1. PsyD Clinical PsyD School PsyD School CAGS School MA Forensic MA Counseling MA Organizational Certificate Executive Coaching Certificate Executive Coaching Certificate Latino Mental Health Certificate Latino Mental Health Massachusetts School of Professional Psychology Massachusetts School of Professional Psychology Founded in 1974 Accredited by NEASC, APA, NASP

2. Mission Statement “MSPP strives to be a preeminent school of psychology that integrates rigorous academic instruction with extensive field education and close attention to professional development. We assume an ongoing social responsibility to create programs to educate specialists of many disciplines to meet the evolving mental health needs of society.”

3. Access to Mental Health “Mental illness, including suicide, accounts for over 15 percent of the burden of disease in established market economies, such as the United States. This is more than the disease burden caused by all cancers.” National Institute of Health, 2004

4. Mental Illness: Prevalence Kessler et al., 2005 World Mental Health Survey Initiative (WHO) Nationally Representative Sample, English speaking adults (N = 9, 282) 12 month Prevalence Estimates Anxiety (18%)Mood (9.5%)Impulse (9%) Drugs(4%)Other (26%)

5. Mental Illness: Facts Kessler et al., 2005; Satcher, 2001 30 % of US adults have a serious mental disorder Fewer than 50% of those in need are treated Independent of insurance, language, trust, relational style, prejudice are barriers to care Culturally sensitive services show superior patient compliance

6. Global Burden of Disease 2004 Update: Selected figures and tables Health Statistics and Informatics Department

7. Health Statistics and Informatics Global Burden of Disease: DALY World Health Organization “The overall burden of disease is assessed using the disability-adjusted life year (DALY), a time-based measure that combines years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health. ”

8. Health Statistics and Informatics Leading Causes of Mortality and Burden of Disease World, 2004 % 1.Ischaemic heart disease 12.2 2.Cerebrovascular disease 9.7 3.Lower respiratory infections 7.1 4.COPD 5.1 5.Diarrhoeal diseases 3.7 6.HIV/AIDS 3.5 7.Tuberculosis 2.5 8.Throat, bronchus, lung cancer 2.3 9.Road traffic accidents 2.2 10.Prematurity, low birth weight 2.0 % 1.Lower respiratory infections 6.2 2.Diarrhoeal diseases 4.8 3.Depression4.3 4.Ischaemic heart disease 4.1 5.HIV/AIDS3.8 6.Cerebrovascular disease 3.1 7.Prematurity, low birth weight 2.9 8.Birth asphyxia, birth trauma 2.7 9.Road traffic accidents 2.7 10.Neonatal infections and other 2.7 MortalityDALYs

9. Health Statistics and Informatics Leading causes of disease burden for women aged 15–44 years, high-income countries, and low- and middle-income countries, 2004

10. Health Statistics and Informatics Ten leading causes of burden of disease World, 2004 and 2030

11. Access to Mental Health “Depression makes a large contribution to the burden of disease, being at third place worldwide and eighth place in low-income countries, but at first place in middle- and high-income countries. Effective treatments for depression are available, suggesting that this burden could be reduced.” National Institute of Health, 2004

12. Substance Abuse Substance Abuse “ The Committee has concerns that people who are seeking substance abuse treatment are unable to access services due to the lack of an adequate clinical workforce. People seeking treatment often have to wait for weeks or months before they are accepted into a treatment facility." Report of the Department of Health and Human Services and the House Committee on Appropriations (2006)

13. Substance Abuse Substance Abuse 23.5 million need drug or alcohol treatment 1.2 million report an inability to access care 67,000 practitioners nationwide 35% increased need for practitioners by 2010 “There is a workforce crisis in substance abuse care.” Report of the National Survey of Drug Use and Health (2005)

14. Children Living in Massachusetts 1, 464, 198 In need of mental health services: 146, 419 Who need but will not receive: 102, 493 “70% of children in Massachusetts who need mental health care will not receive it.” “70% of children in Massachusetts who need mental health care will not receive it.” MSPCC & Children’s Hospital (2006) MSPCC & Children’s Hospital (2006) Children’s Mental Health in the Commonwealth: The time is now. Children’s Mental Health in the Commonwealth: The time is now.

15. Children Children

16. Children

17. Combat duty in Iraq and Afghanistan Barriers to Care Veterans of Iraq, Afghanistan War 1.7 M Veterans of Iraq, Afghanistan War 1.7 M % who report being shot at or near explosions 90 % who report being shot at or near explosions 90 % In need of mental health services 33 % In need of mental health services 33 % victims of Traumatic Brain Injury 20 % victims of Traumatic Brain Injury 20 % diagnosed with PTSD 17 % diagnosed with PTSD 17 “There is a significant risk of mental health problems and subjects report important barriers to care.” Hodge et al. (2000) “There is a significant risk of mental health problems and subjects report important barriers to care.” Hodge et al. (2000)

18. Mental Health Access Racial and Cultural Minorities Four main ethnic groups are projected to account for 40% of the U.S. population by 2025 then continue to grow 2008 2050 Non-Hispanic whites 66 % 46 % Hispanics 15 % 30 % African Americans 14 % 15 % Asian Americans 5 % 9 % U.S. Census Bureau, 2008 U.S. Census Bureau, 2008

19. Race, Culture and Mental Health Race, Culture and Mental Health The prevalence of mental disorders for racial and ethnic minorities in the United States is equal to or less than that of whites (Satcher, 2001; Miranda et al., 2008) Minorities have less access to, and availability of, mental health services (Neighbors et al., 2007) Mental Health Disparities (33%) are worse than those for Medical Health (17%) and they have declined in recent years (Cook et al., 2007) Insurance coverage does not explain difference in access to care (Padgett et al., 1995; Snowden & Thomas, 2000) Prejudice, attitudes towards spirituality, lack of trust, stigma are offered as explanations (Keith, 2000; Cooper-Patrick et al.,1997)

20. Mental Health Access Racial and Cultural Minorities African Americans are over diagnosed with Schizophrenia and under diagnosed for Depression. (Snowden & Cheung 1990) Seventeen percent of African Americans with mental illnesses are treated for them (Satcher, 2001) Minority subjects and issues are underrepresented in mental health research (Hall, 2001; Hogg Foundation for Mental Health, 2006; Satcher, 2001) Some evidence supports ethnic matching to improve compliance and extend the length of treatment. (Sue, 1998; Ziguras et al., 2003) Less than 2% of psychologists and mental health providers are capable of offering cultural and language competent care to racially and culturally diverse persons (Holzer et al., 1998)

21. Mental Health Access Racial and Cultural Minorities “ “ American Indians, Alaska Natives, African Americans, Asian Americans, Pacific Islanders, and Hispanic Americans bear a disproportionately high burden of disability from mental disorders. This higher burden does not arise from a greater prevalence or severity of illnesses in these populations. Rather it stems from receiving less care and poorer quality of care.” Achieving the Promise: Transforming Mental Health Care in America New Freedom Commission on Mental Health (2003)