Transparencies July 2020

July: MINORITY MENTAL HEALTH DISPARITIES & COVID -19

A Message From Our CEO

Nurses in Beaumont, Texas / Photo credit: New York Amsterdam News

Travis County is grappling with a spike in COVID-19 cases and racial/ethnic minority communities are being disproportionately affected by the virus. Austin Public Health’s COVID-19 dashboard indicates that death rates (when compared to percentage of the population) are highest for Hispanics, followed by Black Travis County residents. As we recognize Minority Mental Health Month, let’s look at how COVID-19 is impacting existing health disparities across a variety of communities – Black, Hispanic, LGBTQIA+, Asian and Native American.

Due to long-standing systemic health and social inequities, minority communities are at a higher risk of COVID-19. Many minorities are more likely to hold essential and frontline jobs that require person-to-person contact without the flexibility of working from home. Blacks, Hispanics and Native Americans disproportionately experience chronic health conditions, among them asthma, diabetes, heart disease, high blood pressure and obesity, which leave them more susceptible to COVID-19. There are also mental health disparities to consider.

Experts predict the pandemic will result in a behavioral health crisis with a historic rise in mental health issues and substance use disorder. For everyone, the pandemic is a destabilizing storm. Those without a strong foundation of health and well-being due to socioeconomic, health or health care disparities are on even shakier ground when it comes to mental health and substance overuse in this moment. And studies show that many minorities – including those with good access to care – are less likely to seek behavioral health treatment or often terminate treatment prematurely because of stigma or care that does not take into account culture or other unique issues. The National Alliance on Mental Illness reports that among adults with mental illness, 31% of Black and 33% of Hispanic adults receive mental health care each year compared to 49% of white adults.

For the Black community, racial injustice compounds the effects of the pandemic. Experiencing systemic racism and witnessing racial violence (either first hand or in video footage) are both factors known to impact mental health. Stress and anxiety is heightened for immigrants (many of them Latinos in Texas) who fear that seeking medical care will make them ineligible for a visa or citizenship due to the federal public charge rule, established in February. Asians show the sharpest increase in severe anxiety of any population in the U.S., but are 3 times less likely to engage in mental health services. Asians in Austin and across the state have reported xenophobic attacks, traumatic events that could exacerbate the stress of COVID-19 and result in longer lasting effects on their mental health.

COVID-19 presents another set of challenges for the LGBTQIA+ community. Stay at home orders and social distancing from supportive environments has resulted in negative consequences for LGBTQIA+ youth and the transgender community. The national Trans Lifeline is seeing four times the number of calls for domestic violence and workplace discrimination.

Possibly the hardest hit by the pandemic are Native Americans. Reservations like the Navajo Nation have the highest numbers of confirmed cases per capita in the U.S., due to poverty, living in multi-generational homes and in remote areas isolated from medical care. Native Americans have the highest rates of substance use disorder and are 2.5 times more likely than other Americans to experience serious mental illness. Add the grief, stress and trauma caused by COVID-19 to their generational trauma and experts expect a wave of behavioral health needs for this population.

Photo credit: Brian van der Brug / Los Angeles Times

What can we do to close the gap and bolster health and safety for everyone? Make sure all communities have access to equitable access to quality, culturally competent health care. Integral Care’s vision is Healthy Living for Everyone. Across the organization, we work to support the diverse community of Travis County, offering our services in multiple languages. When someone calls our 24/7 Helpline, there are prompts in 15 languages. We are currently disseminating information about the Helpline in five languages through social media and a larger media campaign in an effort to ensure our community is aware of free, around-the-clock emotional support during this uncertain time. The Substance Abuse and Mental Health Services Administration (SAMHSA) has developed a brief outlining policy efforts, communication strategies and community partnerships that could make a real difference. A collective effort is necessary. When we work together and share responsibility for each other’s health and safety, we can build well-being across all communities. We are stronger together.

David Evans
Chief Executive Officer

AGENCY UPDATE

Due to a rise in COVID-19 cases and increase in hospitalizations in Travis County, Integral Care continues to provide most services by telehealth and telephone. Face-to-face appointments are available as needed at a limited number of locations. We are currently planning for a phased-in approach to return to clinic and office-based work in early August. When we begin this transition, we will remain flexible and make any needed adjustments based on current data, information and guidance from local health authorities.

Integral Care continues to follow the latest guidance from the Centers for Disease Control and Prevention and Austin Public Health to minimize risk of community spread and ensure the safety and well-being of clients and staff. As we prepare to open more of our clinics, we will take the following precautions.

Face masks are required of all clients, visitors and staff.
Everyone is screened before entering the building.
Infection prevention measures are strictly followed.
The clinic is set up to maximize social distancing.
Clients limited to one essential companion.
All staff are required to wear Personal Protective Equipment (PPE).

Integral Care is proud to support our community through the pandemic and beyond. We know that strong, sustained behavioral health care is an important foundation to help our community be resilient and strong. For more information on our adjusted operations, click here.

PROGRAM HIGHLIGHT

NEW PROGRAM TO REDUCE INPATIENT STAYS AND INVOLVEMENT WITH CRIMINAL JUSTICE

Integral Care received a grant award from SAMHSA for Assisted Outpatient Treatment (AOT) in the amount of $1M per year over 4 years. The funding will be used to develop a new AOT program, using practice and evidence-based interventions to:

bridge the gap between inpatient and outpatient mental health services,
reduce incidence of inpatient psychiatric stays,
reduce criminal justice involvement,
improve treatment outcomes,
promote treatment adherence,
and increase client engagement in managing their care.

The program will focus on adults in Travis County who persistently struggle with adherence to treatment for their mental illness and meet criteria for AOT under Texas state law. All client treatment plans will employ a recovery-oriented approach, including motivational interviewing, psychiatric advanced directives, and collaborative, individually tailored recovery plans.

Integral Care is proud to collaborate with Travis County Probate Court, Travis County Clerk’s Office and Dell Medical School at the University of Texas at Austin to establish a framework for identification, referral and the care and treatment of clients living with serious mental illness. Other community collaborators include NAMI Central Texas, Austin State Hospital and Travis County Sheriff’s Office.

Our sincere thanks to the large group of stakeholders who supported the AOT application, including the Travis County Attorney’s Office, Austin Lakes Hospital, Housing Authority of the City of Austin and Disability Rights Texas.

LOCAL GROUPS KEEPING HEALTH AND HOPE ALIVE

Image credit: Austin Public Health

The Austin-Travis County community is rallying together to keep each other safe and healthy despite the stress and strain of the ongoing pandemic. Here are some virtual gatherings, support groups and other offerings keeping us connected. We are stronger together.

Austin Public Health’s Multilingual Conversation: Together Against COVID-19 will be held Saturday, July 11 at 10am. Interpretation and breakout groups will be provided in Arabic, Burmese, English, Spanish, and Vietnamese.

Central Texas African American Family Support Conference is launching a monthly virtual forum, Together We Will Heal, starting July 15^th at 1:30pm. The forum will focus on all things mental health, substance use and intellectual and developmental disabilities in the Black community.

City of Austin will be hosting a Facebook Live event: COVID-19 and the African American Community on Saturday, July 18 at 10am. Get your questions answered and provide feedback on improvements they can make.

Austin Public Health is forming a task force and holding forums to address that the COVID-19 disparity within the Latinx community. Task force outreach will take place mostly in Del Valle, Manor and Pflugerville. More details to come.

For the Asian and South Asian community, Asian Family Support Services provides free counseling and a 24/7 hotline around domestic violence, which has spiked since mid-March. Austin Asian Community Health Initiative provides healthcare navigation in many languages for Austin’s Asian subpopulations, including the Burmese, Korean, Nepali, Vietnamese, Syrian, Iraqi, and other Arabic speaking communities.

For LGBTQIA+ people, quarantining and social distancing may separate them from important social networks.

Out Youth and the Gender Wellness Program are offering a Queer and Trans Community Closet with items such as H-E-B gift cards, select gender affirming items and face masks for those in need.
Austin LGBT Chamber of Commerce offers a variety of insightful webinars and meetings aimed at employers and business owners.
Equality Texas has a helpful listing of LGBTQIA+ specific resources for Texans.

What’s New at Integral Care

Integral Care’s Board of Trustees has appointed a Board/Staff Ad Hoc Committee on Racial Equity to focus attention, questioning and policy review on all aspects of the organization, so as to identify racial inequalities and opportunities to employ equity practices to overcome and eradicate racism. Read our pledge to take meaningful and effective action to eradicate institutional racism and support equity and inclusion within our own organization and with our collaborative organizations.
Check out the summer issue of Living Well, our quarterly newsletter edited by a peer support specialist. In it, peers share stories about recovery and offer hope for tomorrow. This issue features an interview with Valerie Milburn, local recovery and mental health advocate.
Integral Care seeks public comment from the Travis County community on two draft plans – the draft Consolidated Local Service Plan (CLSP) and the draft Local Provider Network Development Plan (LPND). Feedback due by July 15.
NAMIWalks will be held virtually this year on October 10^th. We are planning what the virtual experience will be. You’re invited to join us, Team Incredibles, for a memorable and meaningful event. More information to come!

TRANSPARENCIES

July: MINORITY MENTAL HEALTH DISPARITIES & COVID -19

AGENCY UPDATE

PROGRAM HIGHLIGHT

LOCAL GROUPS KEEPING HEALTH AND HOPE ALIVE

What’s New at Integral Care

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