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Margarita Alegria | g Force

Mental health champion

(Justin Knight Photography)
July 4, 2011

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Q. What do you think are the biggest issues in mental health care for racial and ethnic minorities right now?

A. The biggest issue by far is access. Policies make it very difficult for people to access mental health or substance abuse care. [Also,] the issue of low medicaid payments to providers. The workforce issue. There’s still a lot of worry about your employer finding out you might be going to a mental health provider or substance abuse provider. If we had mechanisms in place where people could call during their lunch hour, that would make it a lot easier.

Q. When someone does come in to get care, what problems do they face?

A. People have the expectation that they should start feeling better right away, but it takes a little while. And then people drop out of care because they feel, “Well, I’m not getting better right away.’’ Or “I can really solve the problem on my own.’’ Or thinking the type of problem they have is not really going to be solved by professional health care.

Q. But obviously, you think it’s important to address mental health.

A. In the same way that you should exercise, try to eat healthy, and do things to better your physical fitness, we should be doing the same for mental health. We should be trying to make sure that people feel that their stress levels are under control, that they have coping skills, that they have people with whom they can disclose their problems.

Q. Is stress a particular problem in minority communities?

A. The stress that people are experiencing today is enormous. We are seeing people who are undergoing a lot of stress, a lot of isolation. But they think maybe this is going to pass and maybe I can solve it on my own. There is a lot of resilience, which is really good - I don’t want to minimize that. But I think learning when do you have to get professional help to make sure you don’t go under, is quite important.

Q. So, when should people seek help?

A. When you start seeing that your functioning is not the same. If you start seeing that it’s a lot harder to work, that you’re feeling hopeless, that you don’t feel yourself.

Q. Do people respond better to a mental health counselor who is from the same ethnic or racial background?

A. I actually think it doesn’t necessarily have to be someone from the same racial, ethnic background, or the same gender. I think what really matters is that that connection gets established.

Q. Substance abuse is also a big concern of yours. What do you think is most important in this area right now?

A. I think we’re not making enough of an effort to provide easy access to substance abuse treatments. There’s limited [racial or ethnic] disparity because no one’s really getting any care.

Q. And what role do patients need to play in getting better mental health or substance abuse care for themselves?

A. More than ever, I think people have to become their care managers and really learn how to advocate for themselves. There is some evidence that the people who are [active in their care] are the ones who have increased likelihood of getting good quality care. Knowing more about your condition, knowing more about your options for treatment, knowing more about what are the things you should ask to make sure you’re getting the best quality of care. It also makes the provider react differently to you.

KAREN WEINTRAUB

This interview has been edited and condensed. Karen Weintraub can be reached at karen@karenweintraub.com.

WHO
Margarita Alegrķa
WHAT
Alegrķa is director of Cambridge Health Alliance’s Center for Multicultural Mental Health Research.

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