[Congressional Record Volume 170, Number 126 (Thursday, August 1, 2024)]
[Senate]
[Pages S5755-S5757]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
National Minority Mental Health Month
Mr. President, I have been in the Senate now for 18 years, and I am
proud of the progress that we have made in dealing with mental health.
I served in the Senate with the late Senator Ted Kennedy as he fought
for mental health parity. So that once and for all we would find that a
person who suffers from mental illness would get the same type of
respect, attention, and coverage as someone suffering from a physical
illness.
We recognize that mental health is an illness, and mental health
parity was important. We have made progress. During COVID-19, I was
very proud that we had bipartisan efforts to expand telehealth to
mental health because we recognize that access was critically important
and that during COVID, getting access to healthcare was particularly
challenged.
And then in the Safer Communities Act, which we all supported here,
we provided help to our children in our schools suffering from mental
illness. So we have made progress. We have made progress. But more
needs to be done.
I rise today to urge my colleagues to recognize that we have just
completed July as National Minority Health Awareness Month. So I want
to comment on the gap that exists in regard to mental health services
and our minority communities.
This July, the U.S. Department of Health and Human Services Office of
Minority Health is focusing on improving mental health outcomes for all
communities through this year's theme: ``Be the Source for Better
Health.''
Let this month--and all month--serve as an opportunity to bring
awareness of these mental health challenges and recommit our efforts to
tackling longstanding health disparities in the United States.
Unfortunately, the subject of mental health is surrounded by stigma.
About half of all people in the United States will be diagnosed with a
mental health disorder at some point in their life. Mental illness can
have a devastating impact on the individual as well as their
surrounding community.
Racial and ethnic minorities often suffer from poor mental health
outcomes due to multiple factors, including lack of access to quality
mental health care services, cultural stigma surrounding mental health
care, discrimination, and overall lack of awareness about mental
health.
Today, because of deep-rooted inequalities that exist in our society,
including those in our healthcare system, communities of color continue
to face health disparities that result in poorer quality of life and
lower life expectancies when compared to their White counterparts.
According to the Kaiser Family Foundation 2023 analysis, 39 percent
of Black or African-American adults and 36 percent of Hispanic Latino
adults who reported fair or poor mental health were less likely than
White adults to say that they received mental health services in the
past 3 years.
In our country, we are incredibly fortunate to have the National
Institute on Minority Health and Health Disparities at the National
Institutes of
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Health. And I was proud to help create that division of the national
health system. Our national health status depends on our ability to
improve health of all communities and eliminate mental health
disparities.
The stigma surrounding mental health poses challenges for communities
of color. Among adults who receive or try to receive mental health
care, Asian and Black adults are more likely to report difficulty
finding a provider who can understand their background and experiences
compared to their White counterparts. Hispanic adults also reported
being afraid or embarrassed to seek care. These are circumstances that
we have to acknowledge and we have to deal with.
Suicide is one of the leading causes of death in the United States.
Certain groups have disproportionately high rates of suicide. Between
2011 and 2021--those 10 years--the suicide death rate showed a
substantial increase among people of color. There was a 70-percent
increase among American Indian and Alaskan Native people, followed by a
58-percent increase among Black people and a 39-percent increase among
the Hispanic population.
Thanks to the Biden-Harris administration, 9-8-8, the Suicide and
Crisis Lifeline, has served as a resource for over 20 million callers
looking for support in times of distress. These numbers are to be
commended. However, overall awareness remains low, particularly among
Black, Hispanic, and Asian adults.
The Kaiser Family Foundation reported that immigrant adults--those
with limited English proficiency--were less likely to have heard about
the 9-8-8 number compared to U.S.-born and English-proficient
individuals.
A 2023 Milliman Report found that over half of the U.S. populations
live in counties that are entirely designated as ``Mental Health
Professionals Shortage Areas.'' The mental health provider workforce
has not increased. The country has less than a third of the
psychiatrists needed to meet provider shortages. The national average
self-pay cost for someone who does not have insurance is over $170 per
visit. These out-of-pocket costs that individuals can face can serve as
a barrier to care.
This is simply unacceptable. Stigma, cost, and provider shortages
prevent many individuals from receiving necessary mental health care.
We must act to improve access to high-quality, evidence-based mental
health care services in our country.
Maternal mental health has been a persistent issue that has deeply
affected individuals of families across our Nation. Depression,
anxiety, and substance use disorder are the most prominent
complications of pregnancy, childbirth, and postpartum. According to
the CDC, one of eight women experience postpartum depression, and 50
percent of them are untreated.
While maternal mental health disorders impact all women, there is
evident disparity in the rates at which certain racial and ethnic
groups are affected. Women of color are three to four times more likely
to experience complications during pregnancy and childbirth and die
from these complications than White women. Despite this alarming
statistic, these mothers of color--and Black mothers, in particular--
are still less likely to receive both a diagnosis and treatment for
these disorders.
Many factors affecting mental health and well-being later in life
start during childhood and adolescence. Certain social and economic
circumstances, such as experiencing a trauma, which is all too common,
particularly in minority communities; economic circumstances, again, in
the underserved communities and minority communities; lacking a support
system; and having limited access to healthcare leave racial and ethnic
minorities and American Indian children and Alaska Native children and
adolescents at an increased risk for many mental health problems that
are preventable.
Children and their families lack access to high-quality specialty
child and adolescent behavioral health care. There is currently a
shortage of inpatient child and adolescent psychiatric beds. We say our
youth are our priority, and yet we don't provide the beds for the
mental health services for our children.
According to the American Academy of Child and Adolescent Psychiatry,
there are over 1.3 million children under the age of 18 in my State of
Maryland but only 386 practicing child and adolescent psychiatrists.
This means that, for every 100,000 children, there are 28 professionals
covering them. Unfortunately, the number of counties in Maryland that
had no child or adolescent psychiatrists available has increased from 6
to 9. We only have 24 jurisdictions in our State, and 9 of them have
zero help for child psychiatry. This is simply unacceptable. Children
should have access to a full range of prevention, early intervention,
and treatment options within all mental health care systems.
The time to act is now. The lack of behavioral health services in
Maryland and the United States prompted me to help introduce the
Medicaid Ensuring Necessary Telehealth is Available Long-term Health
for Kids and Underserved Act in 2022. It is a long title but an
important title. This bipartisan legislation offered guidance to the
Centers for Medicare and Medicaid Services to increase access to
behavioral health services and treatment via telehealth.
Also, in 2022, I voted to help pass the Bipartisan Safer Communities
Act, which included a provision to allocate funding to support school-
based mental health service providers.
I am proud to have supported the Health Equity and Accountability Act
since its introduction to the Senate. This comprehensive legislation
aims to address health disparities throughout our healthcare system,
including eliminating structural barriers that contribute to mental
health and substance use disorder inequities.
Older adults' mental health needs are often forgotten or thought not
necessary. In 2020, the Kaiser Family Foundation found that one in four
adults aged 65 and older reported anxiety or depression. Among Medicare
beneficiaries, older Hispanic adults reported the highest rates of
being diagnosed with mental health conditions. The number of
psychiatrists accepting Medicare has declined over time--greater need,
less providers, particularly in minority communities. We must find ways
to expand mental health resources to older Americans in our Medicare
system.
I was happy to reintroduce the bipartisan Telemental Health Care
Access Act. This legislation would eliminate certain restrictions or
remove barriers to telemental health services for Medicare
beneficiaries. While this legislation increases access to mental health
care, Congress can always do more. Underserved communities and older
American adults may experience barriers to telehealth access. We have
to make sure that is available.
It is one thing to provide the services; it is another thing to make
sure there is access to the services. People need to know about it.
They need to know it is available. We need to have providers that
participate in it need. We need to have reimbursement systems that
recognize this. All of that has to come together. Unfortunately, when
we look at the underserved communities and minority communities, it is
much more of a challenge.
Behavioral health equity is the right of all individuals--regardless
of race, age, ethnicity, gender, disability, socioeconomic status,
sexual orientation, or ZIP Code--to access high-quality and affordable
healthcare support.
Mental health affects the lives of so many Americans. As a nation, we
have made great progress in better supporting individuals and
communities. So let us, at this time, honor the National Minority
Mental Health Awareness Month, which was held in the month of July. Let
us commit to working together to improve mental health care for all of
our country. The United States has an ever-changing cultural landscape.
We all know that. We must continue to find ways to make sure that no
one group gets forgotten. We must prioritize health equity every month.
I urge my colleagues to join me as we continue to improve behavioral
health for everyone in the United States and work together to ensure
the elimination of health disparities.
With that, I yield the floor.
The PRESIDING OFFICER. The Senator from Hawaii.
Ms. HIRONO. Mr. President, I want to start by thanking my colleague
from Maryland, Senator Cardin, for pointing out the need for mental
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health services in our country and the disparities that exist in our
country in providing such services. I thank Senator Cardin.