By Jessica Douglas, external relations officer, CVT Georgia

As much of the world begins to increase focus on mental health, you may have seen Georgia in the news. In 2021, Georgia was at the very bottom of the list when it came to access to mental health care, ranked 51st in the nation behind all 50 states and the District of Columbia. At a time when the COVID pandemic was exacting a terrible emotional toll on Americans everywhere, Georgians had nowhere to turn for the mental health services and support they needed.

Advocates and lawmakers came together with a goal of moving Georgia from ‘worst to first.’”

Advocates and lawmakers came together with a goal of moving Georgia from “worst to first.” Just this year, both chambers of the Georgia state legislature unanimously passed the Mental Health Parity Act, a groundbreaking bill to overhaul Georgia’s mental health system. As a part of the Georgia Mental Health Policy Partnership (GMHPP), CVT Georgia actively advocated for the passage of this bill and for several provisions which specifically addressed mental health disparities for the over one million foreign-born Georgians living and working in the state.

CVT Georgia was successful in getting language access provisions added into the Mental Health Parity Act so that all Georgians– including Georgia refugees and immigrants who speak other languages– can participate in a new parity enforcement process and compel their insurers to cover their mental health claims to the same extent as their physical health claims. In a state where anti-immigrant rhetoric and legislation is common, it is remarkable that this landmark act was amended to include foreign-born Georgians and ensure they, like other Georgians, have better access to the care they need.

But there is still more to do to ensure that mental health access is equitable in Georgia.

In a series of presentations to the Governor’s Behavioral Health Innovation and Reform Commission, Darlene Lynch, head of external relations for CVT Georgia, made the case that Georgia falls behind similarly diverse states in terms of resources and infrastructure to support the mental health needs of diverse Georgians. She also outlined several recommendations which would help to address disparities, expand access to care, and create a mental health system which better serves all Georgians.

Today, one in ten Georgians– or more than one million people– are foreign-born. In the last 20 years, this population has surged, growing by almost 90% compared to 25% for the U.S.-born state population. This rise is in part due to Georgia’s leading role in refugee resettlement; indeed, Georgia is a top ten state for refugee resettlement, having welcomed tens of thousands of refugees over the last four decades.

While foreign-born Georgians contribute to the state in substantial ways– fueling the economy, enriching cultural diversity, starting small businesses in disproportionate numbers– Georgia has not done enough to consider their diverse needs. An estimated 5% or half a million Georgians have limited English proficiency (LEP) that prevents them from accessing mental health care. In more diverse areas of the state, that percentage is far higher. And with the current crises in Afghanistan and Ukraine, Georgia is poised to welcome more individuals in need of refuge than ever before. These new Georgians have endured severely traumatic experiences– with up to 44% having endured some form of torture– and mental health services are vital to help them heal, integrate and thrive in their new communities.

Compared to similarly diverse states, Georgia lags far behind in addressing the needs of the state’s diverse communities. While other states have invested for years in innovative programs to ensure mental health equity for their changing populations, Georgia has not done the same. As a result, the Department of Behavioral Health and Developmental Disabilities (DBHDD) has no good means of data collection, no dedicated office, no comprehensive strategic plan, and no coordinated effort to ensure access to culturally and linguistically appropriate care for the more than one million foreign-born Georgians in the state.

Based on feedback from mental health professionals, advocates and community members, CVT Georgia made the following recommendations to the commission to promote access to mental health care for Georgia’s increasingly diverse population:

1. Establish and fully fund a DBHDD Division of Cultural and Linguistic Competence (or Behavioral Health Equity)
2. Incentivize professionals to provide culturally-competent care in underserved communities
3. Implement National Culturally and Linguistically Appropriate Service (CLAS) Standards
4. Provide regular provider training & assessment on cultural competence
5. Improve coordination between community service boards, state refugee programs & trusted community providers
6. Ensure crisis services are culturally-responsive

Each of these recommendations would improve Georgia’s mental health care system by taking diverse needs into consideration. To read CVT Georgia’s full report and recommendations, click here.

As much-needed strides are taken to improve mental health care across the country and in Georgia– including the rollout of the 988 crisis line, expansion of telehealth services, and more states opting to expand Medicaid– there is still much to be done to ensure that refugees and immigrants see their access to mental health care improved as well.

While the world sees unprecedented displacement, with over 100 million forcibly displaced people worldwide, Americans will continue to welcome those in need. But our work does not stop there. When we extend welcome, we must also ensure that individuals have the tools they need to heal and to succeed in their new American– and Georgian– communities. The time to expand culturally-responsive and linguistically-accessible mental health care is now. The need is great and our actions must match the urgency of the moment.