July is BIPOC Mental Health Month — A look at some of what’s going on in DCHS  

July is BIPOC Mental Health Month. Established in 2008 in honor of Bebe Moore Campbell, and formally recognized as National Minority Mental Health Awareness month, this event was created to bring awareness to the unique mental health struggles that historically marginalized groups in the U.S. experience. People of all backgrounds and cultures experience mental health challenges, but it’s important to recognize that one’s background and identities can present unique experiences, specific barriers, and opportunities to get support.  

As BIPOC Mental Health Month comes to a close, we at the Department of Community and Human Services (DCHS) want to highlight some of the work DCHS is doing to address BIPOC mental health and increase culturally relevant programming. 

Community Behavioral Health Treatment funded by the MIDD Behavioral Health Sales Tax 

Community Behavioral Health Treatment is an initiative that provides outpatient mental health and substance use disorder treatment services for people who have low incomes but are not eligible for Medicaid, so that they can receive the same services available to Medicaid recipients, including access to outpatient behavioral health services. This initiative serves BIPOC communities, particularly immigrants and refugees who can have a hard time getting other coverage.  

Community Behavioral Health Treatment is funded by King County’s MIDD Behavioral Health sales tax, which is a countywide 0.1% sales tax that supports high-quality programs and services to address mental health, substance use, and other behavioral health conditions for those most in need in King County, with a particular focus on providing equitable opportunities for improved health and wellness, connection to community, and recovery.  

Community Behavioral Health Treatment is one of MIDD’s largest initiatives, receiving nearly $11M in funding from MIDD in 2021. In 2021, the program provided 3,282 people with outpatient mental health and/or substance use disorder treatment services, helping to reduce emergency department admissions, jail bookings, and psychiatric inpatient hospitalizations over the long term for those who participated. 

MIDD served 18,907 people overall in 2021, investing $64M+ in communities across King County, in partnership with over 141 community and implementing partners. To learn more about the Community Behavioral Health Treatment initiative and the MIDD, you can explore the 2020 annual report here. In early August, the 2021 annual report and interactive data dashboard will also be available at the same link.  

Connecting community members to BIPOC mental health providers  

The Community Well-Being Initiative (CWI) is a new strategy in the Best Starts for Kids Levy, led by Public Health in partnership with DCHS and community partners. Formed during the County’s COVID response, CWI builds community capacity to share resources and deliver culturally relevant programming on emotional health and wellbeing to reduce stigma associated with mental health topics and reinforce compassion, connection, and care in communities.   

CWI partners with community leaders, young people, mental health providers, and organizations, to reduce stigma and head up immediate responses to need for mental health care.  

In a partnership with the South King Emotional Wellness League (SKEWL), the focus is on connecting community members to Black, brown, Indigenous, and bilingual or multilingual mental health care providers. One of the consistent challenges in BIPOC communities is access to mental health care, and moreover, access to mental health providers from the same community and background. These community-based efforts to host free mental health connections to BIPOC mental health providers not only make the initial connection between community members and providers, but also can foster long-lasting trust and connection with the mental health system overall.  

CWI and SKEWL are exploring how to expand supports for both current BIPOC mental health providers and healers, as well as BIPOC young people interested in pursuing careers in the field.  

Recently, CWI and SKEWL changed the format of the Free Mental Health Supports event. Rather than hosting the event as a one-time drop in, SKEWL will be taking messages directly from community members the week of July 25 and working to coordinate with BIPOC providers for a free mental health session.   

To sign up to talk with a provider, send us an email or message SKEWL on Facebook.  

$2M for Culturally Appropriate services to be awarded soon through King County BHRD 

DCHS’s Behavioral Health and Recovery Division (BHRD) released a funding opportunity seeking community-based organizations to provide and expand culturally appropriate behavioral health treatment, with the goal of improving outcomes for those disproportionately impacted by the COVID-19 pandemic.  

BHRD issued a request for proposals, which closed earlier this July, making available up to $2,000,000 of American Rescue Plan Act (ARPA) funds to build, improve and enhance culturally appropriate behavioral health services to communities in King County who were disproportionately impacted by the COVID-19 pandemic. Multiple awards are anticipated at approximately $200,000 per award. We are excited to share that we received 22 applications. More to come soon around who will be selected for awards.  

Programs funded will define, create and expand community-driven behavioral health treatment and interventions to support creative, culturally relevant interventions for improved behavioral health outcomes. These funds will be used to meet the behavioral health needs of communities in King County that have been disproportionately impacted by COVID-19, as defined by recent public health statistics in King County, including South King County along the I-5 corridor (Auburn, Tukwila, SeaTac, Federal Way, Southeast Kent, South Renton) and South Park, Georgetown, and White Center neighborhoods in Seattle. 

According to extensive data, those most likely experience disproportionate impacts from the COVID-19 pandemic include Native Hawaiian/Pacific Islander (NH/PI), American Indian/Alaskan Native (AI/AN), Hispanic and Black residents, residents at or below 40 percent Average Median Income, and young people from underserved and economically under resourced communities. 

Here are a few striking items from the data that highlight the need for culturally appropriate services: 

• Unemployment claims were the highest among NH/PI and Black populations 
• During the pandemic, life expectancy decreased among NH/PI and Hispanic populations 
• Life expectancy has been decreasing for the past 10 years among South King County residents 

• Medicaid members are primarily people of color 
• AI/AN and Black Medicaid beneficiaries face disproportionate risks for adverse health events 
• Child access to primary care and mental health care have significantly decreased 
• Highest increase in emergency department visits related to suicide attempts or suicide ideation were among school-aged youth (10-19), AI/AN and Black populations 

Funded programs will address the cultural diversity and needs of the populations to be served, provide services that meet the individual’s beliefs and background, and take into account the experiences of communities that have resulted in a distrust of behavioral health systems, inability to access timely and sensitive treatment, stigma, and other barriers to care. 

Anticipated activities could include: 

• Outreach, engagement, and education on behavioral health, services, and resources 
• Design and implementation of programs and interventions that are appropriate to the language and culture of people receiving services 
• Expansion of services not otherwise covered by existing funding sources 
• Creation of culturally appropriate care guidelines, assessments, materials, and tools 

What is culturally appropriate treatment? 

In 2021, to help identify what culturally appropriate treatment should look like, King County held focus groups and interviewed dozens of subject matter experts to identify the components of culturally appropriate behavioral health care, as well as how that care can be improved. Respondents identified four key components: 

1. Service providers reflect and understand the cultural background of those they serve. 

2. Services are creative and flexible. They are offered, unconditionally, in a manner, timeframe, language, and setting that is meaningful and appropriate to the recipient; and regardless of the recipient’s immigration or benefits status, ability to meet pre-determined eligibility criteria, or other factors that impose barriers to necessary treatment. 

3. Data is disaggregated, detailed, and interpreted to show who is and is not being served, how and by whom they are being served, and how they are responding to treatment. 

4. Services incorporate and strengthen communities, families, schools, support networks, and other systems. 

Interviewees drew attention to the complex service needs of communities, much of which falls outside of traditional insurance coverage or medical necessity criteria. These unfunded services are necessary to explain complex and unfamiliar paperwork prior to enrollment; coordinate referrals; build trust and lower stigma; provide education; outreach difficult-to-locate referrals; provide intervention before a behavioral health need reaches the clinical threshold for diagnosis and treatment; or stabilize, engage, or improve a behavioral health need in a culturally relevant manner that is outside of the “medically-accepted” model of care. 

More resources 

To celebrate BIPOC Mental Health Month, Mental Health America compiled a toolkit with resources specifically for Black, Indigenous, and people of color, which you can view here.  

This blog post from King County’s Balanced You is also a helpful resource with tips for talking to your provider about mental health and more mental health resources.