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The Affordable Care Act and integrated behavioral health programs in community health centers to promote utilization of mental health services among Asian Americans

  • Practice and Public Health Policies
  • Published:
Translational Behavioral Medicine

An Erratum to this article was published on 17 May 2016

Abstract

The Affordable Care Act has greatly expanded health care coverage and recognizes mental health as a major priority. However, individuals suffering from mental health disorders still face layered barriers to receiving health care, especially Asian Americans. Integration of behavioral health services within primary care is a viable way of addressing underutilization of mental health services. This paper provides insight into a comprehensive care approach integrating behavioral health services into primary care to address underutilization of mental health services in the Asian American population. True integration of behavioral health services into primary care will require financial support and payment reform to address multi-disciplinary care needs and optimize care coordination, as well as training and workforce development early in medical and mental health training programs to develop the skills that aid prevention, early identification, and intervention. Funding research on evidence-based practice oriented to the Asian American population needs to continue.

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References

  1. U.S. Department of Health and Human Services. Health Insurance Marketplaces 2015 Open Enrollment Period: March Enrollment Report. 2015 [updated 2015; cited December 2015]; Available from: http://aspe.hhs.gov/sites/default/files/pdf/83656/ib_2015mar_enrollment.pdf.

  2. Department of Health & Human Services. Medicaid & CHIP: August 2015 Monthly Applications, Eligibility Determinations and Enrollment Report. 2015 [updated 2015; cited December 4, 2015]; Available from: http://medicaid.gov/medicaid-chip-program-information/program-information/downloads/august-2015-enrollment-report.pdf.

  3. Urban Institute Health Policy Center. Health care access and cost barriers for adults with physical or mental health issues: evidence of significant gaps as the ACA marketplaces opened their doors. 2014 [updated 2014; cited December 4, 2015]; Available from: http://hrms.urban.org/briefs/evidence-of-significant-gaps.pdf.

  4. Beronio K, Glied S, Frank R. How the affordable care act and mental health parity and addiction equity act greatly expand coverage of behavioral health care. J Behav Health Serv Res. 2014; 41(4): 410-28.

    Article  PubMed  Google Scholar 

  5. Substance Abuse and Mental Health Services Administration (SAMHSA). Health Financing. 2014 [updated 2014; cited November 10, 2014]; Available from: http://www.samhsa.gov/health-financing.

  6. Leong FTL, Kalibatseva Z. Cross-cultural barriers to mental health services in the United States. Cerebrum: Dana Forum Brain Sci. 2011; 2011: 5.

    Google Scholar 

  7. U.S. Census Bureau. The Asian Population: 2010: U.S. Census Bureau; 2012 Contract No.: Document Number|.

  8. Grieco EM. Race and Hispanic Origin of the Foreign-Born Population in the United States: 2007 (American Community Survey Report): U.S. Census Bureau; 2010 Contract No.: Document Number|.

  9. Pew Research Center. The rise of Asian Americans. Washington, DC: Pew Research Center; 2013. Contract No.: Document Number|.

    Google Scholar 

  10. Sorkin D, Tan AL, Hays RD, et al. Self-reported health status of Vietnamese and non-Hispanic white older adults in California. J Am Geriatr Soc. 2008; 56(8): 1543-8.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kwok J. Factors that influence the diagnoses of Asian Americans in mental health: an exploration. Perspect Psychiatr Care. 2013; 49(4): 288-92.

    PubMed  Google Scholar 

  12. Tang M. Psychological effects on being perceived as “model minority” for Asian Americans. New Waves: Educ Res Dev. 2007; 11(3): 11-6.

    Google Scholar 

  13. Lin KM, Cheung F. Mental health issues for Asian Americans. Psychiatr Serv. 1999; 50(6): 774-80.

    Article  CAS  PubMed  Google Scholar 

  14. Abe-Kim J, Takeuchi DT, Hong S, et al. Use of mental health-related services among immigrant and US-born Asian Americans: results from the National Latino and Asian American Study. Am J Public Health. 2007; 97(1): 91-8.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Lee SY, Martins SS, Lee HB. Mental disorders and mental health service use across Asian American subethnic groups in the United States. Community Ment Health J. 2014.

  16. Leong FT, Lau AS. Barriers to providing effective mental health services to Asian Americans. Ment Health Serv Res. 2001; 3(4): 201-14.

    Article  CAS  PubMed  Google Scholar 

  17. Tabora BL, Flaskerud JH. Mental health beliefs, practices, and knowledge of Chinese American immigrant women. Issues Ment Health Nurs. 1997; 18(3): 173-89.

    Article  CAS  PubMed  Google Scholar 

  18. Webster DW, Fretz BR. Asian-American, black and white college student’s preference for helping services. J Couns Psychol. 1978; 25: 124-30.

    Article  Google Scholar 

  19. Spencer MS, Chen J, Gee GC, et al. Discrimination and mental health-related service use in a national study of Asian Americans. Am J Public Health. 2010; 100(12): 2410-2417. doi:10.2105/AJPH.2009.176321.

    Article  PubMed  PubMed Central  Google Scholar 

  20. World Health Organization. Integrating Mental Health into Primary Care: A Global Perspective. 2008 [cited December 4, 2015]; Available from: http://www.who.int/mental_health/resources/mentalhealth_PHC_2008.pdf.

  21. National Association of Community Health Centers (NACHC). United States Health Center Fact Sheet. 2011 [cited December 4, 2015]; Available from: http://www.nachc.com/client/US121.pdf.

  22. Health Resources & Services Administration. 2011 National Uniform Data System Report. 2012 [updated 2012; cited October 15, 2014]; Available from: http://bphc.hrsa.gov/healthcenterdatastatistics/.

  23. Collins C, Hewson DL, Munger R, Wade T. Evolving Models of Behavioral Health Integration in Primary Care. Milbank Memorial Fund, New York, NY, 2010. p.16 [updated 2010; cited December 4, 2015]; Available from: http://www.milbank.org/uploads/documents/10430EvolvingCare/EvolvingCare.pdf.

  24. O’Donohue WT. Integrated behavioral health care: a guide to effective intervention. 2006. Humanities Books p. 10.

  25. Kroenke K, Spitzer RL, Williams JB, et al. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009; 50(6): 613-21.

    PubMed  Google Scholar 

  26. Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. Psychiatry Annals. 2002; 32: 9.

    Article  Google Scholar 

  27. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 19(9): 606-13.

    Article  Google Scholar 

  28. Zhang Y, Ting R, Lam M, et al. Measuring depressive symptoms using the Patient Health Questionnaire-9 in Hong Kong Chinese subjects with type 2 diabetes. J Affect Disord. 2013; 151(2): 660-6. doi:10.1016/j.jad.2013.07.014.

    Article  PubMed  Google Scholar 

  29. Yeung A, Fung F, Yu S, et al. Validation of the patient health questionnaire-9 for depression screening among Chinese Americans. Compr Psychiatry. 2008; 49(2): 211-217.

    Article  PubMed  Google Scholar 

  30. Chen S, Fang Y, Chiu H, et al. Validation of the nine-item patient health questionnaire to screen for major depression in a Chinese primary care population. Asia-Pacific Psychiatry. 2013; 5(2): 61-68.

    Article  PubMed  Google Scholar 

  31. Arroll B, Goodyear-Smith F, Crengle S, et al. Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Ann Fam Med. 2010; 8(4): 348-53. doi:10.1370/afm.1139.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Substance Abuse and Mental Health Services Administration (SAMHSA). PHQ-9 Patient Depression Questionnaire. 1999 [cited December 4, 2015]; Available from: http://www.integration.samhsa.gov/images/res/PHQ%20-%20Questions.pdf.

  33. Cummings NA, Cucciare MA, Runyan CN, Ciummings JL. Integrated behavioral health care. In: O’Donohue WT, eds. 2005. p. 10.

  34. University of Washington. IMPACT: Evidence-based depression care. Seattle, WA; 2012 [updated 2012; cited November 19, 2014]; Available from: http://impact-uw.org.

  35. University of Washington. AIMS Center: Advancing Integrated Mental Health Solutions. 2014 [updated 2014; cited November 19, 2014]; Available from: http://aims.uw.edu/.

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Acknowledgments

Asian Health Services’ integrated behavioral health program was funded by the Health Resources and Services Administration (HRSA) and the Alameda County Behavioral Health Care Services (ACBHCS). We are grateful to the University of Washington AIMS Center for providing technical assistance and support during the development of our overall behavioral health program as well as the Alameda Behavioral Health Care Services Consortium for providing support and guidance around program sustainability. We would also like to thank Mr. Thanh Nguyen for his assistance with the background literature for this paper.

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Correspondence to Thu Quach PhD, MPH.

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The Affordable Care Act and integrated behavioral health programs in community health centers to promote utilization of mental health services among Asian Americans

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Huang, S., Fong, S., Duong, T. et al. The Affordable Care Act and integrated behavioral health programs in community health centers to promote utilization of mental health services among Asian Americans. Behav. Med. Pract. Policy Res. 6, 309–315 (2016). https://doi.org/10.1007/s13142-016-0398-4

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