mental healthcare in primary health care and how to tackle those problems.
Finding Your Voice: Self Advocacy For Individuals and What Their Support Groups
Advancing mental health in the world starts with you. Whether you use your voice to share your personal experience or connect someone to support, or you volunteer for mental health support groups, finding your voice through a mental crisis and using it will help make a difference in your community, country, and the world at large.
Finding your voice and self-advocating requires self-awareness and ability to discern what works for you and what doesn’t. Sometimes, all you need is the courage to say ‘I don’t know what I need or what is wrong with me. Can you help me figure it out?’
Self-advocacy involves addressing every possible layer that could affect your life: personal, family and community. This is because these layers are all equally important and have profound influences on each other.
Be assertive but respectfully express your needs.
Practice self-care. Taking good care of yourself shows that you value yourself. Eat good foods, take your medications, and exercise regularly.
Be well versed with your medication and therapy option.
Document how you feel. We’re launching the Patient Orator app, a HIPAA compliant mobile health app to help with symptom documentation. Sign up for our newsletter to learn more about our app launch.
- Build your team. When you have good relationships with your friends, family, and community, you are creating a great support system for yourself.
- Work with mental health advocacy groups. By joining these organizations, you will be able to play your part in creating mental health awareness and reducing the stigmas around it.
Change is Coming; Innovative Approaches Around The World
Many studies and researches have been carried out in a bid to find ways to change the status quo of mental healthcare for the underserved communities and minorities.
So in general, researchers recommend these approaches;
- Expand outreach outside the clinic walls and meet people’s needs in the right and comfortable setting for them with mobile clinics and innovations like telephone/video-based treatment.
- Create more public awareness via different mediums where information will be shared to reduce stigma and also state treatment options.
- Get survey reports from individuals about their mental health needs and obstacles to care, then inform providers and policymakers about the needs of minorities and underserved communities.
- Provide adequate mental health training to community healthcare workers working in clinics and organizations treating minority populations.
- Improve payment options.
Even though there’s still a long way to go regarding mental health care equality, the road ahead seems promising. As more research is carried out and educates the healthcare leaders and health policymakers, more meaningful change will make its way into the world.
Williams, David R., and Ruth Williams-Morris. “Racism and Mental Health: the African American experience”. Ethnicity &Health, em>2000.
Chun-Chung Chow, Julian, et al. “Racial/Ethnic Disparities in the Use of Mental Health Services in Poverty Areas.” National Center for Biotechnology Information, May 2003.
McManus S, Bebbington P, Jenkins R, Brugha T (eds) (2016). Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014
Achenbach, J. (2020, Apr 2). Coronavirus Is Harming the Mental Health of Tens of Millions of People in the U.S., New Poll Finds. Washington Post.
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