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Mental Health in Black/African American Communities

Introduction

It is estimated that 13 million American women and 6 million American men may experience depression in any given year. A recent large-scale nationwide study found that 10.5% of African Americans had experienced major depressive disorder at some point in their lives. The results also indicated that the prevalence of depression was more remarkable among African American women than among African American men, which is in line with previous research showing that women have a higher rate of depression than males. Considering that lower educational attainment and income contribute to depression, the fact that African American males had a lower psychological prevalence rate than African American women is an intriguing finding. African-American males with fewer than 12 years of formal education and income levels below poverty, as reported by Lincoln, Taylor, Watkins, and Chatter (2011), had more significant depressive symptoms than their more affluent male and female counterparts. Nonetheless, further study is required to understand this phenomenon fully.

According to Breland et al. (2022), the Common Sense Model (CSM) served as the theoretical framework for this investigation of attitudes toward mental illness. In the CSM, people’s responses to health risks and diseases are shaped by their commonsense beliefs and representations of such risks and illnesses. A person’s representation of a health danger or sickness includes their thoughts and feelings regarding the threats or illness’s identification or symptoms, source, timeframe, repercussions, treatment and control consistency, and emotional effect. Both informal and formal information sources inform the representations. Regardless of their integrity, Portrayals affect the coping mechanisms people choose to get rid of or manage the health risk or sickness. Research on African American perspectives on mental illness and mental health care use has shown contradictory findings. The critical paper Mental Health: Culture, Race, and Ethnicity are only one of many studies that have revealed that African Americans have a negative perspective of obtaining treatment for mental illness due to the associated stigma. Similarly, recent qualitative research of beliefs and attitudes about psychological health among older African American people found that participants considered a mental illness, especially depression, as a vulnerability.

Discussion

Mikhail et al.(2021) research on African Americans’ informational needs and service gaps in the area of mental health reveals several patterns, including a lack of knowledge due to shame, restricted access owing to multiple pressures, reliance on faith and religion as a primary resource, and significant informational gaps. As other external stressors have long loomed bigger in the African American community regarding the movement for equality and civil rights, discussions regarding mental health problems and mental illness have been hushed up (Bauer et al., 2022). Furthermore, mental illness is often stigmatized outside the African American community. In the present political and social context in the United States, mental health financing is constantly in jeopardy since it is not seen as vital as physical health. Mental health services, personal and governmental, are few for African Americans. When it comes to mental health services, Byers et al. (2021) note that stigma “may be a primary barrier to treatment among rural populations” but that there are other issues at play. African Americans with mental health issues are more likely to seek help from friends, family, and the community, such as their church or school, rather than a doctor.

Since they do not come from a conventional medical perspective, they are considered alternative sources of knowledge. Families struggling to cope with a child’s mental health issue often report feeling stigmatized by their community (Johnson, 2020). There is peer pressure within the African American community, but most of that peer pressure originates with parents. A study by Bauer et al.( 2022) found that parents of individuals with developmental illness expressed concerns such as “some individuals might take pity on me,” “my child’s teacher would treat him/her unfairly,” and “I would be worried that people in town would find out” when discussing their hesitation to seek mental health care for their children (Johnson et al., 2020). Findings revealed that parents’ reluctance to seek help for their children in conventional and non-conventional settings was proportional to the stigma they experienced.

Beliefs

Male and female participants had similar beliefs regarding their familiarity with mental illness symptoms and causative elements. The results are at odds with those of other investigations. Sixty-four percent of African Americans, for instance, agreed that mental illness is an indicator of character flaws in the National Mental Health Association poll. Similar to Byers et al. (2021) revealed that African American males attributed mental health issues to a lack of drive. Recent research by Rosen et al. (2020) showed that older African American people viewed depression as an indication of weakness and the absence of inner power. There are several possible explanations for the discrepancy between the present study and previous ones; these include cohort consequences, respondents’ exposure to mental disorders, and potentially improved understanding of the mental disease among study participants, 32% of whom reported having a psychological illness or undergoing care for one.

Since the IPQ-subscales R’s are not very reliable, it is unclear whether or not they should be used with African Americans. In the one research in which the IPQ-R was administered to African American women, issues with low dependability on the chronology and controllability subscales were found (Byers et al., 2021). There was not a single research that included African American males that employed the IPQ-R. Additional research into the IPQ-psychometrics R’s is warranted in light of issues with its subscales in the current study and findings from Bauer et al. (2022). Fewer items on the subscales, respondents guessing or misinterpreting things, inconsistent replies, limited variation in responses, and cultural appropriateness are all potential psychometric difficulties that might have affected the validity of the IPQ-R in the current research. To add insult to injury, it is possible that skewed reliability estimations were obtained using solely coefficient-alpha on the IPQ-R (Byers et al., 2021). The makers of the IPQ-R propose using the subdimensions rather than the aggregate of all test items; hence the scale is classified as multiple unidimensional. Because tau-equivalent requirements may not have been satisfied, using coefficient-alpha on numerous unidimensional scales may result in an underestimation of genuine dependability (Byers et al., 2021). To meet the tau-equivalent requirement, each component of the test must be measuring the same unifying feature or skill. The IPQ-R reliability test may be enhanced by future investigational usage of stratified alpha and factor analysis of the IPQ-R.

Information Seeking Behaviors, Needs, and Barriers

Social and cultural factors are also key factors in mental disorders among African Americans and notably for African American women. Brown and Keith write in “In and Out of Our Right Minds: The Mental Health of African American Women” that African American women have traditionally juggled paid work with caring for children and other family responsibilities, which can lead to feelings of being overwhelmed or at odds with one another. This is especially true in situations where coping mechanisms are scarce. DiMaggio et al. (2020) theorize that people searching for information will not have a specific search term or ideas in mind and will instead find relevant pieces of information without necessarily noticing the bigger picture or information that might interrogate assumptions. Many people, according to DiMaggio et al. (2020), learn something by chance. Both of these ideas stress the fact that people don’t always seek information with the same level of planning and preparation and that their methods of doing so may be more ad hoc. When it comes to mental health or medical information this is worrisome. If African Americans are poor, they may be less likely to receive help for their mental health issues (Byers et al., 2021). Homelessness, frequent relocation, a lack of health insurance, and the strain of supporting a family while making ends meet are just a few of the factors that might keep a family from escaping the cycle of poverty. Because of this, many children may not get the help they need for concerns connected to mental health or environmental stress. In addition, people in rural areas may be less likely to actively seek out information. DiMaggio et al. (2020) concentrate their study on the diverse forms of therapy and referral patterns for persons diagnosed with depression in rural locations. Accepting referrals to mental health practitioners was associated with significant wait times, a lack of treatments, and payment concerns. Those in need of mental health care may be sent to specialized facilities. There were several cases when no recommendations were made at all.

According to Ransome et al. (2021), for African Americans, living regions may determine how readily or difficult it is to access resources and treatment for mental health, as well as work toward recovery. The study looked at the prevalence of mental health issues and access to treatment among rural African American and White adolescents (Byers et al., 2021). Subsequent studies confirmed that young people of color are just as likely as their white counterparts to suffer from psychiatric problems, but they are less likely to seek help from specialized mental health facilities (Bauer et al., 2022). In addition to the already extensive list of information obstacles, one may add the lack of ethnic and racial diversity among behavioral health professionals, as well as a lack of time, money, transportation, and large travel distances.

Insight into why so few African Americans seek help might be gained from the conclusion that both women and men exhibit low support for psychological openness (DiMaggio et al., 2020). The historically and currently low rates of usage of mental health care among African Americans are well-documented. Poor access to treatment, receiving poor quality care, a lack of available care, and the stigma related to mental illness are all factors that have been proposed as reasons why people don’t seek mental health services. The connection between mental openness and the choice to seek professional care for mental health disorders isn’t discussed in the research on treatment-seeking and obstacles (DiMaggio et al., 2020). The subject of whether or not mental openness affects coping strategies or adherence to treatment and client or patient persistence remains unresolved. Implications for future study and treatment adherence are drawn from the fact that African American women and men are less likely to report high levels of psychological openness.

There is a consensus within the existing research on the stigma that our findings on worries about stigma are consistent. In reality, the African-American community as a whole has widespread worries about being stereotyped. However, our research adds fresh insight into the topic of racism and prejudice toward black males (Byers et al., 2021). A majority of studies on prejudice and discrimination have ignored African American males because they did not want to generalize findings from studies that only focused on women. Nonetheless, the results imply that stigma is a problem for African American males as well. These results may help shape initiatives aimed at educating and decreasing stigma in the African-American community that targets certain genders. While participants were moderately receptive to the idea of obtaining mental health treatment, they were highly worried about the stigma associated with mental illness and endorsed psychological openness at very low levels (Bauer et al., 2022). In contrast to the majority of the present research, which implies that African Americans have unfavorable views regarding obtaining mental health care, these individuals are more amenable to doing so than was found in a previous study by Diala et al. (2022). Since 31% of those who participated in the study reported having a mental illness and 32% of those with a mental illness sought treatment, it’s probable that this contributed to a more honest and open atmosphere. Since they may have had personal experience with mental illness and its treatment, this may have encouraged a more accepting attitude about seeking such help for others.

Age and Gender Differences in Attitudes and Preferred Coping

The study’s findings that attitudes and coping mechanisms varied by age and gender are unique. Specifically, the results demonstrated that women were far more psychologically open and responsive to seeking professional assistance than males were, despite the fact that both groups had low psychological openness and help-seeking inclination (Bauer et al., 2022). Women with greater incomes and levels of education may be more likely to have access to health insurance and medical treatment because they are more likely to be mentally ready and willing to seek professional assistance. Some of the observed discrepancies in African American women’s and men’s perspectives may be attributable to the fact that women have generally fared better economically than males have historically (Bowie, 2021). Research examining within-group distinctions among African Americans pertinent to gender and age group is important given the findings of age gaps revealing that older individuals were less mentally and emotionally open than youth and that middle-aged attendees were more open to pursuing professional support than young participants.

Further studies are required to determine what factors contribute to greater psychological openness among older individuals and African American males in the hopes of enhancing treatment-seeking behaviors, as shown by the present study (Bauer et al., 2022). In order to better understand which segments of African Americans are not receiving professional treatment, the finding that older and middle-aged individuals were less likely to seek help to deal with a mental health condition than young participants is crucial. Although the research has shown that young persons are more prone to utilize informal support and religious coping strategies, the opposite was seen for elderly adults (DiMaggio et al., 2020). Among elder African Americans, religious coping was shown to be the most culturally acceptable technique for managing depression. It’s possible that the variety of experiences and perspectives within the African-American community accounts for the contradictory results. The existence of different faiths and nationalities is one example of this variety. Furthermore, it is probable that the effect of sickness and death among older African Americans reduces their propensity to make use of informal assistance.

Research Surrounding the Black Community and Mental Health

Studies show that Black adults are 21% more likely to suffer from major mental health issues such as Major Depressive Disorder or Generalized Anxiety Disorder (DiMaggio et al., 2020). Furthermore, compared to both White emerging adults and older Black individuals, Black emerging adults (ages 17-25) had a greater prevalence of mental health issues and a lower prevalence of mental health care consumption (Bauer et al., 2022). These depressing numbers reveal that racial and economic inequities in the United States are growing, despite attempts to lessen them. More study is needed to explain these results and identify the causes of the Black community’s disproportionately low rate of mental health care use. Reduced access to appropriate insurance, culturally relevant mental health practitioners, affordable treatment, and a history of prejudice in the mental health system are all contributing factors (Bowie, 2021). Research suggests that a lack of insurance, stigma, and a fear of future treatment may all contribute to the low rate of Black people seeking mental health care.

According to Bauer et al. (2022), the mental health of the Black population is clearly disproportionately affected by systemic impediments. While just around 13% of Americans, Black people are disproportionately represented in high-risk demographics (a group that is often impacted by specific negative occurrences). For instance, around 42% of the homeless, 53% of the incarcerated, and 46% of the foster care population are people of African descent (Bauer et al., 2022). The risk of acquiring a mental disorder has been linked to a number of factors, including exposure to violence, jail, and the foster care system. Therefore, owing to historical, economic, social, and political pressures that systematically expose the Black community to variables known to be destructive to psychological and physical health, members of the Black community are disproportionately likely to suffer from mental health problems (DiMaggio et al., 2020). The data reveals over and over again that this inequality has persisted for a very long time and over several generations. Slavery, oppression, colonialism, racism, and segregation all had a toll on the mental health of the African-American community, and those problems persist today. There is mounting evidence that exposure to stressful events may trigger significant physiological changes in the individual experiencing them (Bauer et al., 2022). Modern scientists are also getting a handle on how these alterations in physiology are encoded in genes and transmitted down through the generations (Bowie, 2021). Intergenerational trauma may be handed down not just culturally and psychologically but also physiologically, as shown by these studies.

Despite advancements in the field in recent years, mental health issues continue to be mostly stigmatized. Religious coping and approaches like pastoral advice and prayer are frequently the most favored coping strategies in the Black community, despite the community’s reluctance in openly discuss mental health issues (Bauer et al., 2022)s. Reducing the negative connotations associated with mental health may be accomplished by educating the public, particularly the Black community, on the need to treat mental health as seriously as one would physical health issues such as eating well, getting enough sleep, and being active. These misconceptions, based on harmful preconceptions of emotional instability and stigmatizing attitudes, cause many individuals to see mental health issues as signs of personal weakness (Bauer et al., 2022). It is not always evident when one would need it or where to receive assistance due to the paucity of knowledge on mental health problems in the Black community.

According to Armstrong et al. (2022), the health and mental healthcare profession also needs more cultural sensitivity and understanding. The provision of mental health treatments to the Black community may be negatively affected by the therapist’s lack of cultural responsiveness, cultural distrust, and maybe negative attitudes connected with stigma. Fortunately, because of the spread of information and greater understanding of mental health issues, more resources are being allocated to the research, development, and implementation of culturally sensitive mental health care. When it comes to the mental health of the Black community, one solution is to provide care that takes into account the culture of the patient. Culture, which includes a person’s beliefs, conventions, values, and language, influences every part of our existence. The capacity to perceive and comprehend the importance of culture, both the client’s and the clinician’s, and to adjust therapy to fit the client’s requirements within their sociocultural context constitutes cultural responsiveness in mental health care (DiMaggio et al., 2020). Clients should probe providers with questions designed to gauge their cultural sensitivity during the first meetings. However, clinicians frequently anticipate and appreciate inquiries since doing so helps them understand better the client and what is most important to them.

Conclusion

There are several barriers that make it difficult for people of African descent to have access to mental health services and education. The African American community faces several obstacles, including widespread prejudice towards those who suffer from mental illness and a lack of funding for research that might address those needs. The literature assessment shows that more study on African Americans’ mental health issues is required, which might lead to new studies that open up a wide variety of avenues for progress. Research has tended to concentrate on what is already out there rather than developing a clear strategy or prescription for altering how information resources are seen. For many people, issues with their mental health may have far-reaching consequences that extend well beyond their present physical well-being and state of mind, including involuntary psychiatric detention or arrest as a result of acting out from their condition, or even worse. When it comes to African Americans’ information needs and information-seeking behavior, as well as their mental health, library resources, and other information-based institutions are more important than ever. The development of new community services, organizations, and online forums for African Americans with mental health disorders might benefit from a further study on the present information-seeking practices of this population.

References

Armstrong, C. C., Dong, L., & Harvey, A. G. (2022). Mediators and moderators of outcome from the Transdiagnostic Sleep and Circadian Intervention for adults with severe mental illness in a community setting. Behavior Research and Therapy151, 104053.

Bauer, A. G., Pean, K., Lalwani, T., Julien, L., & Shevorykin, A. (2022). Community needs and recommendations for multilevel mental health interventions among young Black men with previous trauma exposure. Journal of Consulting and Clinical Psychology90(10), 760.

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Byers, O. M., Fitzpatrick, J. J., McDonald, P. E., & Nelson, G. C. (2021). Giving while grieving: racism-related stress and psychological resilience in Black/African American registered nurses. Nursing Outlook69(6), 1039-1048.

DiMaggio, C., Klein, M., Berry, C., & Frangos, S. (2020). Black/African American Communities are at highest risk of COVID-19: spatial modeling of New York City ZIP Code–level testing results. Annals of epidemiology, 51, 7-13.

Johnson, A. D. R. (2020). Implicit Provider Bias and its Implications for Black/African American Mental Health. In The International Handbook of Black Community Mental Health (pp. 113-134). Emerald Publishing Limited.

Mikhail, M. E., & Klump, K. L. (2021). A virtual issue highlighting eating disorders in people of black/African and Indigenous heritage. International Journal of Eating Disorders54(3), 459-467.

Ransome, Yusuf, et al. “Neighborhood social cohesion and inequalities in COVID-19 diagnosis rates by area-level Black/African American racial composition.” Journal of Urban Health 98.2 (2021): 222-232.

Rockich-Winston, N., Taylor, T. R., Richards, J. A., White, D., & Wyatt, T. R. (2022). “All Patients Are Not Treated as Equal”: Extending Medicine’s Social Contract to Black/African American Communities. Teaching and Learning in Medicine, 34(3), 238-245.

Writer: Chris Peiris
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