Bringing Mental Health Services to Those Who Need It
By Alisa Orlowsky, Communications Associate
October 10th is World Mental Health Day. We’re spotlighting a few of our partners who’ve committed to making mental health services more widely available, particularly for underserved groups.
With the growing normalization that mental health affects us all, access to care is becoming less stigmatized and more available. Even so, many folks face significant disadvantages in their ease of access to quality treatment and support. Whereas data indicate similar rates of mental health disorders between white individuals and BIPOC broadly, disorders experienced by BIPOC tend to last longer and are more likely to go untreated. In 2015, among U.S. adults with any mental illness, 48% of white people received mental health services, compared with 31% of Black and Hispanic people, and 22% of Asian individuals.
The gap in mental health service provision is not just a racial or ethnic one; it is compounded by the negative impacts of longstanding systemic issues within our institutions that disproportionately harm underserved groups such as transgender and gender-nonconforming people (TGNB), youth and young adults, and people impacted by the criminal legal system.
To better serve these groups, policymakers, elected officials, and other practitioners must intentionally gauge the accessibility of mental health care and consider new ways of reaching people who have been systematically excluded. Because of their proximity to their communities, city and local governments are uniquely positioned to identify and address these accessibility gaps. By leaning on the expertise and connections that community-based organizations and nonprofits establish within their communities to reach underserved groups, local and city governments can direct resources more efficiently, but most importantly, more effectively.
By leaning on the expertise and connections that community-based organizations and nonprofits establish within their communities to reach underserved groups, local and city governments can direct resources more efficiently, and most importantly, more effectively.
CUNY ISLG forged nonprofit partnerships with local governments that provide these much-needed services. Whether through research and analysis designed to help partners identify the scope, range, and impact of mental health needs among populations served, or enhanced support for service delivery, this work demonstrates that ample opportunity exists to improve and expand access to mental health services. Some of these partners have already made meaningful progress on this front for a range of underserved groups, including among transgender and gender-nonconforming people (TGNB), youth and young adults, and people on probation.
Making Mental Health Care More Accessible to the Trans & Nonbinary Community
TGNB communities face higher rates of mental health challenges that, among other reasons, are worsened by barriers to gender-affirming care. In 2020, a survey found that 54 percent of transgender and gender nonbinary (TGNB) youth and young adults reported having seriously considered suicide in the past year. Another study found that negative healthcare experiences, including overt and subtle forms of discrimination from doctors, caused significant additional mental health and substance use challenges in TGNB individuals.
Given this context, it’s critical that TGNB folks receive care from providers specifically trained to provide care to this population or, better yet, with shared lived experiences. However, a 2021 study found that only 1.2% of matriculating medical students identified as TGNB.
Supported by a partnership between CUNY ISLG and the Manhattan DA’s Office, Mount Sinai designed the Trauma Healing and Resilience Initiative for Transgender Survivors of Violence (THRIV) as a TGNB-centered program to increase access to trauma-focused, gender-affirming therapy for TGNB survivors of interpersonal violence and trauma. Healthcare staff were educated on best practices in working with TGNB participants, which are often left out of traditional training and medical education. A trans-identifying full-time Program Associate was also hired following an initial evaluation of the program.
One participant said they
“felt respected by [staff] and felt that they could genuinely trust them,” with one participant noting “This has been a chance to actually feel safe regarding talking to doctors.”
Learn more about the program evaluation here.
Supporting People on Probation with Substance Use and Mental Health Needs
Nationally, adults on probation are more than twice as likely to have a serious or moderate mental health disorder as those not on probation. This overrepresentation of adults with mental health disorders is magnified by the reality that many probation agencies do not have sufficient resources to meet the needs of people on probation or provide their officers with specialized training on working with people with mental health conditions.
The Santa Cruz County Probation Department joined the Reducing Revocations Challenge to gain insights that would help them eliminate unnecessary probation violations and revocations. Through partnership with a local research group, they learned that more than a third of technical probation violations were related to substance use and/or engagement in treatment; they also learned that people on probation with substance use disorders, mental health conditions, and housing instability are more likely to have a probation violation likely due to common barriers, biases, and practices impacting those populations.
With this information in hand, this Action Research team worked together to create a revocation reduction strategy centered on the probation population with behavioral health needs. This strategy included piloting an incentive-based case management system that transformed the department’s approach to supervising people with substance use concerns, as well as mental health conditions and other vulnerabilities, with a goal of supporting positive behavior change and reducing violations. The county also engaged in a collaborative process of department-wide culture change influenced by community collaborators, including individuals with lived experience on probation, to better meet the unique needs of folks on probation.
For additional details on the work of Santa Cruz County and three additional sites, review the From Research to Action to Successful Outcomes report.
Increasing Students’ Mental Health Resources in Schools
In 2023, Latine and Black students were more likely than other racial groups to miss school due to safety concerns. For students with experiences of trauma and violence, access to mental health services is crucial for healing, as well as for preventing additional harm.
In two public Washington Heights high schools predominantly comprising Latine and Black students, Margaret’s Place in Communities Impacted by Trauma-exposed Youth (MP-CITY) provided a range of services for students, including individual and group counseling, spaces for discussion about violence and trauma, and multiple school-wide approaches to learning about and addressing the impact of trauma. Implemented by Joe Torre Safe at Home (JTSAH), MP-CITY was evaluated as a model for non-profit partnerships with schools with support from the Criminal Justice Investment Initiative.
Evaluators identified opportunities for program improvement that could be implemented before the end of an evaluation process and provide immediate value to participants, like the introduction of a validated trauma screener for new participants. The emphasis on collaboration between nonprofit program staff and evaluator creates the opportunity for real-time improvements that are tailored to best serve the needs of students.
Additional program evaluation information can be found here.
Image by jordi2r on Adobe Stock.