4 - Health and Mental Health Disparities

Summary

This chapter is premised on the belief that ethical medical and mental healthcare require a social justice framework, one that takes as its principal stance that healthcare is a human right. Utilizing Ruger’s health capability paradigm, we consider how, both within the United States itself and globally, the engagement of a perspective of positive rights regarding health and healthcare is required when approaching how to best address social disparities and access to medical and mental health treatment. We first consider the health capability paradigm and how it conceptually frames, within a social justice perspective, the right to health and the provision of healthcare for children and youth. We next explore how this model can be considered within a discussion of how dual medical and mental healthcare is currently practiced in a context where patients referred and treated are from lower- to lower-middle-class socioeconomic status communities, and who utilize Medicaid as their primary source of insurance for healthcare. We focus specifically on the provision of forms of medical and mental healthcare that are often the least considered and subsequently unreimbursed by Medicaid, neuropsychological assessment and consultation/liaison for mental health. We next present a case that addresses the application of the health capability paradigm within a child and adolescent psychiatric care setting, and then end with a discussion of how communities, both locally and within the United States, can better engage this model as a means for justifying more equitable and conscientious care for children and adolescents.