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.”

2 Responses to Report highlights need for more diversity in health care system

  • May 19th, 2022 at 8:26 pm Paula posted:

    Yes I to agree about the severe crisis with the mental health myself have suffered from a pretty lenghtly psychology history but I’m sorry but my ideas may not matter but to me they do mywar with this sucks because every color race nationality should never be turned away I if not for any other reason simply is mentally ill people may not still be here on earth all becauseturned away when all they wanted was just help I know first hand I lost my 35year old daughter 2018while living at crossroads she was trying so long and hard but in the end because of drugs now like myself so so so very many parents loss their child where since COVID hit a lot more human beings with mental health try everywhere everything but please let’s all stop about your euthenics Mental Health. Help Now For all this illness is also a deadly killerHelpAll thankYou

    • June 21st, 2022 at 2:02 pm Effy posted:

      I have to agree with Paula. I have completed the 46 hour training in my his to become Certified Peer Recovery Speciaist. The next step is to complete a 500 hour internship. But – as I have unfortunately learned, if you are white – you most certainty will be overlooked if there are other non-white applicants. It matters not my extensive background in the fields of mental health & substance use disorder, my previous jobs where my skills of listening to clients with compassion (regardless of race or ethnicity or sexual orientation) were recognized as valuable assets, or my previous background experience managing a mental health disorder & recovery from substance abuse. I understand the need of the clients who prefer to work with someone who “looks” like them, to feel more confortable, but the color of one’s skin does not translate into their competence or non-competence as professionals in the mental health field. I know African American clients who prefer a white professional who has the same background experience as them, who can relate to growing up feeling stigmatized due to their family’s poverty staus, who can relate to the dysfunctional family dynamics as they’ve experienced. So, please stop the discrimination of those folks like myself who want to be in the mental health field. Not all white people come from “priviledged” backgrounds just like not all African Americans have grown up in poverty & experienced discrimination. We are all of one race: the human race. As far as ethnicity in the feld, again – it depends on what the client prefers, however – excluding “caucasians” of an assumed “European background that became white colonists who settled America” is absurd. I am of mixed decent – daughter of poor immigrants who nearly died coming to this country to seek a better life, and have a dominant Scottish ancestry – which has its own unique cultural aspects. How come Scottish is not an option to check off in a list of etnicities? Again, no one is talking about the systemic racial & ethnic bias of “white” people in the mental health field. Lastly, let’s address sexual orientation, which should have nothing to do with evaluating the competence of mental heath professionals. I happen to be in the unpopular category of being a heterosexual woman. Using words like “cis-gender” is offensive & divisive. I am also a mother, not a “birthing person”. Those who use these definitions are as offensive to me & other woman like me as “gay” is to those who are homosexual. I have no judgement whether you are of a different “race”, “ethnicity” or “sexual oriemtation”. All I care about in becoming a professional in the mental health field is how to best serve you, while at the same time, being respected regardless of my “race”, “ethnicity” , or “sexual orientation” . If a client prefers to be identified by certain words like “non-binary”, or introduce their “pronouns” ( as ‘her/she ” or “he/him” , etc.) I will happily comply to make them feel comfortable, however I should not be expected to use those terms to identify myself because it is offensive to me. THAT needs to be addressed and respected. Unfortunately the “equity, inclusion, diversity” (E.I.D) movement in the mental health field fails to recognize how dangerously bias & divisive it is in implementing these concepts to all. But, unfortunately – money & funding trumps all & favors its inherit bias & discrimination of white, heterosexual professionals – who see the deeper, damaging aspects of E.I.D. And who not only want to expand their knowledge of ALL clients backgrounds, but want to be respected of their backgrounds as well. But, of course, that does not fit the popular narrative. “Unity” is a concept now lost in the E.I.D. word salad for the above reasons. And with the present high demand of those needing mental health assistance – it is no wonder why their is a shortage of mental health professionals. It is not only due to unfair insurance reimbursements for mental health workers, it has more to do with the silent ostracization of “white, heterosexual” professionals. The Mental Health organizations would be best served by recognizing this if we are to move forward in removing its own discriminatory practices, which it apparently fails to see.

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