Addressing Stigma
Although mental illnesses are surprisingly common, affecting up to 28 percent of our nation, recovery is possible. Studies show that many people with mental illnesses recover completely (SAMHSA, 2003). With treatments and supports available now more than ever, people with mental illnesses can lead active, productive lives and contribute to their communities.

Yet stigma continues to be a major barrier to seeking out care. Many people are still confused between facts and myths. They don't understand what mental illnesses are and continue to believe that there is something shameful about them. In addition to shame, minorities often feel the legacy of racism and discrimination, leading to the distrust of health and mental health professionals. Feelings of stigma, discrimination, and mistrust of authorities preclude individuals in need from seeking out and receiving the help and treatments that can lead them to recovery.

Because the small numbers of minorities that do seek behavioral health care prefer seeking and receiving that care in primary care settings, it is in our best interest to nurture and further develop this entry point into treatment, and we must assure the presence of a sensitive workforce that is culturally and linguistically competent. As such, providers themselves will help to break down some of the barriers created by stigma, while providing needed care .

Mental Health Treatment
Treatment for mental health depends on the specific condition or combination of conditions, and should rely on evidence-based practices. These treatments have been studied and proven effective in reducing symptoms and promoting wellness.

Research has contributed to our ability to recognize, diagnose, and treat mental health conditions effectively in terms of symptom control and behavior management. Medication and other therapies can be independent, combined, or sequenced depending on the individual's diagnosis and personal preference. A new recovery perspective is supported by evidence on rehabilitation and treatment as well as by the personal experiences of consumers.

Substance abuse is a major co-occurring problem for adults with mental disorders. Evidence supports combined treatment, although there are substantial gaps between what research recommends and what typically is available in communities.

Although sensitivity to culture, race, gender, disability, poverty, and the need for consumer involvement are important considerations for care and treatment, barriers of access exist in the organization and financing of mental health services for adults.

Because of the lack of access to preventive care, early identification of mental illness and lack of quality interventions, the service needs of minorities may exceed those of Whites. Poverty and lack of (or insufficient) medical insurance hampers access to care, often leading to more chronic mental health conditions. High concentrations of poverty in inner cities and the combination of isolation and poverty in rural and frontier areas pose additional challenges for residents of these areas.

In a recent report titled: "Health Centers' Role in Answering the Behavioral Health Needs of the Medically Underserved" (2004), the Health Resources and Services Administration (HRSA) reported that community health centers (CHC) are the primary care providers to 15 million medically underserved individuals. They have become critical sources of behavioral health services to those most vulnerable, particularly minority populations, the poor and the uninsured. According to the 2003 CHC Uniform Data System, health centers reported 2.1 million encounters for mental health conditions and 720,000 contacts for drug or alcohol dependence.

The Indian Health Service (IHS) is an integrated health care system that provides valuable mental health services to American Indians and Alaska Natives (AI/AN) through its Mental Health and Social Services program. This program is community oriented, clinical and preventive - providing care to more than 1.6 million consumers, both urban and reservation-based. Nevertheless, the accessibility of mental health and substance abuse treatments continue to be a problem. Proven and Carle (2000) found the greatest unmet needs for adult AI/ANs to include substance abuse and mental health out-patient counseling services.

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