A recent report by KFF, a foundation that provides health policy analysis, found mental health issues on the rise and disparities in mental health treatment in the U.S. for people of color. 

The report found that death by suicide, as well as increased drug overdoses rose during the COVID-19 pandemic and these fatal consequences of mental health and substance abuse disorder disproportionately impact people of color in the U.S. 

According to KFF, New Mexico has slightly higher rates of anxiety and depressive disorder. Drug overdose took a sharp uptick during the pandemic, with New Mexico higher than the national average. 

New Mexico’s drug overdose rate nearly doubled between 2019, the year prior to the pandemic, and 2022, the second year of the public health emergency, from 599 drug overdose deaths in 2019 to 1,052 deaths from drug overdose in 2022.

Death by suicide has been on the rise, in both the U.S. and in New Mexico, since at least 2011. But New Mexico’s rate of death by suicide is higher than the national average, with 525 deaths by suicide in New Mexico in 2022. Of those 525, 409 were male. 

Death by suicide increased fastest in the U.S. among people of color, for younger individuals and for people who live in rural areas, KFF reports.

State Sen. Jerry Ortiz y Pino, D-Albuquerque, who chairs the Senate Health and Public Affairs Committee, told NM Political Report that there are “shortages everywhere,” in behavioral health. 

He said there are treatment facilities that operate under capacity because they are understaffed. He said there aren’t enough behavioral health therapists and, in addition to an overall shortage, there is also a shortage of culturally competent therapists in New Mexico. 

KFF found in its report that people of color are more likely to have trouble finding a therapist who understands their experiences. 

Ortiz y Pino said one possible solution is for the state to create its own educational pipeline for behavioral health therapists to come from New Mexico communities to help with the lack of culturally competent behavioral health therapists. 

He said he would also like to see the licensing process sped up for individuals who have graduated but are waiting to be licensed. He said another tactic is to streamline licensing procedures for out-of-state therapists so they can start practicing right away if they relocate to New Mexico. Ortiz y Pino said that, currently, a licensed therapist in another state has to wait months to begin practicing due to a lengthy process.

He said another tactic is to increase Medicaid reimbursement rates so that a behavioral health therapist can “make a living here.” Nearly half of the state’s population is covered by Medicaid.

“How do we increase services? Bottom line, we need more facilities and more programs to meet the needs of people with serious mental illness. I think we need day treatment programs,” Ortiz y Pino said. 

He said one idea he’s trying to push is a day treatment program where a person who needs treatment could live at home but spend time in the treatment facility each day. Ortiz y Pino said this would cut down on costs. He said providing night staff, security, food and beds to a treatment facility increases the overhead but does not increase the efficacy of the treatment.

KFF found that the number one reason people who reported needing mental health treatment but did not seek it was because of the expense. This can also especially create a barrier for communities of color. 

Deidre Yellowhair, (Diné) a UNM research assistant professor for the UNM Division of Community Behavioral Health, said COVID-19 “really highlighted the need for infrastructure or resources to get services people really do need.”

“When we switched to telehealth [during the pandemic], some patients who needed it the most didn’t have the infrastructure to support telehealth services,” she said. 

Another barrier to accessing mental health treatment is unfair or negative treatment. KFF reports that people of color experience higher levels of unfair or negative treatment, which frequently means they do not return to the therapist or seek a new one.

Thomas Anthony Chavez, University of New Mexico assistant professor in the division of Community Behavioral Health, said the issues begin with the way mental health is studied. It is mostly white people studying the mental health of other white people, he said, which institutionalizes bias. Chavez said this can lead to people of color being compared to the understandings of white mental well-being and for people of color to be mythologized.

“In that regard, what we know about people of color is pretty new in the literature right now,” Chavez said.  

He said the fact that the therapeutic process has been focused on the white middle-class community can lead to treatment being more of “an assimilation process more than a therapeutic process” for people of color. 

“For someone referred to a counselor or therapist in a behavioral health specialty, the value system may not match up, or align well. That’s because every cultural group has its own way of dealing with mental illness. It’s not new to these cultural groups. There could be traditional practices. We have to take that into consideration,” he said. 

Chavez said that there is a hesitancy to seek help in any medical system because of distrust and because “racial bias is perpetuated or continues on through every system from structures, institutionalized in every system.” 

In addition to her role as a UNM research assistant professor, Yellowhair is also the project director of a program that provides educational training and knowledge about historical trauma and its impact on both parenting and suicide rates amongst Native people. She said that when considering culture and traditions and languages for communities of color, a person of color could be “stigmatized or pathologized when really it may be a cultural difference in values and views of the world.”

Yellowhair used as an example the fact that in many Tribal communities, it’s normal to have multigenerational housing, with aunts, uncles and grandparents living under one roof. She said that could be seen as “not individuating or a lack of autonomy.”

“But from a cultural perspective, having a multigenerational family home is really a protective factor,” Yellowhair said. 

Yellowhair also said historical trauma has an impact on the way an individual processes things and influences how that person interacts with different systems. 

“If you take a look at the history of the U.S. since colonization, the policies and events in history have shaped the way communities of color have had interactions with the judicial, educational and healthcare systems. With healthcare, what is measured with wellness, they don’t use people of color and their experiences. Rather, they often use white populations to measure what is normal,” Yellowhair said. 

Chavez said that people of color are more likely to come from a more collectivist society “so that family is an essential way of being.”

“How we define the self can be very different for people of color; it can be very interdependent. How family is defined varies and how structures of family are, are very different across cultures. Family might be a strong source of resiliency,” Chavez said. 

Yellowhair said a “multisystemic cultural shift” is necessary, which would include more people of color on licensing boards, in professional organizations, as well as in the field itself. 

Yellowhair said there are more than 570 federally recognized tribes in the U.S. but only about 200 Native psychologists. She said to change that requires a multisystemic change so that there are “culturally safe spaces” for Indigenous individuals to get degrees and find institutions to work with. 

Chavez said another problem is that, as a researcher, it can be hard to obtain funding to study issues relevant to communities of color. One example of this is that “healing practices are rarely funded.”

“But those are practices that are important for Hispanic, Latino communities. It’s part of life and what kept them strong for generations,” Chavez said. 

Yellowhair said institutions need to “make room for Indigenous traditional knowledge and accepting it as knowledge.”

“We have to not take a top-down approach, put funding into communities and building more mental health services but at the grass roots level. It feels so hierarchical; it’s embedded in our language. It takes the grass roots level of helping us with the understanding to provide these services that help their needs. Instead of saying ‘here’s a box; this is what wellness looks like, we want you to fit into it,’” Yellowhair said.