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Behavioral
Health disparities in Lucas County means that minorities
such as African Americans are more likely to be needlessly
hospitalized, experience unnecessary direct encounters with
the criminal justice system and less likely to receive
access to proactive mental health care compared to whites.
Ultimately, then, not only are underserved populations
deprived of positive mental health outcomes, the lack of
health equity for blacks also jeopardizes valuable economic
benefits for the community and the entire county.
Last year
the Lucas County Mental Health and Recovery Services Board (MHRSB)
served 32,000 people in order to save lives and lead
individuals to recovery. Thirty three percent of those
served were African Americans and another six percent were
Latino. Ten thousand of the 32,000 were youth.
The MHRSB,
now in its 50th year, is currently running Issue
11, a renewal levy to continue promoting inclusion,
diversity and health equity. I spoke with MHRSB Executive
Director Scott Sylak, to discuss the levy and issue of
mental health equity. This is the final installment of our
two-part conversation.
Perryman:
What is meant by the term health equity?
Sylak:
We want to improve health outcomes for minority populations
who would otherwise not receive the quality of care that
will allow them to thrive in their communities. So we know
that in receiving quality behavioral healthcare you are more
than likely to improve your physical healthcare too. People
who are not stable on their psychotropic medications are
unlikely to be taking their insulin, for instance, or their
high blood pressure medications, cholesterol medications or
other more serious medications, so that using behavioral
healthcare as the bridge to improving healthcare in general
is something we are very interested in.
Perryman:
And closing disparities among people of color as compared to
the majority population, I would assume.
Sylak:
That’s well stated. The other thing I wanted to bring up in
relation to African American males being overrepresented is
the realization that 36% of the individuals that receive
services in our system are referred through the criminal
justice system. The disproportionate minority contact
within the criminal justice system is well documented in
Lucas County and a strategy that we are implementing is to
divert individuals away from the system. This strategy is
changing the way we improve access to diversion programs,
services or employment opportunities that can lead to
stability within their communities.
Perryman:
We’ve talked so much about the link between criminal justice
and mental health, but there is also an important but
underreported economic link to mental health. A study by the
National Institute of Mental Health concludes that poor
functioning while at work accounts for more lost days on the
job than absenteeism. So that means that there’s a lot of
lost productivity due to people who are functioning, but who
still have some mental health challenges. Additionally, the
study estimates that over six percent of workers in this
country have major depression, which translates to
approximately $37 billion lost to this illness every year.
So this is an issue that’s not just in the criminal justice
system, but it’s an issue that’s in the everyday population
that may indicate a silent epidemic.
Sylak:
We need to do a better job of creating employment
opportunities and supporting those who are already employed,
there’s no doubt about that. We also need to do a better job
of identifying people earlier on in the spectrum of mental
health issues so that doesn’t evolve into more serious
issues down the road, and that is one of the reasons why the
continuation of these local levy funds are so important to
us.
But yes,
individuals who are more stable in their recovery are more
productive in their employment, and are able to work and
thrive. Many of the people in our system are employed and
are employable and actually want to work.
Perryman:
As a pastor, I have observed, that sometimes those who have
mental health challenges such as anxiety or depression, are
sitting in our congregations. Someone has asked the question
“What does depression look like?” The answer was,
“Depression could be a black and blue bruise on a relative,
it could be an overweight mother who forgets to take her
blood pressure, it could be a corporate executive who wears
an airtight game face all day, overworking themselves, or a
person overeating or even a pastor who preaches with the
Holy Spirit on Sunday but has some substance usage problems
at night or even somebody just that’s not functional at home
as far as cleaning up the house or taking care of themselves
personally,” (Williams, 2008). So, my question is, how can
we recognize mental health issues in our churches or in our
families when the symptoms are not so pronounced, but where
intervention is truly critical?
Sylak:
Research tells us that most people, if they’re feeling that
way, that they will tell you. So asking them in a
supportive manner, identifying why you are asking the
question, is very appropriate. Educating yourselves as to
what resources are available is the second step of helping
that individual engage in at least an assessment to
determine if there are more treatment services needed.
There are many things out there that can help our local
faith communities. The MHRSB has a mental health first aid
component that is available to the faith community. It is
an 8-hour training to help people identify when individuals
are likely to need an intervention of some kind, somebody to
talk to and what to do when that intervention moves beyond a
spiritual base to a need for a clinical intervention,
potential medication or hospitalization. We don’t want to
discount the role that spirituality plays in recovery. Many
people enter recovery through spiritual guidance and there
are many examples of both spiritual and clinical practices
coexisting and supporting each other.
Perryman:
Finally, talk about the groundbreaking work you’ve done in
diversity and inclusion, including your efforts to engage
with black vendors and to increase African-American
employment throughout the system.
Sylak:
It is my belief that our work in this area needs to be
intentional. We need to create strategies that engage
minority communities in a way that they are comfortable to
seek employment, seek board leadership not only on our
board, but also in the agencies that we fund. So, we have
actually added policy language into our contracts and are
monitoring efforts to improve percentage rates at our board
level, our staff level, our agency employment level and at
our agency board leadership goals. We want to ensure that
our public monies reflect the demographics of those in which
we represent. So we take our role of diversity and
inclusion very seriously.
In
addition, we have a director in charge of health equity. We
have $300,000 in our line item budget to improve health
equity conditions in Lucas County as they relate to
behavioral health. We have a $100,000 budget for community
funds of which many of those small $5000 grants go to
minority led enterprises in the communities that are
engaging at risk populations and minority populations in a
way that our provider networks will never be able to do. We
know that by doing that, we can help improve development,
social emotional development of youth, to help them develop
better skills, to improve conflict resolution, perform
better in school and to then ultimately help them to avoid
contact with the criminal justice system.
Perryman:
Is there anything else you want to add?
Sylak:
Well, I’m going to remind you, sir, that this is a not a new
tax and we also have a fantastic levy chair, Pastor Donald
L. Perryman, if you want to call him for any additional
questions (Laughter).
Perryman:
Thank you!
* full
disclosure: Donald L. Perryman is a former board member of
the MHRSB and is current levy chairman for Issue 11.
Contact Rev. Donald Perryman, D.Min, at
drdlperryman@centerofhopebaptist.org
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