What Patients in Marginalized Communities Can Do Right Now to Advocate for Their Mental Health

In the second part of our conversation with Rimal Bera, M.D., clinical professor of psychiatry at the University of California, Irvine, and chairman of the Alliance for Patient Access Mental Health Working Group, the focus shifts from systemic barriers to practical solutions, and some of his most powerful pieces of advice are remarkably simple.

Bera begins with the question of cultural fit in mental health care. Finding a provider who shares your cultural background or speaks your language is meaningful, but it is not always possible. The shortage of mental health providers from marginalized communities is significant, meaning many patients will never have a perfect cultural match with their clinician. What matters most, he says, is finding ways to make the evaluation as complete as possible within those constraints, whether that means bringing in a family member as a translator, using available community resources or leaning on a trusted primary care physician who has received some mental health training.

That last point is increasingly important. In communities where mental health specialists are scarce, the primary care doctor, the family medicine physician, and the pediatrician often become the front line of mental health care. Programs are now working to bring behavioral health training to these providers, equipping them to screen for depression, anxiety, substance use and serious mental illness. It is not a perfect solution, Bera acknowledges, but it is a meaningful step forward.

When it comes to self-advocacy, Bera’s recommendations span from the legislative to the deeply personal. Voting, he says, is one of the most underutilized tools available to marginalized communities. Engagement in civic life is directly linked to improved health outcomes and a greater sense of connection to society. Parents can advocate by staying involved in their children’s schools, where mental health screening and teacher training programs are becoming more common. And everyone can advocate by feeling comfortable sharing their own mental health experiences with their primary care provider rather than waiting until a crisis forces the conversation.

But perhaps his most resonant message is the simplest. If you notice someone in your life who seems a little quieter, a little more withdrawn, a little less like themselves, reach out. Ask how they are doing. That single question, he says, can plant a seed that grows into something life-changing. We are going to conquer mental illness, Bera concludes, by being socially connected.