Running head WHY IS THERE A STIGMA OF MENTAL HEALTH IN THE AF.docx

Running head: WHY IS THERE A STIGMA OF MENTAL
HEALTH IN THE AFRICAN
AMERICAN COMMUNITY 1
Why is there a stigma of mental health in the African American
community
Xavier De La Cruz
Benedict College
Applied Social Work Research II SW 434 01
Dr. Miller
November 2nd, 2019

AFRICAN AMERICAN MENTAL HEALTH 2
Abstract
Everyone is susceptible to the development of mental health
regardless of race, color,
gender, or identity. More than half of the citizens in the United
States are recognized with a
mental illness in their lifetime, and African Americans are at
higher risk of developing a mental
illness due to limited resources and other barriers. The
challenge is further enhanced in the
community due to a stigma prevailing in the group that prevents
most members from seeking
medical help. The lack of knowledge about mental illness calls
for increased awareness of the
challenge, especially when the condition is viewed differently
from other physical diseases. The
significant impacts of mental illness in the African American
demography makes it a healthcare
issue and calls for further consideration of the condition as
more social workers are needed to

work with the community to address the issue. The barriers to
knowledge and access to medical
assistance among African Americans take center-stage in this
paper.
Introduction
Mental health conditions have effects regardless of color, race,
identity, or gender.
Anybody can experience the challenges of mental illness
regardless of their background.
Although we are similar, your experiences and how you
understand and deal with these
conditions may be different. Anyone can develop a mental
health problem, but African
Americans sometimes experience more severe forms of mental
health conditions because of
limited resources and other barriers. African Americans are
twenty percent more likely to have
severe psychological distress than Whites are. Also, African

Americans and other minority
communities are more likely to have similar experiences, such
as barriers from health,
educational, social, and economic resources because of cultural
and societal factors. These may
contribute to worse mental health outcomes. More than half of
the people in the United States are
being recognized with a mental illness in their lifetime;
however, now not everybody will
acquire the assistance they need. Even though mental illness is
common and might affect
everyone, there is still a stigma attached. This stigma creates
shame in seeking help, especially in
the African American community. The understanding of mental
illnesses has come a far way
from where it used to be, but improvements have to make.
Mental illnesses should not be viewed
any differently from physical diseases. I believe the two are
very similar. When the mind is ill, it
is not just the brain, but it has effects on the whole body and
health overall. Substance abuse,
self-damage, and suicide are widespread and dangerous in
people with mental illness. The stigma
connected to mental illness stops people from getting the

assistance they need and causes them to
cover their pain. Clinically trained social workers are the
nation's largest group of mental health
service providers. (Staff, 2016). This is important to social
work because social workers push the
conversation of mental health forward. Many social workers in
the field are first responders to
most mental health claims. Also, the stigma of mental illness in
the African American
community has to change, and social workers can be the driving
force of a new outlook of
mental health. This navigates towards a better view of mental
health. It is important to
understand how we got to this point. Though this text will
discuss the following, what is mental
illness, historical information of mental health in the African
American community, barriers to
mental health in the African American community, also the
perspective African Americas have
on mental health.

Literature Review
WHAT IS MENTAL ILLNESS
Mental illness is a general term referring to all mental health
conditions that involve changes in
emotions, thinking, interaction with other people, and behavior
in a person. The changes can be
caused by different factors, such as genetics, daily habits,
environment, biology, and life
experiences (McNally, (2011).). Mental illness is diagnosed and
treated like any other physical
disease. They often lead to significant distress and can alter the
ability of a person to function.
For a person to be considered as mentally ill, their social,
educational, or occupational
functioning must have been affected. Daily experiences where
one encounters some stressing
moments should not be considered like mental illness. When the
effects or symptoms are
prolonged, though, it has to is treated as a mental illness case.
Mental illness includes many types
of mental health problems. According to the American
Psychiatric Association's Diagnostic and

Statistical Manual of Mental Disorders, the following classes of
mental illnesses are found;
bipolar and related disorders, neurodevelopmental disorder,
depression, schizophrenia spectrum,
psychotic disorders, trauma-related disorders, eating disorders,
sexual dysfunction, personality
disorders, elimination disorders, somatic symptom and related
disorders, sleeping and waking
disorders, gender dysphoria, paraphilic disorders, substance-
related and addictive disorders,
neurocognitive disorders, and disruptive, impulse-control and
conduct disorders. Some
definitions are found below:
Depression: has been one of the most common mental disorders.
It is estimated that about 300
million people in the world are affected by depression. As
compared to men, more women are
more prone to depression. A chronic type of depression is a
persistent depressive disorder, also
known as dysthymia. A person with this disorder might

experience symptoms for up to two
years. In America, about 1.5 percent of adults are said to
experience dysthymia each year.
Clinical depression, also called major depressive disorder, is
experienced through extreme
sadness, feelings, and hopelessness. People experiencing
clinical depression might think about or
attempt to commit suicide. Seven percent of Americans are said
to experience at least one major
clinical depression episode per year. Depression may be
characterized by displeasure, sadness,
guilty feelings, and low self-worth, poor concentration,
tiredness, disturbed appetite, and
disturbed sleep. Depression is treatable through therapy and the
use of antidepressants for severe
cases.
Schizophrenia: is a psychosis mental disorder that affects how a
person perceives reality. It is
characterized by distorted thoughts, language, behavior, and
sense of self. Everyday experiences
may include hallucinations whereby they hear, see, and feel
things that do not exist, and
delusional with false beliefs and suspicions firmly held on to
when there is really nothing. In the

world, it affects 23 million people, while in America, about 1
percent of the population is
estimated to have schizophrenic experiences. Persons
experiencing schizophrenia may
experience stigma and discrimination hence resulting in a lack
of access to health or social
services. They're also at high risk of being exposed to human
rights violations leading to being
confined in institutions for a longer time. It can begin from as
early as adolescence or in young
adults. Schizophrenia is treatable with appropriate medicines as
well as psychosocial support.
Bipolar affective disorder: is a mental illness that is
characterized by manic and depressive
episodes with an in-between of regular mood periods; a person
with bipolar disorder experiences
episodes of manic highs, energetic, and depressive lows. The
person's energy levels are affected,
elevated moods, the pressure of speech, decreased need for
sleep, inflated self-esteem, and they

cannot reason. Bipolar disorder causes extremely severe mood
swings, which are not comparable
to the small ups and downs experienced daily. Bipolar disorder
affects 60 million people in the
world, while in America, about 2.6 percent of the people are
affected yearly. Medicines to
stabilize the moods are used for treatment during the acute
phase and to prevent relapse.
Development disorders: these include pervasive developmental
disorders such as autism and
intellectual disability. They usually begin during childhood but
can continue into adulthood,
resulting in delayed functions in relation to the maturation of
the central nervous system. As
compared to other mental health illnesses, developmental
disorders are characterized by
following a steady course as opposed to occurring in periods.
The primary characteristic is the
impairment of skills in developmental areas such as adaptive
behavior and cognitive functioning.
In autism, there is impaired communication and language, social
behavior, and carrying out
activities repetitively. Persons affected by these disorders need
the support of family in setting up

environments that they are comfortable and setting daily
routines that are not disrupted as well as
identifying where they can learn better.
Dementia: is the result of deterioration in cognitive function,
the processing of thoughts, which is
more than what is expected as one ages normally. It usually
affects one's ability to comprehend,
remember, calculate, learning, language, and judging. These
impairments lead to a lack of
emotional control, deteriorated social behavior, and motivation.
Stroke can contribute to
dementia.
Anxiety disorder: is the type of disease that is more than usual
anxiety experienced on a daily
basis. A person with this condition tend to worry about many
things, sometimes with no reason
to worry at all. People with this condition are often afraid that
things will never work out in their
favor.

Post-traumatic stress disorder (PTSD): is a mental illness that
results from one experiencing
traumatic events in their lives. These experiences can range
from war or national disasters to
physical or verbal abuse.
Common signs of other mental illnesses may include: having
insomnia or too much sleep,
depriving oneself of food or overeating, feelings of fatigue
without doing much, numbness,
experiences of unexplainable pains in the body, feelings of
hopelessness, indulging in drinking,
smoking, or drug abuse, feelings of confusion, irritability,
anxiety, anger, and forgetfulness.
These symptoms help the physicians to come up with a
diagnosis so as to give the right
treatment.
Mental illnesses treatments are aimed to reduce the symptoms
while making the condition to be
manageable. It may include medications such as
antidepressants, anti-anxiety, mood-stabilizing,

and antipsychotic drugs. Psychotherapy, hospitalized care, and
lifestyle treatment is other forms
of treatment.
HISTORICAL INFORMATION OF MENTAL HEALTH THE
AFRICAN AMERICAN
COMMUNITY
According to the 2014 U.S. Census, 13.2 percent of the U.S.
population is African
Americans, which is roughly 45.7 million people. However,
these figures might not be accurate
due to the overrepresentation of people who are hard to find
during the census. Those who are
homeless are many African Americans, whereas some just
decline is participating in the poll.
African Americans trace back their ancestry to the slave trade
from Africa. For a period of more
than 200 years, millions of them were purchased and brought to
the west. When slavery ended in
the early 1800s, their economy activities relied heavily on
agriculture, with most of them being
sick. They were exploited and remained at the bottom of the
economic ladder as most African

Americans were sharecropping. They continued to live in
poverty with meager incomes and little
or no opportunity for betterment. The African American
community has tried to make changes to
the fights for social and economic justice, but however, there
still exist disparities in mental
health issues. African Americans suffer more increased rates of
mental illnesses. Historical
adversities including slavery, sharecropping, racial based
exclusion from health services,
exclusion from education, and differences in social and
economic resources, which translates
into disparities in the socioeconomic status (Jones, (1998)).
These differences automatically turn
into the causes of mental illnesses among African Americans.
Homeless people and those in
prisons have a higher chance of suffering from mental illnesses
too. Racism continues to impact
mental health conditions and has done so for generations, and it
is yet to be addressed.

Psychiatrists and medical professionals have been engaging in
misdiagnosis through exploiting
African Americans by specific mental illnesses hence
prolonging the problems. Some mental
diseases could be used to suggest that African Americans were
inferior compared to other races.
John Galt, a physician of the Eastern Lunatic Asylum in
Virginia in 1848, referred to African
Americans as being immune to mental illness because they do
not own property, engage in
business, vote, or hold office. He assumed that in the time when
wealthy white men were being
exposed to the emotional stress of profit-making. Mental illness
has been in existence in a long
time, but for African Americans, little about the condition has
been available. According to Dr.
Benjamin Rush, many of the people in slavery experienced
abnormal behaviors, one of which
was "negritude," a desire by the African Americans to become
white. Drapetomania is another
mental health condition that caused slaves to run away from
their plantations. Dysesthesia, which
is now depression was a disease that caused dullness in the
slaves. Severe beatings and abuse

were often used to treat both conditions, according to Dr.
Samuel Cartwright. He also believed
that the slaves had to be treated like children by their owners in
order for them to remain
submissive. However, both physicians failed to recognize that it
was the emotional stress causing
the conditions and therefore offer the appropriate medication.
Mental health facilities during the
pre-civil war barred slaves from receiving treatment. The
mental health experts believed that if
the African Americans were put together with the whites, they
would affect the white's healing
process. The African Americans were therefore housed outside
near the institutions. Some child
slaves were, however, cared for in the yards of those asylums.
They were, however,
misdiagnosed and often falsely accused of crimes, which led to
prolonged stays in the
institutions. The distrust of the healthcare system might have
started here since the children were

regularly being subjected to child labor, which was being
praised by the authorities of the
asylum. There is no way they could carry out manual work if
they were mentally ill. After the
Civil War led to the freedom of almost four million slaves,
there were increased cases of insanity
and consumption, which Dr. Powell of the Georgia Lunatic
Asylum argued that it was due to the
freedom accorded to them that is why they could not control
their appetites or passions thus
leading to increased vices. Like other medical experts, he also
failed to acknowledge that
socioeconomic factors such as poverty and racial discrimination
could be leading to those
improved conditions. Individuals with mental illnesses, and the
inadequate faced sterilization in
the 1920s as they were seen as unfit for reproduction. Eugenics
movement is what resulted in
this. They only wanted people who had good genetic stock to
give birth. Sterilization focused on
African Americans in the U.S., with their populations
decreasing due to the practice. States
passed laws for sterilization, even for the misdiagnosed
individuals. In the 1960s in North

Carolina, sterilized African American women were more than 85
percent of the legal
sterilizations. During the 1930s to 1960s, African Americans
were victimized through
psychosurgery, which is a surgical process of removing a part of
the brain (lobotomy) in order to
treat mental illnesses. The reasons for performing this
procedure were, however, ruled to be
socio-political rather than medical. Brain dysfunction was
believed to be the cause of widespread
violence in urban places and the inner city, hence
psychosurgery was viewed as the treatment.
Social scientists, however, saw the urban violence as reactions
due to poverty, oppression,
discrimination, and police brutality against African Americans
(Fink, & Tasman, (1991)). The
doctors argued that the brain disorder could be treated
surgically hence promoting their agenda in
trying to end the political unrest in that period. The procedures
were performed on children who

were even five years when they show aggressive behaviors. Two
New York psychiatrists
identified a condition known as protest psychosis in 1968. The
situation was said to drive "Negro
men" to insanity. They believed that African American
liberation caused delusions and
hallucinations in African American men. Later, they identified
protest psychosis like
schizophrenia, and today African American men are the ones
diagnosed with schizophrenia
mostly. Psychology and science show that African Americans
were exploited through medical
experiments. In the 1800s, a physician by the name Marion Sims
carried out surgical
experiments on female African slaves and infants without using
anesthesia on them. They were
used to carry out medical research and mostly died from the
tests. From 1932 to 1972, African
American men were used in the Tuskegee Experiment by the
U.S. Public Health Service. They
were made to believe that they were being treated for free, but
they were being experimented on
to study how untreated syphilis progresses. It resulted in most
of them dying from the disease

and passing it on to their unborn children. These historical
traumas have impacted the mental
health in the African American community.
BARRIERS TO MENTAL ILLNESS IN THE AFRICAN
AMERICAN COMMUNITY
Several barriers contribute to mental illnesses in the African
American community.
Racial bias plays a significant role since they are always
perceived as violent, and therefore,
when they get involved in criminal activities, no one really
cares to help them. When a white
person is involved in illegal activities such as mass shootings,
there is speculation that he is
mentally ill. Mental illness doesn't discriminate; it affects all
people despite their color. Mental
illnesses can affect African Americans more severely because of
unmet needs and the other
barriers they face. They face cultural barriers, religious
barriers, and language barriers. When

they deal with these barriers, they are denied their right to
treatment since mental illnesses are
diseases like any other physical disease. Some of the issues they
are facing in dealing with
mental illnesses are.
Misunderstanding of mental illness
African American community does not understand what mental
health is and does not
talk about the topic. Coping with mental illnesses like
depression is considered a spiritual or
moral weakness due to negative stereotypes and attitudes of
rejection. The lack of knowledge
might lead some to believe that mental illness is a punishment
from God. Therefore, the shame
and stigma associated with mental illnesses might make some of
them not to seek treatment. The
signs and symptoms associated with mental illnesses might not
be clear to all of them. Hence it
can go unrecognized. Some of them refer to depression as "the
blues," and they think that it is
something they can control. The lack of information makes them
not aware of when to seek help.
Studies show that 63 percent of African Americans believe that

depression is a personal
weakness, with only 32 percent finding that it is a health
problem. Six percent believe that it is
normal in aging for one to be depressed. Forty percent believe it
is normal for a partner to get
depressed for more than a year after losing their spouse to
death, while 45 percent believe that it
is normal for a mother to get depressed after giving birth for at
least two weeks.
Reluctance for treatment
Only a quarter of African Americans, which accounts for about
30 percent of adults,
willingly seek treatment for mental illnesses as compared to
about 40 percent of whites who
receive treatment in America per year. The barrier to treatment
is due to factors such as denial
when one does not accept that they might be dealing with a
mental health condition. Another
factor is some don't want help. Some people might feel
embarrassed or ashamed, and since they

fear to be labeled as weak in the community, they decide not to
seek advice concerning the
conditions. Lack of money or insurance is another factor why
some cannot receive treatment.
Hopelessness also can contribute to one being reluctant to seek
help. African Americans distrust
the health system due to past misdiagnoses. They are negatively
affected by discrimination in the
system hence receiving the inadequate treatment most times.
The lack of cultural competency
prevents many of them from staying without treatment. Studies
also show that medications are
metabolized slowly in African Americans, and since they
receive high doses, the adverse side
effects are more, therefore, discouraging them from continuing
with medication.
Inability to access mental health services
Many African Americans are not able to access mental health
care due to a lack of health
insurance or money. Eleven percent of African Americans lack
any form of health insurance as
of 2017. The percentage of people who are unable to get
treatment or prescribed medicine is high

for people with no health insurance. In the poor working
category, the most significant
representation is African Americans, and they do not qualify for
public coverage, and the jobs
they work in do not offer private coverage. Poverty is also a
contributor since it increases the
chances of being mentally ill. The people experiencing hunger,
homelessness, and lacking basic
needs are more prone to mental health disorders such as
depression and even engaging in the use
of drugs. According to the U.S. Census Bureau of 2014, the
poverty rate for African Americans
was 26.2 percent. Poverty contributes highly to mental health
issues.
Faith, spirituality, and community
In the African American community, religion, family, and
community are the most
significant sources of support. At least 85 percent of African
Americans consider themselves
religious. Research shows that they rely on faith, social

communities, and families for emotional
support, with most commonly turning to prayer to deal with
stressful moments instead of seeking
health care, which most times is necessary (Taylor, Chatters, &
Levin, (2003)). As much as these
spiritual beliefs are excellent sources of support, it can be a
hindrance to receiving professional
treatment or therapy. Faith, family, and community can help in
the process of recovery, but it
should be accompanied by other treatment forms. Since
spirituality is an integral part of their
lives, they can actively help in the treatment plan. If they lack
information about mental illnesses,
though, they can be a source of stigma instead of support.
Racism
Racism continues to impact the mental health of African
Americans. There have been
several historical instances of adverse treatments leading to
mistrust. In the slavery era, if one
displayed mental illness signs, they would receive more
beatings, which led them to hide or
disguise any psychological issue they might have. Myths have,
therefore, been created about

mental health conditions. African Americans also believe that if
their people made it through
slavery, they can make it through anything, hence no need to
take their problems to some
stranger/psychiatrist.
Provider bias and lack of cultural competency
Lack of cultural competence in providers leads to misdiagnosis
and poor quality of
treatment for African Americans. In African American women,
physical symptoms such as body
aches and pains are mentioned as part of the depression, but
since the provider is not competent
with the culture might not recognize it as a mental illness
symptom hence leading to
misdiagnosis (Metzl, (2010)). African Americans only make up
3.7 percent of members in the
American Psychiatric Association, with only 1.5 percent of
members in the American
Psychological Association.

Violence
African Americans witness or are victims of abuse and crimes.
The exposure to violence
increases their chances of being prone to suffering from PTSD,
anxiety, and depression. Children
who are exposed to violence experience long term effects of
mental illnesses.
THE PERSPECTIVE AFRICAN AMERICANS HAVE ON
MENTAL ILLNESS
Mental illnesses can affect anyone, regardless of color, race, or
gender. The experiences
and concerns, though, might differ. African Americans
sometimes experience mental illnesses
more severely because of the barriers they experience and are
20 percent more likely to develop
severe problems of mental illnesses than other populations, as
stated by Health and Human
Services Office of Minority healthy. African American adults
are three times more likely to get
severe psychological distress as compared to those living above
poverty (Breland-Noble,
Al-Mateen, & Singh, (2016)). They are also more likely to
experience sadness, feelings,

worthlessness, and hopelessness as compared to white adults.
African American teenagers
commit suicides at a higher rate than white teenagers. Since
African Americans are more prone
to exposure to violence and crimes, they are more likely to be
diagnosed with post-traumatic
stress disorder (PTSD) throughout their lives. These statistics
show that mental illnesses are
more amongst the African American community, and it is
essential for them to acknowledge the
same in order to get treatment. Ward, Wiltshire, Detry, and
Brown in 2013 conducted a study
that shows that African American communities have several
attitudes towards mental illnesses.
African Americans believe that mental health is a stigma that
leads to non-openness about the
same. For example, they do not seek help, which leads to their
behavior is affected. In the study,
those who participated were reluctant to acknowledge mental
health problems and not sure about

seeking treatment for the same. The African American
community relies on religious teachings,
including pastoral guidance and prayer to cope with mental
illnesses, and cultural lessons on the
origins of mental health and the nature in which mental
illnesses appear. Beliefs in a person
about psychological diseases can influence their willingness to
seek treatment or not. Therefore,
cultural opinions on mental disorders are essential. Mental
illnesses are viewed as:
Taboos
The stigma surrounding mental illness in the African American
community is a major
taboo. Depression and anxiety, which can lead to suicide, are
still treated as a taboo hence
leading to no health treatment sought by those affected by the
conditions.
Stigma
Stigma results when a person who has a mental illness is
negatively evaluated by those
surrounding them. In most cases, this is what happens in
African American communities. The
whole society suffers from perceived stigma where they view
people with mental illnesses in a

certain way. A common belief is that mental illness is one's
fault. Mental illness stigma generally
develops from a lack of knowledge about mental health. The son
believes of causes of mental
illnesses being biological leads to passing down of
misinformation from one generation to the
other hence the continued lack of information concerning
psychological disorders in the African
American communities. Due to this misinformation, it might not
be evident when one needs to
find the required help.
Weakness and instability
The National Mental Health Association conducted a national
survey in 1998, which
indicated that 63 percent of African Americans believe that
mental illnesses such as depression
are an indication of personal weakness. Another study showed
that some men believe that it is a
lack of being motivated. African American adults who are older

think that depression is a sign of
weakness and one's lack of inner strength. Clinical depression is
not a personal weakness;
however, but a medical illness that needs to be treated.
Knowledge of mental illnesses needs to
be increased so that the exposure can open up the African
Americans' minds on the issues of
mental health.
Myths
Depression in African American communities is perceived as
the "blues," which means
referring to life's ups and downs. However, that is not the case
because there are several
moments of happiness and sadness in a person's life (Neighbors,
(1996)). It is normal to feel
sadness during bad times, such as mourning, or when one is
getting through a divorce, financial
problems, or when sick. However, if the "blues" are prolonged,
that is a sign of clinical
depression that might go untreated if the myth is not changed.
Another myth about depression is
that some groups of African Americans are expected to undergo
depression, for example, new

mothers, teenagers, older people, women experiencing
menopause, or the ones having chronic
illnesses.
The mindset that they can survive anything.
African Americans, especially women, are expected to be active
as identified in the idea
of "strong black woman" and persevere anything they are going
through. The concept of African
American women being strong suggests that African American
women are expected to go
through all kinds of hardship without them breaking down,
whether physically or mentally. The
people believe that if their ancestors made it through slavery,
they could also make it through
anything, and they should take it to God in prayer instead of
telling strangers/psychiatrists their
problems. The mindset makes one seem as spiritually weak if
they say that they are feeling
sadness or anxiety. African Americans also believe that it
doesn't exist amongst them, or those

are not their type of concerns. A study conducted for 18 months
showed that African Americans
emphasized on non-biomedical interpretations of signs and
symptoms of mental illnesses. The
psychiatric medication was viewed as frustrating due to the
professionals' medication focus.
These cultural stereotypes lead to African Americans to denying
emotional problems.
Methodology
Mental health stigma is a negative evaluation for people with
mental health illness and/or
mental health treatment. It can be received in specific
categories, such as perceived stigma and
personal stigma. Perceived stigma is a mental health stigma
where one believes that society has a
particular perception of mental health patients. Its stigma is an
individual's belief in people with
mental illness. The stigma of mental health in the African
American community is built on the
grounds of personal stigma where an individual focuses on their
own beliefs on mental health.
These categories of individuals with mental health are never
willing to undergo any procedural

treatment. In most cases, personal stigma denounces the thought
of getting treated until the
disorder nearly incapacitates. Within the African American
regions, the problem is pronounced
by the fact that members of a particular ethnic minority group
are less likely to seek health
treatment. (Corrigan, 2015). Getting to the task to understand
the effect of prevalent stigma helps
determine the dangers of the illness. Some individuals never
recover due to their own fault. Most
of the African American beliefs can result in an assortment of
negative results for those with
health illness. Such effects include; inadequate and unsafe
housing, low employment, and even a
reduction in the utilization of mental health care. People with
personal stigma play a more
significant role in the development of mental health stigma in
the African American
communities. One of the most researched health topics
associates some factors to health stigma

in relation to ethnic minorities is lack of knowledge. Different
misinformation on the illness has
led to varying levels of stigmatization. Few African Americans
believe in the genetic sources as
a psychiatric source of the problem. The biological causes are
related to beliefs whose
probability will not add up for an individual with any kind of
mental health illness and is an
African American. It is, however, researched that culture among
the Latino population has
lessened the effect of stigma. There is more will and power to
attend any institution of health in
order to check for the issue of mental health as for the
acculturated individuals. Stigma reduction
may be due to information and acquisition of knowledge on
disorders related to mental health.
Creating familiarity with different causes of mental health
treatment reduces mental health
stigma among African Americans by a high percentage. The
ECA (Epidemiologic Catchment
Area) of the 1980s sampled citizens of Baltimore, St. Louis,
Durham-Piedmont, Los Angeles,
and New Haven and assessed both the community at large and
institutions which includes mental

health hospitals, jails, residential drug or alcohol treatment
facilities, and nursing homes (Robins
& Regier, 1991). Overall, it included 4,638 African Americans,
12,944 whites, and 1,600
Hispanics. A current look at the NCS (National Comorbidity
Survey), covered a representative
sample of people residing inside the network that protected 666
African Americans, 4,498
whites, and 713 additional U.S. Citizens (Kessler et al., 1994).
Participants of both studies
discussed whether or not they had signs of frequently diagnosed
mental disorders within the past
month, year, or at any time in the course of their lives. Results
for certain disorders are provided
in Figure 1. After analyzing demographic differences among
African Americans and whites, the
ECA discovered that African Americans have been much less
probable to be depressed and more
likely to be affected by phobia than have been whites (Zhang &
Snowden, 1999). The NCS

findings additionally suggest that African Americans were less
likely than whites to be affected
by the main despair.
The studies displayed gender differences in rates of mental
illness. Anxiety disorder,
prevalence rates of depression, and phobia were found to higher
in African American women
than in African American men. These differences paralleled
those found for white women and
men. Lack of knowledge creates anxiety and further frustrates
the situation, thus worsening.
Individuals in such a case usually experience interpersonal
stress, and this means that individuals
who are suffering from this medical condition experience a lot
of fear of anxiety on mental
illness. (Thompson, 2004). Ethnic bias manifests and maintains
the alarms by putting up a belief
that one group is superior to another or otherwise and,
therefore, should not meet or instead

collaborate. Racial biases have increased anxiety and thereby
increasing the mental health
problem occurrences amongst African Americans. African
Americans are usually less willing to
treat medical conditions. People with anxiety often have less
affinity to relationships due to
established myths and concerns, thereby leading to mistrust.
Within the American states, the
fears are much developed by the fact that mental health is
associated with the term crazy or
somewhat illegal drug use. Research shows that the minority
ethnic groups were reported to be
visiting a psychotherapist but with fewer results due to the
already formed opinions:
discrimination, unwillingness, and the inability to comprehend
life circumstances and not based
on color. Many in the African American community, the story is
one of resilience and
perseverance. Since we survived slavery, of course, we can
handle “sadness” or “anxiety.” With
this outlook, anything less would be considered moral or
spiritual weakness. Part of the issue is
that we often fail to recognize that mental illness is much more
than feeling anxious or

melancholy. We fail to realize mental disease as an “illness,” as
we would cancer, diabetes, or
high blood pressure.
Results
The results of the study show significant disparities among the
demographic groups in
America. The survey conducted for 12 months reveals that
major depression among white
participants was higher than that of the blacks at 2.8%
compared to 2.2%. However, blacks
exhibit higher ECA in panic and phobia disorders compared to
their white counterparts at 1.0:0.9
and 16.2:9.1%, respectively. However, the same trend is not
exhibited in the NCS study as the
whites show slightly higher rates compared to the blacks at
8.2:9.9, 1.1:2.4, and 14.5:14.8
respectively for the three disorders. On the other hand, the
lifetime study on major depression,
dysthymia, panic disorder in the ECA study exhibited higher

rates among white participants than
the blacks did at 3.1:5.1, 4.0:6.3, and 1.3:1.6 respectively for
the three disorders. However,
phobic disorder among blacks was remarkably higher than that
of the blacks at 23.4:9.7%. In the
NCS studies, the white population exhibited higher rates than
the blacks did in all the four
disorders.
These results led are an indicator of the health differences
between the two
demographics. While white participants in the study exhibited
slightly higher rates than that of
the blacks, the barriers to access to medical help is more
prevalent among African Americans.
The fact that the prevalence of the disorders is nearly the same
as that of the whites indicates the
need for interventions to address the challenge. Black
Americans exhibit low socioeconomic
status in which makes factors like the high prevalence of phobic
disorder a significant issue that
needs to be addressed. At a rate of 23.4 %, which is double that
of white Americans, indicates
the amount of input that social workers need to make to bridge
the gap.

Discussion
Mental health stigmatization among African Americans has
risen since the recent past to
unexpectedly high volumes. There are organizations put down
to help curb the pain of mental
health among Americans. However, there are several barriers to
such assistance, mostly realized
along the African Americans. The challenges are so
excruciating and detrimental to people who
suffer these menace. Culture is one significant barrier to this
question. African American men
have thrived to mask their pain thus more increase in mental
prevalence among them
The internal forces within us shape the darkness in our
struggles, and this, therefore, gives the
platform for mental health cases. More individuals in black
American society are at high risk
following the notion that ‘big men don’t cry.’ This idea creates
the fear of being labeled as less

of a man or rather as weak. To an extent, they can vocalize their
pain whatever the case. In this
case, we realize that we cannot have a stance to provoke such
emotions in such a society.
There is nothing as devastating as a depressed loving man.
African Americans fear the step to
togo visit mental health professionals for counseling. They least
understand that the bold step
might be a key strategy on not only trying to reinforce a
positive perception but also shed light
on the health of the African American society. Millions of
individuals in these societies suffer
these cases, and it is quite evident that men are suffering more
in the brutal hands of a mental
health menace. Stigma, a place of danger, is a consuming aspect
of mental health, and as
elucidated above, it is based on the ethnic minority who already
has suffered discrimination and
prejudice in the society. It means, therefore, stigma should first
be dealt with to help curb the
problem with ease and speed.

Conclusion
In conclusion, African American communities aren't different
from any other groups of
people in that everybody wants to live healthily: physically,
mentally, spiritually, and
emotionally. The challenge for groups of color and healthcare
companies is defining what a
healthy community looks like through the prisms of stigma and
historic adversity, which
includes race-primarily based exclusion from economic
resources, academic, social, and fitness.
It's only by working together collaboratively as fully engaged
partners we can overcome this
obstacle. In the African American community, many
misunderstand what mental health illness
is, and therefore the situation is uncommon. This lack of
information leads many to believe
mental illness is a shape of punishment or personal weakness.
Many African Americans have
problems recognizing the symptoms and signs and symptoms of
mental illness such as

depression and anxiety, which leads to them underestimating the
outcomes of mental health
conditions. African Americans can also be reluctant to discuss
mental health issues and receive
treatment due to the stigma and shame that is associated with
such conditions in the community.
The African American community approves people taking
medications for hypertension or
getting dialysis for kidney failure, then there shouldn’t be a
stigma around people for getting
treatment for mental health disorders. Mental health care is
marginalized in the healthcare
system. It isn't usually part of primary care visits. Lack of trust
in the medical system is due to
historical mistreatment of African Americans in health care
systems. Also a some deterrents,
difficulty in finding culturally responsive mental health
providers, less adequate insurance, past
and recent history with discrimination in the mental health
system and financial burden. Another,
a fear that these experiences will be repeated is all suggested by
other research.

Summary
It is clear that systematic barriers heavily impact mental health
in the Black community.
Although there has been a progression in mental health recently,
a significant stigma associated
with mental health concerns is still prevalent. In the African
American community, there is often
difficulty acknowledging psychological difficulties, but useful
strategies, including religious
coping and methods such as prayer and pastoral guidance, often
are the most preferred coping
mechanism. Destigmatizing mental health can be reached by
assisting people, especially in the
African American community, to better understand that mental
health is an essential part of
well-being. Culturally responsive mental health services are one
way of addressing the
disparities in psychological wellbeing in the African American
community. Stigma and judgment
prevent African Americans from finding treatment for their
mental illnesses. Research indicates
that African Americans believe that mild depression or anxiety

would be considered “crazy” in
their social circles. In the African American community,
spiritual beliefs, community, and family
are heavily relied on for support and strength. Although
research has found that many
African-Americans depend on faith, social communities, and
family for emotional support rather
than seeking proper health care professionals, even though
medical and therapeutic may be
necessary. African Americans may be hesitant to receive
treatment because they fear it may
reflect poorly on their families. A cultural change is necessary
to create a climate in which loved
ones and friends can receive non-judgmental support for a
mental health condition. This could
make a difference in helping others feel empowered to get the
help they may need.
References

Addressing Mental Health in the Black Community
https://www.columbiapsychiatry.org/news/addressing-mental-
health-black-community
African Americans
https://adaa.org/african-americans
Alvidrez, J., Snowden, L. R., & Kaiser, D. M. (2008). The
experience of stigma among Black
mental health consumers. Journal of Health Care for the Poor
and Underserved, 19(3), 874-893.
Black & African American Communities and Mental Health:
Mental Health America
https://www.mhanational.org/issues/black-african-american-
communities-and-mental-health
Breland-Noble, A. M., Al-Mateen, C. S., & Singh, N. N. (2016).
Handbook of mental health in
African American youth. Cham [u.a.: Springer.
Bureau of Labor Statistics. (2014). Occupational outlook
handbook, 2014-15 edition. Retrieved
from http://www.bls.gov/ooh/community-and-social-
service/social-workers.htm#tab-6

Clark, E. J. (2002, July 19). Testimony submitted to the
President's New Freedom Commission
on Mental Health. Retrieved from
http://www.socialworkers.org/pressroom/events/nfcmh.asp?print
=1
https://www.columbiapsychiatry.org/news/addressing-mental-
health-black-community
https://adaa.org/african-americans
https://www.mhanational.org/issues/black-african-american-
communities-and-mental-health
http://www.bls.gov/ooh/community-and-social-service/social-
workers.htm#tab-6
http://www.socialworkers.org/pressroom/events/nfcmh.asp?print
=1
Corrigan, P., Pickett, S., Kraus, D., Burks, R., & Schmidt, A.
(2015). Community-based
participatory research examining the health care needs of
African Americans who are homeless
with mental illness. Journal of health care for the poor and
underserved, 26(1), 119.

Fink, P. J., & Tasman, A. (1991). Stigma and mental illness.
Hastings, J. F., Martin, P. P., & Jones, L. V. (2015). African
Americans and depression: Signs,
awareness, treatments, and interventions.
Hays, K., & Aranda, M. P. (2016). Faith-based mental health
interventions with African
Americans: A review. Research on Social Work Practice, 26(7),
777-789.
In Griffith, E. E. H., In Jones, B. E., In Stewart, A. J., &
American Psychiatric Association
Publishing, (2019). Black mental health: Patients, providers,
and systems.
Jones, R. L. (1998). African American mental health: [theory,
research, and intervention].
Hampton, VA: Cobb & Henry.
June, L. N., Black, S. D., & Richardson, W. (2002). Counseling
in African-American
communities: Biblical perspectives on tough issues. Grand
Rapids, Mich: Zondervan.

Kritsotaki, D., Long, V., & Smith, M. (2019). Preventing mental
illness: Past, present and
future.
Link, B. G., & Phelan, J. C. (2006). Stigma and its public health
implications. The Lancet,
367(9509), 528-529.
McNally, R. J. (2011). What is mental illness? Cambridge,
Mass: the Belknap Press of Harvard
University Press
Mental Health: Culture, Race, and Ethnicity: A Supplement to
Mental Health: A Report of the
Surgeon General.
Office of the Surgeon General (US); Center for Mental Health
Services (US); National Institute
of Mental Health (US).

Rockville (MD): Substance Abuse and Mental Health Services
Administration (US); 2001 Aug.
Metzl, J. (2010). The protest psychosis: How schizophrenia
became a black disease. Boston:
Beacon Press.
Neighbors, H. W. (1996). Mental health in black America.
Thousand Oaks: SAGE Publ.
http://www.samhsa.gov/
Qualitative and Mixed Methods in Mental Health Services and
Implementation Research
Lawrence Palinkas -
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212209/
Staff, G. T. (2016, April 18). The Important Role Social
Workers Play in Mental Health.
Retrieved December 1, 2019, from
https://www.goodtherapy.org/blog/the-important-role-social-
workers-play-in-mental-health-1214

157.
Stigma Regarding Mental Illness Among People Of Color
https://www.thenationalcouncil.org/BH365/2019/07/08/stigma-
regarding-mental-illness-among-
people-of-color/
Szasz, T. (2010). The myth of mental illness: Foundations of a
theory of personal conduct. New
York: Harper Perennial.
Taylor, R. J., Chatters, L. M., & Levin, J. S. (2003). Religion in
the lives of African Americans:
Social, psychological, and health perspectives. London: SAGE.
Thompson, V. L. S., Bazile, A., & Akbar, M. (2004). African
Americans' perceptions of
psychotherapy and psychotherapists. Professional psychology:
Research and practice, 35(1), 19.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212209/

regarding-mental-illness-among-people-of-color/
regarding-mental-illness-among-people-of-color/
Thornicroft, G. (2008). Stigma and discrimination limit access
to mental health care.
Epidemiology and Psychiatric Sciences, 17(1), 14-19.
Turner, E. A. (2019). Mental Health among African Americans:
Innovations in Research and
Practice. Lanham: Lexington Books.
Critical Thinking Assignment 4
Levels of Achievement

Criteria
Not
Acceptable
Poor Fair Good
APA Style,
Proofreading &
Editing of
Paper
0 %
Paper has
more than 5
problems or
errors in the
format and
mechanics.
50 %
Paper has 3-5
problems or
errors in the
format and
mechanics.
75 %
Paper has
one or two
problems or
errors in the
format and

mechanics.
100 %
Paper is formatted
using an APA style:
(Includes: Title Page,
Abstract & Text
Citations).
Proofreading &
Editing of Paper
(Overall paper is free
of spelling, grammar
and punctuation
errors)
Integration of
course
materials (how
does the
assignment
relate to items
and objectives
in the chapter-
must give in-
text citations)
0 %
Course
concepts are
not
integrated to
the
response(s).
Explanations

are not clear
or no
citations to
the textbook
chapter(s).
50 %
Course
concepts are
integrated to
the
response(s)
but with little
explanation
and few
citations to
the textbook
chapter(s).
75 %
Course
concepts are
integrated
to the
response(s)
with some
explanations
and citations
to the
textbook
chapter(s).
100 %

Course concepts are
integrated to the
response(s) by
providing clear
connections,
explanations and
citations to the
textbook chapter(s).
Quality of
Response(s):
Address each
question
thoroughly and
in an organized
manner.
0 %
The
responses
are di�cult
to
understand
and follow.
50 %
Many areas in
the responses
need
improvement.
75 %
Most

questions
are clearly
answered.
100 %
Address all the
questions thoroughly
and in an organized
manner.
Name
Description
Rubric Detail
Weight
20.00%
Weight
40.00%
Weight
40.00%
Week 7
Critical Thinking Assignment – Employee Relations
Case: Metropolitan Insurance: Employee Counseling
NOTE: This assignment must include a title page, an executive
summary and a maximum of three pages of text.
You are the HR Manager for Metropolitan Insurance, a property
and casualty insurance firm based in New Jersey. The office is

in a high-rise building and occupies four floors of the tower. A
total of 238 employees work in the call center and interact with
customers and independent insurance agents across the eastern
U.S.
To enter the office of the Metropolitan Insurance, employees
are required to use “swipe cards” that are used to open doors in
order to gain access. When the swipe cards are drawn through
the unit outside the door, the employee’s name and the time he
or she entered is recorded in the company’s security system.
(The is official company policy.)
One of the employees in the call center, Jennifer (Customer
Service Representative), has had an attendance problem. Her
supervisor, Robert, has asked you to give him guidance for
counseling Jennifer on her attendance issues.
According to Robert, “Jennifer’s office is two floors below
mine, and I think she assumes I have no way of knowing when
she arrives for work, returns from lunch, or is absent
altogether.”
Responding to him, you say “Right. So she doesn’t realize that
every time she enters the building, the swipe card logs her
entry?”
“No, she apparently thinks she is slipping in and out without
our knowledge,” Robert replies. “My records indicate that in
the last month, she was late to work 9 times and took a lunch
longer than an hour a total of 10 times.”
Mulling over, you ask, “Have you approached her on this matter
yet?” “Not really,” he says. “I asked her yesterday why she
was late coming to work the day before, and she simply
responded that she wasn’t late.”

“Yet you know she was,” you counter.
“Exactly. She didn’t swipe in until 30 minutes after her
workday should start.”
After giving the situation some thought, you ask, “It is possible
that she was on time but didn’t swipe her card at the access
door?”
“What do you mean?” Robert asks.
“Perhaps she was here when she was supposed to be here, but
someone held the door open for her. If that was the case, she
wouldn’t need to swipe her card to gain access.”
Robert nods. “That is possible, but then why would she swipe
in 30 minutes later? After all, she should have been at her desk
at that point.”
“True”, you say. “but she may have forgotten something in her
car and gone out to retrieve it. When she came back in, it might
have appeared that it was the first time she swiped in.”
“Well that certainly sounds plausible and might account for
incident, “Robert says. “But what about all the other times?
Surely you don’t suggest that people are holding the door open
for her every time she’s been late to work in the morning or
returning from lunch. That’s just too coincidental.”
“I agree. But when we meet with her, we must be prepared for
her to offer just that kind of scenario as her defense.”
Both of you plan to meet with Jennifer this afternoon
concerning her attendance.
Questions:

1. How should you and Robert approach Jennifer regarding her
attendance? What will be said?
2. If Jennifer indicates that she was never late and that
employees held the door open ever time, what will you say?
3. Assume this will be Jennifer’s first disciplinary action.
What steps should be taken?
4. If you discover there is a companywide practice of holding
the door open for employees, should a new policy be created?
If so, what should it say?
Critical Thinking Assignment # 5 Grading Rubric
Employee Relations
Points Possible
Points Awarded
Criteria
5
Paper is formatted using an APA style: (Includes: Title Page,

Abstract & Text Citations)
Student’s Last Name included within MS Word filename, in
submission
5
Proofreading & Editing of Paper
(Overall paper is free of spelling, grammar and punctuation
errors)
10
Quality written paper that addresses the employee counseling
issue presented and documents a reasonable plan of action
related to progressive employee discipline.
5
Integration of course materials (how does the assignment relate
to items and objectives in the chapter-must give in-text
citations)
25
Total

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