The majority of patients in state mental hospitals are ethnic minorities and they are diagnosed with more severe mental disorders than are whites at both state and local mental health centers, state officials said Wednesday in presenting new data to the first statewide conference on mental health and ethnic population growth.
As the non-white population grows to two-thirds of California's total by century's end, the number of non-white residents needing mental health treatment will increase significantly and require much greater attention from mental health professionals, the conference in San Diego was told.
Officials later visited a socialization and rehabilitation center for chronically mentally ill Southeast Asian residents in San Diego, the first in the nation to offer such service, as an example of treatment programs they want to see expanded.
"A lot of time (in the past) this issue has just been given lip service," Dr. D. Michael O'Connor, director of the California Department of Mental Health, said at the meeting. "I hope that (this conference) will be a trend-setter and that the issue will take hold . . . all counties now have minority mental-health coordinators."
The number of persons being treated in public mental health programs is at least half the total number of Californians seeking such medical help and the individuals tend to be in lower socio-economic positions, according to Dr. Steven P. Shon, the department's clinical services director. Wealthier individuals can seek a wide array of private treatment, although Shon said that even those individuals often end up in some form of publicly supported treatment if they require extensive long-range treatment after private insurance benefits end.
The nature of the problem was outlined by Shon, in statistics developed by the state for the first time. Among them:
- Black Californians are admitted to state hospitals at three times the rate expected based on their percentage of state population, and are in local mental health programs at twice their proportion of the general population. Blacks also enter both state and local mental health programs through the criminal system at higher levels, with a disproportionate number classified as mentally disordered offenders.
- Asians and Filipinos are admitted to state and local programs at less than half of their state population percentage, but their numbers are rapidly rising because families split by dislocation and the strains of emigration find themselves unable to care for affected family members as they have traditionally.
- Latinos increasingly are entering mental health programs, which reflects the rapid increase in Latino population. Their use of such programs depends in large part on educational and economic status.
- Minorities have a disproportionately high diagnosis of serious illnesses such as schizophrenia compared to whites in the system, who show less severe diagnoses sometimes referred to as the "worried well" syndrome. Whites also tend to be more elderly than minorities receiving treatment.
Both O'Connor and Shon later offered several explanations for the figures.
Shon said that blacks are concentrated in lower socio-economic brackets and that research has consistently shown a higher level of mental and emotional disorders among poorer people. In addition, he said that blacks may not receive early intervention from community and private programs that either are set up predominantly for white-collar professionals or require private medical insurance.
"They may enter the system much later after the (illness) has become full-blown," Shon said. "We're seeing the same thing beginning to happen with (Latinos) . . . the socio-economic aspect is a very large" factor in terms of when a person begins to receive treatment.
O'Connor agreed, saying that "whites are more likely to take advantage of the system earlier than other groups. We need to make a policy decision to be bi-cultural in our efforts to make sure that minorities will take advantage earlier of services" that are sensitive to their problems.
O'Connor called for immediate recruitment of minorities into mental health fields, and praised the East Wind Socialization Center in San Diego at a special ceremony recognizing its workers for their work in providing mental health rehabilitation to chronically mentally ill Southeast Asian refugees.
The center opened in 1985 and has served 116 persons, mostly Laotian, Vietnamese and Cambodian residents previously hospitalized for serious mental disorders.
State officials praise the program for providing individual attention to ethnic groups unfamiliar with both the concept and treatment of mental illness. An in-patient facility for the Asian-Pacific mentally ill opened last year at the Metropolitan State Hospital in Norwalk.
The center provides pre-vocational training, including clerical help, wood finishing and crafts that are sold in a small thrift shop.
The center also offers courses in English, health education, and field trips as well as individual counseling.
"This is the type of program we need to encourage," O'Connor said, promising to arrange continued funding for the program, which is operating on the third year of a three-year grant combining state and federal funds.