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Methodology 1/1.5 pages
1. Describe what you did a secondary data analysis of…
Racial/Ethnic Differences in Mental Health Service Use among
Adults
2. Describe where it came from..
Data received from links below to Racial/Ethnic Differences in
Mental
Health Service Use among Adults and Charts of the numbers.
https://www.integration.samhsa.gov/MHServicesUseAmongAdu
lts.pdf
https://www.samhsa.gov/data/sites/default/files/MHServicesUse
AmongAdults/Appendic
es.pdf
Describe what you were looking for and how you found it.
Looking to compare mental health service use among adults.
Focusing on
insurance, gender, employment, poverty status and education.
Results/Discussion 2.5 pages
Methodology Drives the Results section.
1. Describe what was found what was found during the
secondary data
analysis. (Discuss the numbers!!!) (at least 1 page)
https://www.integration.samhsa.gov/MHServicesUseAmongAdu
lts.pdf
https://www.samhsa.gov/data/sites/default/files/MHServicesUse
AmongAdults/Appendices.pdf
https://www.samhsa.gov/data/sites/default/files/MHServicesUse
AmongAdults/Appendices.pdf
2. Research Question 1: Are mental health service usage
different among
african american than other races. (Discuss if the research
question is
supported by the data and explain. If not explain as well.)
3. Null Hypothesis: African american men are more likely to
obtain mental
health services between ages between ages 18-25 compared to
other ethnic
groups. (Discuss whether hypothesis is supported or not
supported based
on the same data collected)
4. Alternative Hypothesis: African Americans are less likely to
receive
mental health care services compared to other races. (Discuss
whether
hypothesis is supported or not supported based on the same data
collected)
End the discussion talking about how the data analyzed
connects to the topic “Why is
there a stigma of mental health in the African American
community” and either supports or
disproves my Research question.
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.
AFRICAN AMERICAN MENTAL HEALTH 3
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
AFRICAN AMERICAN MENTAL HEALTH 4
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;
AFRICAN AMERICAN MENTAL HEALTH 5
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
AFRICAN AMERICAN MENTAL HEALTH 6
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
AFRICAN AMERICAN MENTAL HEALTH 7
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,
AFRICAN AMERICAN MENTAL HEALTH 8
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
AFRICAN AMERICAN MENTAL HEALTH 9
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
AFRICAN AMERICAN MENTAL HEALTH 10
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
AFRICAN AMERICAN MENTAL HEALTH 11
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
AFRICAN AMERICAN MENTAL HEALTH 12
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
AFRICAN AMERICAN MENTAL HEALTH 13
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.
AFRICAN AMERICAN MENTAL HEALTH 14
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
AFRICAN AMERICAN MENTAL HEALTH 15
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
AFRICAN AMERICAN MENTAL HEALTH 16
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
AFRICAN AMERICAN MENTAL HEALTH 17
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.
AFRICAN AMERICAN MENTAL HEALTH 18
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
AFRICAN AMERICAN MENTAL HEALTH 19
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.
AFRICAN AMERICAN MENTAL HEALTH 20
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.
AFRICAN AMERICAN MENTAL HEALTH 21
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.
Bailey, Z. D., Krieger, N., Agénor, M., Graves, J., Linos, N., &
Bassett, M. T. (2017). Structural
racism and health inequities in the USA: evidence and
interventions. The Lancet, 389(10077),
1453-1463.
Behavioral Health. (2017, February 8). 5 Factors That Affect
Mental Health in African American
Communities. Retrieved from Behavioral Health:
https://www.arundellodge.org/5-factors-that-affect-mental-
health-in-african-american-communiti
es/
Black & African American Communities and Mental Health:
Mental Health America
https://www.mhanational.org/issues/black-african-american-
communities-and-mental-health
https://www.columbiapsychiatry.org/news/addressing-mental-
health-black-community
https://adaa.org/african-americans
https://www.arundellodge.org/5-factors-that-affect-mental-
health-in-african-american-communities/
https://www.arundellodge.org/5-factors-that-affect-mental-
health-in-african-american-communities/
https://www.mhanational.org/issues/black-african-american-
communities-and-mental-health
AFRICAN AMERICAN MENTAL HEALTH 22
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
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=1
Center for Disease Control and Prevention . (2017). Health,
United States, 2017 – Data Finder.
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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.
http://www.bls.gov/ooh/community-and-social-service/social-
workers.htm#tab-6
http://www.socialworkers.org/pressroom/events/nfcmh.asp?print
=1
https://www.cdc.gov/nchs/hus/contents2017.htm#Table_046
AFRICAN AMERICAN MENTAL HEALTH 23
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
AFRICAN AMERICAN MENTAL HEALTH 24
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
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Metzl, J. (2010). The protest psychosis: How schizophrenia
became a black disease. Boston:
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Neighbors, H. W. (1996). Mental health in black America.
Thousand Oaks: SAGE Publ.
Qualitative and Mixed Methods in Mental Health Services and
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Workers Play in Mental Health.
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Stigma Regarding Mental Illness Among People Of Color
http://www.samhsa.gov/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212209/
https://www.goodtherapy.org/blog/the-important-role-social-
workers-play-in-mental-health-1214157
https://www.goodtherapy.org/blog/the-important-role-social-
workers-play-in-mental-health-1214157
AFRICAN AMERICAN MENTAL HEALTH 25
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.
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.
Weissman, J. S., Pratt, L. A., Miller, E. A., & Parker, J. D.
(2015). Serious Psychological
Distress Among Adults, United States, 2009-2013. US
Department of Health and Human
Services, Centers for Disease Control and Prevention, National
Center for Health Statistics.
https://www.thenationalcouncil.org/BH365/2019/07/08/stigma-
regarding-mental-illness-among-people-of-color/
https://www.thenationalcouncil.org/BH365/2019/07/08/stigma-
regarding-mental-illness-among-people-of-color/
AFRICAN AMERICAN MENTAL HEALTH 26
Appendix A
Appendix B

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Methodology 11.5 pages 1. Describe what you did a seconda.docx

  • 1. Methodology 1/1.5 pages 1. Describe what you did a secondary data analysis of… Racial/Ethnic Differences in Mental Health Service Use among Adults 2. Describe where it came from.. Data received from links below to Racial/Ethnic Differences in Mental Health Service Use among Adults and Charts of the numbers. https://www.integration.samhsa.gov/MHServicesUseAmongAdu lts.pdf https://www.samhsa.gov/data/sites/default/files/MHServicesUse AmongAdults/Appendic es.pdf Describe what you were looking for and how you found it. Looking to compare mental health service use among adults. Focusing on insurance, gender, employment, poverty status and education. Results/Discussion 2.5 pages Methodology Drives the Results section.
  • 2. 1. Describe what was found what was found during the secondary data analysis. (Discuss the numbers!!!) (at least 1 page) https://www.integration.samhsa.gov/MHServicesUseAmongAdu lts.pdf https://www.samhsa.gov/data/sites/default/files/MHServicesUse AmongAdults/Appendices.pdf https://www.samhsa.gov/data/sites/default/files/MHServicesUse AmongAdults/Appendices.pdf 2. Research Question 1: Are mental health service usage different among african american than other races. (Discuss if the research question is supported by the data and explain. If not explain as well.) 3. Null Hypothesis: African american men are more likely to obtain mental health services between ages between ages 18-25 compared to other ethnic groups. (Discuss whether hypothesis is supported or not supported based on the same data collected)
  • 3. 4. Alternative Hypothesis: African Americans are less likely to receive mental health care services compared to other races. (Discuss whether hypothesis is supported or not supported based on the same data collected) End the discussion talking about how the data analyzed connects to the topic “Why is there a stigma of mental health in the African American community” and either supports or disproves my Research question. 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
  • 4. 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
  • 5. 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.
  • 6. AFRICAN AMERICAN MENTAL HEALTH 3 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
  • 7. 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 AFRICAN AMERICAN MENTAL HEALTH 4
  • 8. 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,
  • 9. 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; AFRICAN AMERICAN MENTAL HEALTH 5 bipolar and related disorders, neurodevelopmental disorder, depression, schizophrenia spectrum, psychotic disorders, trauma-related disorders, eating disorders,
  • 10. 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
  • 11. 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 AFRICAN AMERICAN MENTAL HEALTH 6 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
  • 12. 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.
  • 13. 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 AFRICAN AMERICAN MENTAL HEALTH 7 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,
  • 14. 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
  • 15. 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, AFRICAN AMERICAN MENTAL HEALTH 8 and antipsychotic drugs. Psychotherapy, hospitalized care, and lifestyle treatment is other forms of treatment. HISTORICAL INFORMATION OF MENTAL HEALTH THE AFRICAN AMERICAN COMMUNITY
  • 16. 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
  • 17. 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 AFRICAN AMERICAN MENTAL HEALTH 9 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
  • 18. 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
  • 19. 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 AFRICAN AMERICAN MENTAL HEALTH 10 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
  • 20. 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
  • 21. 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 AFRICAN AMERICAN MENTAL HEALTH 11 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
  • 22. 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.
  • 23. 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 AFRICAN AMERICAN MENTAL HEALTH 12 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
  • 24. 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.
  • 25. 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 AFRICAN AMERICAN MENTAL HEALTH 13 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
  • 26. 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
  • 27. 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. AFRICAN AMERICAN MENTAL HEALTH 14 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
  • 28. 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
  • 29. treatment for African Americans. In African American women, physical symptoms such as body AFRICAN AMERICAN MENTAL HEALTH 15 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
  • 30. 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
  • 31. AFRICAN AMERICAN MENTAL HEALTH 16 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
  • 32. 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
  • 33. AFRICAN AMERICAN MENTAL HEALTH 17 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.
  • 34. 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. AFRICAN AMERICAN MENTAL HEALTH 18 The mindset that they can survive anything.
  • 35. 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.
  • 36. Methodology AFRICAN AMERICAN MENTAL HEALTH 19 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
  • 37. 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,
  • 38. 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. AFRICAN AMERICAN MENTAL HEALTH 20 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
  • 39. 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.
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