Study calls for better access to mental health services

PROVIDENCE — Many barriers are preventing Rhode Islanders, including refugees and non-English speakers, from receiving the behavioral healthcare they need. Among them: language and cultural differences, stigma, the cost and scope of insurance, and disregard of federal law requiring equal coverage for mental and physical healthcare — parity, as it’s known.

Those are among the findings of a new study by the Mental Health Parity Initiative, a project of the Mental Health Association of Rhode Island, that was released on Tuesday.

The study draws on the experiences that patients, family members and community health workers shared in focus groups conducted before the coronavirus pandemic, which has compounded mental-health issues for many people, regardless of background.

“It is difficult enough for Rhode Islanders who speak English as their primary language to navigate our complicated healthcare system,” Laurie-Marie Pisciotta, executive director of the Mental Health Association of Rhode Island, or MHARI, said in announcing the results of the study. “Imagine how much harder it is for people who speak little or no English.”

Among the study’s recommendations:

* Expand the network of bilingual and bicultural providers in Rhode Island.

* Increase access to mental health services and education about these services.

* Strengthen standards and monitoring of cultural competence that are spelled out in agreements between funding agencies and providers. Regarding this, the study states:

“Much more must be done, including mandate ongoing cultural competence training for clinicians and others who provide public mental health services and supports [and] incorporating cultural sensitivity of providers as an outcome measure using the SAMHSA uniform reporting system, as is currently done by 47 other states.”

SAMHSA stands for the federal Substance Abuse and Mental Health Services Administration. The New England administrator since November is Tom Coderre, former senior adviser to Gov. Gina Raimondo on substance-use and mental-health policy.

Pisciotta said her organization “is exploring how we can help build a more diverse and linguistically competent mental healthcare system. We are currently conducting a widescale provider survey to assess, among other things, the racial, ethnic, and lingual diversity of Rhode Island’s licensed behavioral health providers.”

Speaking with The Journal on Monday, Pisciotta said “the COVID-19 pandemic has certainly exacerbated the need for behavioral health treatment and services,” including those that can be accessed through BHLink, the state’s 24-hour behavioral-health triage center and hotline.

“The new report demonstrates how prevalent and damaging stigma is,” Pisciotta continued. Mental health advocates, she said, “have a great deal of work to do on the issue of stigma, and we are calling on everyone else — elected officials, state departments, schools and universities, employers, places of worship, and families — to join us. Mental illness is not a moral failing or a choice. It is an illness just like any other illness.”

Addressing insurance, she said the current system “remains complicated and fractured.”

The parity study was overseen by Ernestine Jennings, an associate professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University, staff psychologist at The Miriam Hospital, and a MHARI board member.

At 3 p.m. Tuesday, Jennings will preside over a “Virtual Town Hall on Racism, Equity & Mental Illness” during which, according to MHARI, “local Rhode Island leaders will come together to discuss and examine the impact of systematic racism on mental health, wellbeing, and access to care.” Registration is required: