As Director of Care Management at Blue Cross NC, one of my main responsibilities is to ensure our members receive the best possible care and can achieve good health. Behavioral health issues, like mental health and substance use disorders, can present major challenges to keeping people well. In the United States, one in five people lives with a mental health disorder. What’s more, mental health conditions are among the most common causes of disability.
As a Registered Nurse, I have worked directly with patients, and this experience has given me a unique insight into some of the problems facing our health care system. One critical issue the health care industry needs to address is the disparity in accessing behavioral health care among minority groups. Individuals who fall into these groups—whether based on race, ethnicity, sexual orientation or gender—often suffer from poorer behavioral health outcomes compared to those who do not belong to these groups.
We need to examine why these disparities continue to exist. Why, in a time when our society is working to close the gaps in income, housing, and education, is behavioral health lagging behind?
A Closer Look at the Gaps in Care
Consider these facts:
- Although rates of depression are lower among African Americans and Hispanics than in white Americans, depression among these groups is likely to be more persistent.
- LGBTQ+ individuals are 2.5 times more likely to experience depression, anxiety and substance misuse compared to heterosexual individuals.
- Twice as many women as men will experience depression, generalized anxiety disorder or PTSD in their lifetime.
Diverse communities face barriers to behavioral health access that many people don’t think about. There is greater stigma and misinformation around these issues in some minority communities, which affects whether, when and what kind of help individuals may seek. They might encounter language barriers or bias with providers that can lead to misdiagnosis and receiving inadequate resources. And there is a shortage of “culturally competent” providers, or physicians who can provide services tailored to individuals’ cultural and language preferences.
All of these factors combined have created a system that is failing some of North Carolina’s most vulnerable populations. This has to change.
Our Behavioral Health Strategy
Our mission at Blue Cross NC is to improve the health and well-being of all North Carolinians. That goal cannot be achieved without looking at total health, which includes both behavioral and physical health. The two go hand-in-hand, and that is why neglecting behavioral health can complicate serious like heart disease, high blood pressure, and obesity.
We need to address disparities in behavioral health care because we believe all North Carolinians should receive great care, and because we know behavioral health treatment can lead to improvements in total health and better quality of life.
Our vision is to be a model for health care transformation through our commitments to quality, affordability, and better patient experience. That’s why we’re working to integrate behavioral health across the health care system. We’re building a more robust network of behavioral health providers and providing them with the tools and resources they need to treat their patients.
And we’re addressing barriers to access like cost, coverage and logistical challenges that disproportionately affect specific groups in our communities.
Talk About It: Starting a Community Conversation
To truly integrate behavioral health across our system, we will need to reduce the stigma surrounding it. I recently sat down with Melissa Wade on Working Mom Wednesday’s for this very reason. The more we raise awareness and provide education on behavioral health, the more we can help lessen the embarrassment around a subject that affects so many of us.
That is why it is so incredible to see community groups and organizations of all types come up with innovative strategies for bringing behavioral health care to their communities.
Some of my favorite solutions are below:
- Recognizing the close relationship between community members and barbers in African American communities, 25 students at No Grease Barber School have completed an eight-hour Mental Health First Aid course to help customers who might be facing behavioral health challenges.
- With investments from Blue Cross NC, North Carolina Historically Black Colleges and Universities are stepping up the recruitment of the next generation of health care professionals.
- Within African American rural communities, churches provide an opportunity to reach 85 percent of the community. Though churches have been used to address physical health concerns in the past, the National Institute on Minority Health and Health Disparities has launched pilot programs to address behavioral health in the same setting.
While I believe our work at Blue Cross NC will be key to closing gaps in behavioral health care, this isn’t a problem we can tackle on our own. I look forward to seeing what we can accomplish when we work together with providers, community groups and government to create a more equitable system for everyone.
Additional help is available from these resources
- The National Suicide Prevention Lifeline is a 24-hour, toll-free suicide prevention service available to anyone in suicidal crisis. If you need help, please dial 1-800-273-TALK (8255).
- To find a mental/behavioral health specialist in your area, access our Find a Doctor tool.
- To learn more about disparities in behavioral health care visit the National Institute on Minority Health and Health Disparities site.
 “Major Depression: The Impact on Overall Health.” Blue Cross and Blue Shield Association. (May 20, 2018). Accessed March 2019.
 Mental Health and Mental Disorders.” Office of Disease Prevention and Health Promotion, Health People 2020. Accessed March 2019.
 “Mental Health Disparities: Diverse Populations.” American Psychiatric Association (2017). Accessed June 2019.
 “Depression in Racial and Ethnic Minorities: The Impact of Nativity and Discrimination.” Racial Ethnic Health Disparities. (March 2015). Accessed June 2019.
 “Depression in women: Understanding the gender gap.” Mayo Clinic (January 2019). Accessed June 2019.