Last week, the Biden-Harris Administration hosted its inaugural mental health summit focused on improving equity and access to behavioral health care for Asian American, Native Hawaiian, and Pacific Islander (AA and NHPI) communities. The White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders (WHIAANHPI) and the U.S. Department of Health and Human Services (HHS) hosted this historic event in recognition of National Minority Mental Health Awareness Month, building on the Administration’s unprecedented investments to connect more Americans to care.
In the wake of the COVID-19 pandemic, rising anti-Asian hate, and the twin public health and public safety epidemic of gun violence, AA and NHPI communities have been deeply impacted by the nation’s mental health crisis. And the task of expanding access to quality and culturally competent medical, including mental health services for AA and NHPI individuals has only grown more urgent. In 2020, suicide was the leading cause of death among Asian Americans and Pacific Islanders, ages 10 to 19, and the second leading cause of death among those ages 20-34. And AA and NHPIs currently face unique barriers to behavioral health care, including:
- Language barriers, which can make it difficult for AA and NHPIs to access behavioral health services;
- Stigmatization and negative cultural conceptualizations of behavioral health within AA and NHPI communities, which can reduce help-seeking;
- A perceived lower need of mental health care among AA and NHPIs compared to other racial and ethnic groups;
- A shortage of clinicians with diverse racial/ethnic backgrounds; and
- The lack of culturally competent providers to meet cultural, social, and language-related needs
Through the President’s Mental Health Strategy and other initiatives, the Biden-Harris Administration is leading a whole-of-society approach to transform behavioral health services and bolster support, particularly for underserved communities, including AA and NHPI communities. Over the past two years, federal agencies have worked to eliminate barriers to care; expand the full continuum of prevention, treatment, and recovery services; and prioritize integration of these services into settings where they can be more easily accessed.
Funding Programs to Advance Behavioral Health Equity
- In September 2022, the Department of Health and Human Services (HHS), through Substance Abuse and Mental Health Services Administration (SAMHSA), awarded a 5-year grant for $700,000 per year to the Hawaii State Department of Health to establish the first ever Asian American, Native Hawaiian, and Pacific Islander Behavioral Health Center of Excellence (AANHPI-CoE) to advance behavioral health equity for AA and NHPI communities. The purpose of the COE is to develop and disseminate culturally-informed, evidence-based behavioral health information and to provide technical assistance and training on issues related to addressing behavioral health disparities in AA, NH, and PI communities, include addressing mental health impacts caused by unconscious bias and hate against AA and NHPI communities. The COE serves as a resource to behavioral healthcare providers, community-based and faith-based organizations, research institutions, and federal entities. SAMHSA expects this program will help reduce the impact of behavioral health-related disparities on AA, NH, and PI communities.
- HHS/SAMHSA also funds the National Network to Eliminate Disparities in Behavioral Health (NNED), a network of more than 1,500 community-based organizations serving underserved communities across the U.S., including AA and NHPI populations, focused on the mental health and substance use issues facing diverse racial and ethnic communities. Organizations can contact the NNED to request information, training, and technical assistance to promote behavioral health equity.
- HHS’s Administration for Children and Families (ACF), Family Violence Prevention and Services Act (FVPSA) Program awarded $1 million in September 2022, through a cooperative agreement to Pouhana O Na Wahine, to serve as FVPSA’s national technical assistance provider for the Native Hawaiian communities and to establish the first ever Native Hawaiian Resource Center on Domestic Violence (NHRCDV). The historic center will provide culturally informed support and care specific to Native Hawaiians, offering a comprehensive array of statewide community education, training, and technical assistance resources to organizations and providers of services to Native Hawaiians, specifically designed to enhance the capacity of organizations and providers to respond to family violence, domestic violence, and dating violence in a culturally sensitive and relevant manner.
- HHS’s Administration for Community Living (ACL) funds the National Asian Pacific Center on Aging (NAPCA) as part of the Older Adults Equity Collaborative. NAPCA launched a National COVID-19 Vaccine Resource Map, including in-language support for scheduling vaccination appointments and in December 2021, called upon the nation’s leaders to meet the emerging needs of AA and NHPI caregivers.
- HHS’s Centers for Disease Control and Prevention (CDC) has an Office of Island Affairs (OIA) that strengthens public health systems to improve public health outcomes for the U.S. territories and freely associated states by facilitating technical assistance, training, information, funding, and technology transfer. OIA works closely with the five territories (American Samoa, Commonwealth of the Northern Mariana Islands, Guam, Puerto Rico, and the U.S. Virgin Islands) and three freely associated states (Federated States of Micronesia, Republic of Palau, and the Republic of the Marshall Islands), connecting them to CDC programs, funding, and resources to strengthen their public health systems and improve community health.
- CDC supports the Interagency Island Affairs Council. Launched in 2022, this council convenes federal leaders to identify, coordinate, and advance funding, programmatic, and policy issues to improve health equity in the U.S. Territories and Freely Associated States. CDC also funds the Pacific Island Health Officers Association, which trains the next generation of public health leaders through its Pacific Public Health Fellowship Program. PIHOA played a central role in the region’s COVID-19 response.
- HHS’s ACF is combating human trafficking of AA and NHPI populations. This is a priority pursuant to the National Action Plan to Combat Human Trafficking which calls for HHS to provide training and technical assistance for health and human service professionals working with populations at high risk for human trafficking and intersecting with NHPI community programs. Indigenous people worldwide are at particular risk of both sex and labor trafficking, and HHS’s Administration for Native Americans has found that American Indian, Alaska Native, Native Hawaiian, and Pacific Islander women and girls are at high risk for experiencing sex trafficking.
Promoting Language Access and Disseminating Critical Health Information
- Under Secretary Xavier Becerra’s leadership, HHS has prioritized providing access to language services appropriate to health and behavioral health care services. The cross-agency Language Access Steering Committee was relaunched and in May 2023, the HHS Office of Civil Rights released its Language Access Annual Progress Report which detailed key priority areas of focus and the strategic creation of the new Language Access Coordinator position in OCR, along with a centralized language access center. Full implementation of the HHS Language Access Plan will result in a department-wide culture change that prioritizes equity in the delivery of HHS conducted and funded programs, which ultimately will contribute to improved health outcomes and reduced health disparities for underserved communities, including the AA and NHPI populations.
- CDC awarded over $3M to the Asian & Pacific Islander American Health Forum to forge community partnerships and translate information into over 30 AA and NHPI languages.
- HHS’s Health Resources and Services Administration (HRSA) continues to fund the Association of Asian Pacific Community Health Organizations, which supports health centers serving AA and NHPI populations through technical assistance, training, language access, cultural competency and supportive services. HRSA produced the Pacific Basin Telehealth Resource Center’s “Translation Toolkit” which includes resources in Japanese, Chuukese, Ilocano, Korean, Marshallese, Samoan, Tagalog, Chinese and Vietnamese.
- HHS’s Center for Medicare & Medicaid Services (CMS) expanded culturally appropriate and understandable health care information for AA and NHPI communities, including releasing the “Medicare & You” handbook for the first time in Chinese, Korean and Vietnamese, and the AA and NHPI Fact Sheet on Medicare enrollment. CMS is implementing a new segment of required cultural competency training for Marketplace agents and brokers participating in the Marketplace for Plan Year 2023.
Conducting New Research and Creating Better Data
- In May 2022, the White House and WHIAANHPI hosted the White House Forum on Asian Americans, Native Hawaiians, and Pacific Islanders, which featured a breakout convening dedicated to the mental health of AA and NHPI communities. The event featured White House and federal agency officials, along with community advocates and stakeholders. Watch the breakout convening here.
- SAMHSA is committed to increasing actionable data on AA and NHPI populations and ensuring adequate sampling and disaggregation of the data. SAMHSA’s National Survey on Drug Use and Health with a respondent pool of over 65,000 residents in the U.S. and data analysis separating AA and NHPI presented their first ever report with results disaggregated by race and ethnicity.
- The HHS National Institutes of Health (NIH) Office of Research on Women’s Health funded 28 research projects addressing AA and NHPI populations in a dozen states to reduce the health equity gap among women who have been historically understudied, underrepresented, and underreported through the ORWH U3 Interdisciplinary Research Program.
- The Department of Veterans Affairs conducted an equity assessment to understand the unmet needs of minority and Women veterans in the Pacific Islands and freely associated states (FAS). VA also completed a study on mental health disparities and released the AA and NHPI Mental Health Information Brief and the Asian and Native Hawaiian and Other Pacific Islander Veteran Chartbook.
Providing Mental Health Services in Schools
- Through the Bipartisan Safer Communities Act, the U.S. Department of Education (ED) received $500 million for competitively awarded School-Based Mental Health (SBMH) Services Grants designed to increase the number of credentialed school-based mental health services providers delivering school-based mental health services to students.
- ED also received $500 million for competitively awarded Mental Health Services Professionals (MHSP) Demonstration Grants to support innovative partnerships involving states, school districts, and institutions of higher education (IHEs) to train and increase the number and diversity of high-quality school-based mental health services providers available to address shortages of such providers in schools within high-need districts. Nearly half of the new MHSP awardees included a partnership with a Minority Serving Institution, Historically Black College or University, or Tribal College.
- To support grantees funded under the SBHM and MHSP grant programs, ED will fund a first of its kind school-based mental health personnel technical assistance center. This center will provide support and resources to grantees, help ensure accurate data-collection and reporting to gauge progress, and disseminate best practices in credentialing, recruiting, training and developing, and retaining school-based mental health services providers.
Supporting the Mental Health of Workers
- The U.S. Department of Labor’s Occupational Safety and Health Administration developed a workplace stress toolkit for employers with guidance, training, and outreach materials to help improve employee mental health and well-being. Also, this year’s Safe + Sound week will be focusing on mental health. Safe + Sound Week is a nationwide event held each August that recognizes the successes of workplace health and safety programs and offers information and ideas on how to develop safety and health programs. Throughout the week, OSHA will be providing resources for businesses on mental health and well-being. These OSHA webpages are available in four Asian languages (Chinese, Korean, Nepali, and Vietnamese).
- The U.S. Department of Labor’s Office of Disability Employment Policy (ODEP) launched in March 2022 a Public Service Announcement Campaign titled “Mental Health at Work: What Can I do?” and published a guide to raise awareness about mental health in their workplaces.
Delivering Justice and Providing Resources to AA and NHPI Communities
- HHS’s Office of Minority Health is the lead response agency for the Memorandum Condemning and Combating Racism, Xenophobia, and Intolerance Against Asian Americans and Pacific Islanders in the United States. HHS and the U.S. Department of Justice (DOJ) jointly issued guidance in May 2022 aimed at raising awareness of hate crimes and incidents committed on the basis of personal or group characteristics. The Office of Minority Health (OMH) has convened a cross-Departmental work group of 30+ members to support the development of guidance aligned with the Memorandum directives. Through this guidance, HHS and DOJ aim to raise awareness about hate crimes and incidents and propel the use of awareness as a tool for action, response, and prevention and provide tools to empower law enforcement and communities most frequently impacted by unlawful acts of hate. Implementation of the guidance is anticipated by September 2023.
- Addressing Gender-Based Violence: DOJ’s Office on Violence against Women (OVW) administers grants authorized by the Violence Against Women Act and subsequent legislation to address domestic violence, sexual assault, dating violence, and stalking. OVW provides multiple grant opportunities that fund support services for historically marginalized and underserved communities, particularly those facing disproportionate rates or impacts of violence and multiple barriers to services, justice, and safety. AANHPI community-based organizations are encouraged to apply for all eligible OVW grant programs. In particular, the Grants to Enhance Culturally Specific Services for Victims of Sexual Assault, Domestic Violence, Dating Violence, and Stalking Program (Culturally Specific Services Program) and The Sexual Assault Services Culturally Specific Program (SAS Culturally Specific Program) support organizations that are uniquely situated to respond to the needs of culturally specific populations. AANHPI organizations can also apply as sub-recipients of the STOP (Services, Training, Officers, and Prosecutors) Violence Against Women Formula Grant Program and the Sexual Assault Services Formula Grant Program (SASP), which are awarded to states and territories. More information on STOP and SASP funds can be obtained through their state’s STOP and SASP administrators.
- Department of Justice Community Relations Service (CRS): CRS has designed and offers a community response prevention & response plan to AA and NHPI communities who are facing bias and hate incidents. CRS is prepared to provide services to AA and NHPI communities in the development of community contingency plans to respond to bias and hate incidents. Within this document are best practices that can be used by working groups to develop a community response plan.
- Countering the Rise in Hate Crimes: DOJ has awarded more than $32 million in grants to address the rise in hate crimes. The department looks for applications to support comprehensive community-based approaches to preventing and addressing hate crimes. This represents a continuation of their commitment to improving the investigation and prosecution of hate crimes and cold cases through the Matthew Shepard and James Byrd Jr. Hate Crimes Program and the Emmett Till Cold Case Investigations and Prosecution Program. The Jabara-Heyer NO HATE Act authorized funding for new state hate crimes hotlines. Additionally, they have opened a solicitation for rigorous research and evaluation projects to better understand efforts to prevent hate crimes.
- Justice and Mental Health Collaboration Program (JMHCP): The DOJ Office of Justice Programs’ (OJP) JMHCP supports innovative, cross-system collaborations between public safety and behavioral health professionals to improve responses to and outcomes for individuals with mental health or co-occurring substance use disorders who come in contact with the justice system.. Specifically, grants and associated training and technical assistance under this program is used to create or expand:
- Programs that support cooperative efforts by public safety officials and service providers (at any point in the system) to connect individuals with mental health or co-occurring substance use disorders with treatment and social services
- Mental health courts or other court-based programs
- Programs that offer specialized training for public safety officials and mental health providers in order to respond appropriately to individuals with mental health or co-occurring substance use disorders
- Programs that support intergovernmental cooperation between state and local governments to address enhanced support to individuals with mental health or co-occurring substance use disorders
- Protecting Rights, Access and Equity for Crime Victims: This year, OJP’s Office for Victims of Crime (OVC) has provided new funding opportunities to build the capacity of victim service programs and widen the reach of services. OVC initiatives will deepen expertise and improve cultural responsiveness through fellowships, peer-to-peer support networks and professional development programs in tribal communities. OVC will also solicit field-generated proposals to help close the gap between victims’ needs and available services.
- Advancing Public Safety and Public Trust: Opportunities are available to support innovative evidence-based policing and prosecution practices under OJP’s Bureau of Justice Assistance’s (BJA) Smart Suite. Other grant funding solicitations are designed to support small and rural law enforcement agencies, help police address cybercrime and expand the ranks of women in the law enforcement profession. Additional funding opportunities provided by BJA will help jurisdictions prevent school violence and deliver training and technical assistance to recipients of STOP School Violence grants. Finally, DOJ will continue their long-standing support of state and local public safety efforts under the Edward Byrne Memorial Justice Assistance Grants program.
- Advancing Science and Innovation: This year, OJP’s National Institute of Justice (NIJ) is inviting proposals to deliver insights on some of the biggest challenges of our time, including firearms violence and mass shootings and police accountability and officer wellness. FY2023 solicitations included efforts to study racial and ethnic disparities in the justice system and the impact of court tools, practices and policies on indigent defense services in light of the 60th anniversary of the Supreme Court’s decision in Gideon v. Wainwright. New opportunities in FY2023 also included research to add to the body of empirical knowledge around jails and to develop our nation’s forensic capacity.