Report highlights need for more diversity in health care system

By Danielle Ray
March 31st, 2022
Ernestine Jennings, Ph.D., staff psychologist, The Miriam Hospital, senior research scientist, Centers for Behavioral and Preventive Medicine
Ernestine Jennings, Ph.D., staff psychologist, The Miriam Hospital, senior research scientist, Centers for Behavioral and Preventive Medicine

The Mental Health Association of Rhode Island (MHARI) recently released a 34-page report overseen by Ernestine Jennings, Ph.D., that shines a light on a relevant and timely issue, the need for more diversity in the health care system and among behavioral health care providers in the Ocean State.

According to the U.S. Census Bureau, 16.3 percent of state residents are Hispanic or Latino, 8.5 percent are Black or African American, and 3.7 percent are Asian. The report was based on an in-depth survey of close to 750 specialists and said that Rhode Island’s behavioral health-care workforce is primarily white and English speaking, with 85 percent of those specialists white, fewer than 5 percent Latino, and Blacks and Asians comprising just 2 percent and 1.4 percent, respectively, which does not adequately mirror the cultural and racial diversity of Rhode Island residents.

“The insights of providers gathered through this survey demonstrate the need for a robust commitment to mental health parity,” said MHARI Executive Director Laurie-Marie Pisciotta, who lives with mental illness, in an article published by The Providence Journal late last year.

Jennings, who has been a licensed clinical psychologist since January 2009, said that as a board member of MHARI, she is “involved in their parity initiative.”

“The current study is an extension of the original study to gather information on providers in the state and who they serve,” she said.

“Seeing someone who looks like you or has the same cultural background can facilitate care. By expanding diversity, we increase the stories that are represented in psychology and people feel like they belong in this setting.” --Ernestine Jennings, Ph.D., staff psychologist, The Miriam Hospital, senior research scientist, Centers for Behavioral and Preventive Medicine

Jennings has a personal connection to the issue as a Black health care provider who lives in Rhode Island and works at The Miriam Hospital as a staff psychologist and senior research scientist at the Centers for Behavioral and Preventive Medicine.

In addition, she is an associate professor and teaching scholar at the Warren Alpert Medical School in the department of psychiatry and human behavior at Brown University.

The report also said insurance difficulties and low reimbursement rates to clinical social workers, mental health counselors, psychologists, and other providers are additional obstacles to meeting behavioral health-care needs, which have intensified during the pandemic.

Jennings said it took about a year to complete the study that began in 2019 and then suspended for a while because of the COVID-19 pandemic and “to allow for changes in mental health care.”

“Some of the challenges included reaching providers who moved to remote settings where their contact information was not reflected in our records,” she said. “Additionally, obtaining clear records on who is licensed and in what field and who they provide services to was difficult.”

When it comes to the importance of diversity in the psychology field and how that can translate to helping patients, Jennings said “we often say that representation matters.”

“Seeing someone who looks like you or has the same cultural background can facilitate care,” she said. “By expanding diversity, we increase the stories that are represented in psychology and people feel like they belong in this setting.”

She added that addressing the issue and taking steps to rectify it is possible through action.

“Contribute to the training and retention of diverse provider, help patients understand the process for obtaining care, and continue learning about ways to treat diverse individuals and address structural issues, i.e., reimbursement (and) language,” she said.

“I think (the report) is an initial look at issues providers face and the impact this has on diverse communities. As we continue to collect data about the barriers and challenges these providers face, we can better provide solutions for care and reduce the stigma to seeking mental health care among diverse communities.”

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