In case you missed it, we discussed health equity at length as it relates to mental health and substance use care at the Going Digital: Behavioral Health Tech 2022 summit. We hosted a panel discussion about health equity moderated by André Blackman, the Founder and CEO of Onboard Health, Ashlee Wisdom, MPH, the Founder and CEO of Health in Her Hue, Lauren Powell, PhD, President and CEO of The Equitist, and Gaurang Choksi, Founder and CEO of Violet. We also discussed health equity with Juliette McClendon, PhD, the Director of Medical Affairs at Big Health. Here we highlight both conversations and talk about how startups and other stakeholders can make progress.
The Substance Abuse and Mental Health Services Administration (SAMHSA) says behavioral health equity is “the right to access quality health care for all populations regardless of the individual’s race, ethnicity, gender, socioeconomic status, sexual orientation, or geographical location. This includes access to prevention, treatment, and recovery services for mental and substance use disorders.”
A study by Mangurian et al. emphasizes a few ways to address mental health equity, including increasing population-based care, increasing community-based mental health services, addressing social determinants of health, engaging the community, enhancing the pipeline of diverse providers, and supporting a diverse workforce.
A report by Rock Health discusses equity specifically in digital health and breaks down the specifics between healthcare and technology disparities. Healthcare disparities include inequities in access and outcomes, which stem from social factors. On the other hand, technology disparities relate to issues such as connectivity, affordability, and accessibility of technology services.
Dr. McClendon helps us understand the scope of the problem by saying, “over 75% of Black Americans are not receiving the help that they need…We also know that research has shown over 50% of racial and ethnic minority and people of color have experienced microaggressions in psychotherapy.” Dr. McClendon also emphasizes that LGBTQ+ individuals have faced discrimination in the healthcare system, which makes them less likely to engage with it.
Dr. McClendon also remarks that “a lot of people are not able to access traditional mental healthcare and the way we think about mental health care.” There are many barriers that are not conducive to 50-minute therapy appointments, including cost, lack of insurance coverage, difficulty finding providers, and many people’s work hours.
The intersection of someone’s identity and the difficulty for many people to access care shows an opportunity for digital health solutions to be involved. Dr. McClendon emphasizes the importance of centering identity, saying, “these people’s culture, ethnicity, somebody’s gender identity, all of these things are aspects of how they experience their mental health and how they prefer to receive treatment.” We can start building specifically with these identities in mind.
Dr. Powell emphasized the importance of centering marginalized identities when building these solutions to ensure the most appropriate solution is being built. Dr. Powell says, “I think you bring tailored solutions to the problems. And so I think part of our challenges in really needing to drive towards health equity is that we try to approach things through a lens of equality versus equity.” Dr. Powell continues, “One workbook or one workshop for everyone is really not going to work. So we really like to spend time talking with our clients, really understanding where they are, and understanding their commitment to change.”
André also mentions the importance of not getting lost in the technology. He explains that it’s essential to build “trust, respect, and dignity, which I think sometimes, especially if we’re in the digital health, which we all are, that sometimes that gets lost in the platforms that we’re building and things of that nature, too. But, again, getting back to the basics.” We must remember that the technology is supposed to be built to help people.
Another important step of this work is to build inclusive workplaces for all companies, especially those that are being behavioral health products. In our discussion, Gaurang emphasizes, “DEI isn’t a compliance exercise. It’s not just people taking responsibility; it’s everyone’s responsibility. And I frankly hope more and more companies meaningfully put capital behind it.” We are starting to see a shift in understanding the importance of diversity, equity, and inclusion, but we still have progress to be made.
Violet is also helping providers become more culturally competent, which will have downstream effects on the healthcare system. He explains, “standardizing cultural competence as a skill. To me, it’s very surprising that in our healthcare system, we haven’t said cultural competence is a skill you can build. And that’s exactly what we’re normalizing, which is pretty exciting.” There is still so much to discuss with health equity, so please stay tuned for additional articles.
These are just a few of the many insights from our conversation with Dr. McClendon, and our panel with André, Ashlee, Dr. Powell, and Gaurang. To hear each of these conversations, check out our video library.
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