单选题 Minorities often get separate and unequal mental health care: They"re less likely than whites to receive needed treatment, and the care they do get is of lower quality, says a Surgeon General"s report out Sunday. Among the key causes of the "striking disparities" in care for U.S. whites and minorities are financial barriers, racism, mistrust of doctors and language problems. "Our failure to address these disparities is playing out in homeless shelters, in foster care in prisons and jails," says Surgeon General David Satcher.
Poverty greatly raises the risk of serious mental disorders, so some minority groups are especially vulnerable. Blacks and Hispanics have about triple the poverty rate of whites. And 37% of Hispanics have no health insurance, more than double the rate for whites. Lack of private insurance throws mentally ill people at the mercy of a thinning "safety net" of public treatment centers. In many cities, such as Detroit, the net is so thin, "it"s barely there," says psychologist James Jackson of the Institute for Social Research at University of Michigan-Ann Arbor.
Minority kids pose special concerns. Hispanic youth have significantly poorer mental health than whites, Satcher says. Some 45% of children in foster care are black, as are more than half awaiting adoption. Many have serious mental disorders, research suggests. Even when they can afford care, feelings of stigma may get in the way. "Within many Asian cultures, mental illness is heavily stigmatized. I know, because there"s mental illness in my family," says Richard Nakamura, deputy director at the National Institute of Mental Health. Mistrust of therapists isn"t totally off the mark. There"s evidence of racial and ethnic bias by counselors, the report says.
Minorities are more likely than whites to rely on their primary care doctors for detecting emotional disorders. But "it"s an uphill battle to get treatment for mental problems under managed care," says Ronald Kessler, a health policy expert at Harvard Medical School in Boston. "You have to be very sophisticated. Doctors are not likely to diagnose a mental disorder in the eight minutes they"re allowed with the patient," Kessler Says. The report recommends integrating mental health and medical services.
Research on the mental health of minorities is sparse, because until the past few years, studies didn"t indicate a subject"s race or included mostly whites. In 1994, the National Institutes of Health started to require that its funded studies include minorities. Satcher remains hopeful, partly because federal grants will soon be funding programs to target the disparities. "I"m very optimistic, but I don"t believe it"s going to be easy," he says.
单选题 The "striking disparities" in the passage refer to ______.
【正确答案】 A
【答案解析】[解析] striking意为“明显的,显著的”,disparity意为“差别”。第一段提到,白人同少数民族的人在心理健康医疗上存在“明显差别”,造成这种差别的主要原因包括:经济障碍,种族主义,对医生的不信任,语言问题。
单选题 According to Doctor Satcher, lack of high quality mental health care causes special concern in ______.
A. public treatment centers
B. the treatment of minority children
C the treatment of the homeless patients
D. foster care in prisons and jails
【正确答案】 B
【答案解析】[解析] 第二段第一句提到,贫困大大地增加了患严重心理错乱的危险,因此,某些少数民族特别容易成为受害者。第三段第一句萨彻尔说,少数民族的孩子令人特别担忧:拉丁美洲裔年轻人的心理健康状况明显比白人差。
单选题 Which of the following is not mentioned as a major cause for unequal mental health care?
【正确答案】 D
【答案解析】[解析] 第三段最后两句提到,对治疗专家的不信任也不是毫不相干(即:也在其中起着作用),有些报告指出,有证据表明:咨询员也带有种族和民族偏见。这证明选项A和B表达的内容与文章相符。
有关选项C参阅第二段,这段提到,37%的拉丁美洲裔的人没有健康保险,是白人人数的两倍多。缺乏个人保险使患有心理疾病的人只好转向越来越少的为少数民族办的公共医疗中心安全网。在很多城市,这样的中心稀少得很,Jackson说:“这个网几乎不存在。”
单选题 What Richard Nakamura said emphasizes the ______ cause for the disparities in mental health care.
【正确答案】 A
【答案解析】[解析] 第三段提到,研究显示,许多人有严重的心理错乱现象,他们即使有钱付医疗费,耻辱感也可能形成障碍。Nakamura说:“在许多亚洲文化中,心理疾病在很大程度上被看做是耻辱,这一点我知道,因为我家就有患心理疾病的人。”从他的名字来看,Richard Nakamura是日本裔的美国人。可见,他强调的是文化价值观的差别给人造成的影响。
单选题 Satcher"s attitude to narrowing the disparities in mental health care is ______.
【正确答案】 C
【答案解析】[解析] 在最后一段最后两句提到,萨彻尔保持乐观的看法,部分是因为联邦将很快拨款,资助消除差异的一些项目。他说:“我很乐观,但是我认为事情不会那么简单。”这里,他表达了谨慎的乐观,在对前景表示乐观的同时,也意识到解决问题的难度。