Access to effective behavioral health services for insured minority populations: What works?

Objective: to review the current status of barriers to access to behavioral health services since the 2001 Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General, as well as to identify and issue recommendations to overcome such barriers among insured minority populations. Methods: A review of the literature was conducted, followed by key informant interviews, and a consensus group meeting to identify the main barriers and recommendations to improve access to behavioral health services for ethnic and racial insured minorities. Information was gathered on five domains: social context, culture, access, system of care, and prevention. Findings: Racial/ethnic minorities still are subject to overt and covert discrimination, negative stereotyping and stressful events that result in a greater burden of behavioral health problems and lower access to and utilization of behavioral health services. Specific strategies identified by consensus were: a) acknowledge the separate contribution of socioeconomic status and ethnicity to limited access; b) develop partnerships with academic institutions and behavioral health services at the federal, state and local levels; c) build networks of community and faith based leaders; d) recruit and train mid-level providers such as community health workers and patient navigators to increase outreach and monitor adherence to treatments; e) increase group case management in addition to patient-centered care in communities; f) reduce economic, administrative and location barriers to service utilization; g) adopt guidelines addressing the development of multicultural and multilingual services, training and education of health providers.