Increasing equity in access to mental health care: a critical first step in improving service quality

Alegrı́a, Margarita; Nakash, Ora; NeMoyer, Amanda

doi:10.1002/wps.20486

Cited by 33 publications

(24 citation statements)

References 9 publications

(8 reference statements)

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“…A multitude of factors contribute to health inequity amongst ethnic minority populations including limited social support, lower health literacy, lower socioeconomic status, greater incidence of ill health and a sense of disempowerment [1][2][3][4]. Access to care and language barriers have been the predominant focus of research, with evidence of failure to provide qualified interpreting services to people with limited English proficiency (LEP) as a key contributor to poor care outcomes [5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

The safety of health care for ethnic minority patients: a systematic review

Chauhan

Walton

Manias

et al. 2020

Int J Equity Health

122

145

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Introduction: Evidence to date indicates that patients from ethnic minority backgrounds may experience disparity in the quality and safety of health care they receive due to a range of socio-cultural factors. Although heightened risk of patient safety events is of key concern, there is a dearth of evidence regarding the nature and rate of patient safety events occurring amongst ethnic minority consumers, which is critical for the development of relevant intervention approaches to enhance the safety of their care. Objectives: To establish how ethnic minority populations are conceptualised in the international literature, and the implications of this in shaping of our findings; the evidence of patient safety events arising among ethnic minority healthcare consumers internationally; and the individual, service and system factors that contribute to unsafe care. Method: A systematic review of five databases (MEDLINE, PUBMED, PsycINFO, EMBASE and CINAHL) were undertaken using subject headings (MeSH) and keywords to identify studies relevant to our objectives. Inclusion criteria were applied independently by two researchers. A narrative synthesis was undertaken due to heterogeneity of the study designs of included studies followed by a study appraisal process. Results: Forty-five studies were included in this review. Findings indicate that: (1) those from ethnic minority backgrounds were conceptualised variably; (2) people from ethnic minority backgrounds had higher rates of hospital acquired infections, complications, adverse drug events and dosing errors when compared to the wider population; and (3) factors including language proficiency, beliefs about illness and treatment, formal and informal interpreter use, consumer engagement, and interactions with health professionals contributed to increased risk of safety events amongst these populations. Conclusion: Ethnic minority consumers may experience inequity in the safety of care and be at higher risk of patient safety events. Health services and systems must consider the individual, inter-and intra-ethnic variations in the nature of safety events to understand the where and how to invest resource to enhance equity in the safety of care. Review registration: This systematic review is registered with Research Registry: reviewregistry761.

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Section: Introductionmentioning

confidence: 99%

The safety of health care for ethnic minority patients: a systematic review

Chauhan

Walton

Manias

et al. 2020

Int J Equity Health

122

145

View full text Add to dashboard Cite

show abstract

“…The current trend in measuring the quality of mental health has been taken into account, where research interest has now shifted from measuring structures and services to prognosis, outcome, and outcome measurement [69]. Nor has it escaped our attention that the over-focus on outcomes often overlooks populations with low access to mental health services, mainly due to their disadvantaged socio-economic status [70]. Efforts have been made so that the findings can be generalized in order to provide a tool for quality assessment and improvement in any health system.…”

Section: Discussionmentioning

confidence: 99%

Assessing and Improving the Quality in Mental Health Services

Samartzis

Talias

2019

IJERPH

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Background: The mental health of the population consists of the three essential pillars of quality of life, economy, and society. Mental health services take care of the prevention and treatment of mental disorders and through them maintain, improve, and restore the mental health of the population. The purpose of this study is to describe the methodology for qualitative and quantitative evaluation and improvement of the mental health service system. Methods: This is a narrative review study that searches the literature to provide criteria, indicators, and methodology for evaluating and improving the quality of mental health services and the related qualitative and quantitative indicators. The bibliography was searched in popular databases PubMed, Google Scholar, CINAHL, using the keywords "mental", "health", "quality", "indicators", alone or in combinations thereof. Results: Important quality indicators of mental health services have been collected and presented, and modified where appropriate. The definition of each indicator is presented here, alongside its method of calculation and importance. Each indicator belongs to one of the eight dimensions of quality assessment: (1) Suitability of services, (2) Accessibility of patients to services, (3) Acceptance of services by patients, (4) Ability of healthcare professionals to provide services, (5) Efficiency of health professionals and providers, (6) Continuity of service over time (ensuring therapeutic continuity), (7) Efficiency of health professionals and services, (8) Safety (for patients and for health professionals). Discussion/Conclusions: Accessibility and acceptability of service indicators are important for the attractiveness of services related to their use by the population. Profitability indicators are important economic indicators that affect the viability and sustainability of services, factors that are now taken into account in any health policy. All of the indicators mentioned are related to public health, affecting the quality of life, morbidity, mortality, and life expectancy, directly or indirectly. The systematic measurement and monitoring of indicators and the measurement and quantification of quality through them, are the basis for evidence-based health policy for improvement of the quality of mental health services.

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“…Medicare Parts B and D have both positive and negative outcomes pertaining to the treatment of mental illness for African American and Latin/x older adults. While numerous African American and Latin/x older adults receive mental healthcare services through Medicare Parts B and D, both populations still experience barriers to mental health, which include stigma, inadequate access to healthcare, challenges in affording services, and barriers to treatment (Alegria et al 2018;Miranda et al 2019;Riley 2012;VanderWielen et al 2016). Research has found that across all older adults in need of mental health treatment, Black participants are less likely to receive culturally effective care (Jimenez et al 2012).…”

Section: Phase Five: Actual Impactmentioning

confidence: 99%

A Critical Policy Analysis of Medicare Parts B and D: a Focus on Latin/x and African American Older Adult Mental Health

Miller

Wilfong

2020

J of Pol Practice & Research

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Mental health is critical to age well. Mental health concerns (e.g., depression, anxiety) are pervasive in older adulthood, and older adults of minority status experience compounding consequences such as discrimination and stigma, which may place these populations at a greater risk for mental illness. Current legislation provides mental healthcare for older adults; however, the impact of this healthcare coverage on improving the mental health among minority older adults is less known. Thus, the purpose of this article is to explore the impact of Medicare Parts B and D with a focus on Latin/x and African American older adults in the USA. Guided by the Social Determinants of Mental Health and Segal's (2018) critical analysis framework, this analysis framework expands specifically on five components of Segal's critical framework to include (a) the social issue/social problem and affected populations; (b) the power imbalance or struggle driven by political, social, and economic factors; (c) actual policies, public laws, or administrative rules; (d) the implementation of social welfare programs; and (e) the actual impact. Results of this analysis indicate that minority status seniors may experience ongoing challenges with mental health due to long-standing barriers to unmet needs, treatment access, and restrictions and issues in shortages of mental health service providers, primarily licensed clinical social workers. The authors conclude with implications for policy modifications, such as universal healthcare. Finally, implications for social work practice are discussed, as part of the Grand Challenges for Social Work to close the health gap.

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Increasing equity in access to mental health care: a critical first step in improving service quality

Cited by 33 publications

References 9 publications

The safety of health care for ethnic minority patients: a systematic review

The safety of health care for ethnic minority patients: a systematic review

Assessing and Improving the Quality in Mental Health Services

A Critical Policy Analysis of Medicare Parts B and D: a Focus on Latin/x and African American Older Adult Mental Health

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