How health leaders can counter minority health disparities with clinical decision support

Covid has reshaped mental health in minority groups

The early days of COVID brought a 25% spike in anxiety and depression around the world. But this was just one facet of the pandemic’s impact on mental health, especially for minorities, who often sit at the intersection of mental health and Long COVID challenges.

June 2023, the US Department of Health and Human Services issued an advisory on the identification and management of mental health symptoms related to Long COVID—describing the potential impact on mental health as “devastating” and stressing the fact that social determinants of health can exacerbate the negative impact of Long COVID for racial and ethnic minority populations, people with disabilities, and members of the LGBTQI+ community.

This dynamic of minority health disparities persists around the world. Indigenous patients in Brazil face a lack of mental healthcare along with higher prevalence of COVID-19 (as measured by consecutive antibody seroprevalence surveys). But the problem of minority or racial disparities in mental healthcare is often invisible. The United Nations reports that, while indigenous people in Asia have limited access to health resources, many governments lack the capacity for data collection.

PCPs are the first line of response to mental health disparities

Many countries lack efficient channels of healthcare access, especially for minorities, so the PCP becomes the primary point of mental healthcare access. This is an opportunity for administrators to support and equip clinicians through technology like CDS that simplifies their decision making while improving outcomes.

In the United States, 60% of mental healthcare is provided by primary care providers, who write almost eight of every 10 antidepressant prescriptions. This is despite the fact they are not formally trained as mental health providers and receive little support from specialists. These numbers present a window of new possibilities for healthcare administrators willing to expand the abilities of primary care providers to provide inclusive healthcare.

Creating inclusive healthcare clinics that support mental health in minority groups through CDS

In areas where patients are primarily accessing mental healthcare through their PCP and clinics, CDS can assist providers by filling in gaps around specialist training or access. This happens by expanding the role of CDS in minority health to help create an evidence-based and inclusive healthcare environment.

CDS helps providers empathetically navigate the myriad influences on a patient’s unique culture and life experiences, to better recognize symptoms, support understanding of care management, and foster improved acceptance of preventive measures and medication adherence.

Since patients are already seeking care from PCPs during annual visits and for chronic conditions, opportunity exists at the clinical level to integrate screenings for mental health, especially for minority populations who have nuanced mental health needs.

Leveraging CDS to address mental health in minority groups

Healthcare administrators can leverage multiple strategies for creating supportive, inclusive, and stigma-free clinic environments through the use of clinical decision support. CDS gives providers a neutral and evidence-based source of information to counter bias and facilitate improved relationships with patients. It offers targeted topics on minority mental health and can help align care teams to ensure they’re delivering consistent levels of support and treatment.

This effort starts with creating a culture that prioritizes whole person health for minority patients—looking beyond symptoms to understand their needs and how those needs are shaped by demographics and SDoH. CDS is already used in care settings around the world to connect providers with assistance in diagnosing, treating, and managing mental health conditions in a wide range of settings.

Global minority mental health initiatives and CDS

The Norwegian Individualized Digital DEcision Assist System (IDDEAS) addresses attention deficit hyperactivity disorder (ADHD) using CDS that provides clinicians with step-by-step, real-time guidance when working with their mental health patients. This approach has been helpful considering the complexity and long-term nature of child and adolescent mental health treatment.

And minority mental health is receiving significant attention around the world, increasing the potential for CDS application:

• The European Union has announced its European Mental Health Capacity Building Initiative with an emphasis on LGBTIQ equality.
• The Center for Medicare & Medicaid (CMS) is requiring that providers accepting Medicare Advantage patients work to improve behavioral healthcare access in 2025, a benefit for older patients who navigate specific mental health and discrimination challenges.
• The Strengthening Mental Health and Research Training in Africa (SMART) Africa Project focuses on mental health in Uganda, Ghana, Kenya, and South Africa, with an focus on support for youth and children.

Healthcare administrators can benefit from keeping up with regional programs and leveraging resources as they work to equip their care teams to support positive mental health outcomes for all demographics.

Exploring the role of CDS in minority health at your organization

When examining the potential use of clinical decision support in your mental health initiatives, prioritize the use of advanced CDS technology for your providers—since 2020, PCPs have performed over 2 million searches for mental health topics on UpToDate® every year.

To learn more about this leading source of clinical decision support that will connect your providers with the latest clinical recommendations and information on mental healthcare, start here.