Power Point By 10 am 12/06/2019

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.

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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

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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;

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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

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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

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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,

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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

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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

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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

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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

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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

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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.

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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

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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

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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

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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.

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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

After completing the secondary data analysis the information collected was presented in a

chart to indicate the nature of the relationship that existed between serious psychological distress

and age. From the data collected over the 30 days and the corresponding chart shows that there

was an inverse relationship between psychological distress and their age. Among the

participants, psychological distress was most prevalent among the population of between 45-54

years. African Americans of the Indian origin and the Mexicans aged 18 years and above were

most prone to psychological distress. Females also tend to be highly distressed as compared to

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males in the same age bracket. As a person continues to age, they are less likely to suffer from

severe psychological distress; it is highest among the middle-aged population, that is, 45-54

years. It is lower among the 74and above population as well as those between the ages of 18-24

years. Africans and the Americans of the Indians were also found to be more psychologically

distressed as compared to other races. The number of people insured also differed in terms of

health coverage. The percentage of coverage differed in terms of the type of insurance coverage

given to the patients who suffered psychological distress.

The data was obtained from the National Center for Health Statistics (Center for Disease

Control and Prevention, 2017). The information was captured in a spreadsheet and then

presented in the form of a chart to make the relationship more clear. The data collected ranged

from the period 2006-2016, which was believed to show a trend that has been existing in terms

of psychological distress prevalence and insurance coverage over the entire period between

2006-2016. The data collected was aimed at establishing the relationship between serious

psychological distress and the age as well as the race of the individual. It was also essential to

find out insurance coverage trends for people aged 18 years and above to help identify the nature

of the relationship that existed between severe psychological distress and insurance coverage.

Results/Discussion

The results obtained from the graphs (AA, AB) indicated that people between age 45-64

years tended to be more psychologically distressed as compared to other age brackets. The

people aged 14-24 years and those within the age bracket 74 years and above were least

psychologically distressed. On the other, in terms of racial affiliations, Africans were found to be

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more prevalent in serious psychological distress as compared to other races. Also, individuals

who were highly distressed psychologically were less likely to seek medical attention. However,

people with lower serious psychological distress seemed to seek medical attention. Among those

who sought medical attention, most were least affected by severe psychological distress,

indicating that the chances for trying medication declined as the state of psychological distress

changed over time. In terms of people who sought insurance coverage, it was found that a

majority of the people preferred private insurance as compared to public insurance services such

as those offered by Medicaid. Those who were under insurance by private companies were more

than 50 percent of the total participants, while those under public insurance were much lower.

However, there were high chances that someone was psychologically distressed but did not have

an insurance cover, as indicated by the graph.The research sought to provide an answer to

whether there is a relationship between severe psychological distress and insurance coverage. To

begin with, psychological distress was higher ages 45-64 years and was slower between ages

18-24 and age 74 years and above. Those within the younger age bracket and the elderly were

less likely to suffer from psychological distress. On the other hand, those in the age bracket 74

years and above were also likely to suffer from psychological distress. However, serious

psychological distress was found to be more prevalent among middle-aged individuals. The type

of insurance coverage increased over the years, an indication that there were similarities between

insurance coverage and the state of one’s health. Since the percentage seeking medical attention

increased over the years, those also enrolled for insurance coverage, especially in the private

insurance companies were also increased over the years. They are showing us the people became

more psychological distress. The percentage of insured people even was declining over the years

AFRICAN AMERICAN MENTAL HEALTH 21

because people were enrolled in various health insurance agencies. Therefore, the relationship

between severe psychological distress and insurance coverage was supported by the data.

Therefore, there was a relationship between severe psychological distress and insurance

coverage.

From the data, it has been found that there is a relationship between serious psychological

distress and insurance coverage. On this basis, the null hypothesis that insurance coverage is not

related to serious psychological distress among African Americans is rejected. On the other

hand, the data indicate that there is a relationship between insurance coverage and serious

psychological distress; therefore, the alternative hypothesis is supported by the data.

From the analysis, it has been found that the percentage of people suffering from serious

psychological distress was the highest among the Africans Americans. On the other, the chances

of taking a medical insurance cover were also inversely related to age, and those affected most

by serious psychological distress rarely seek medical attention. This creates a challenge to offer

mental treatment challenges on time for less serious cases. Although there was a correlation

between health insurance and serious psychological distress, there seems to be a huge gap

between those who suffered serious psychological distress, and those who took a health

insurance cover. African Americans were the highest affected by serious psychological distress

(Bailey, Krieger, Agénor, Graves, Linos, & Bassett, 2017). On the other, they were the least who

sought medical attention. This shows that because they rarely seek medical attention, the chances

of developing stigma were likely to be high. Because these populations rarely sought clinically,

attention for their condition, they are more likely to develop mental health stigma, which might

have resulted from other social challenges such as poverty, racial discrimination, and lack of

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cultural competencies (Weissman, Pratt, Miller, & Parker, 2015). The problem among African

Americans seems to continue worsening despite the fact various measures have been put in place

to control the problem.

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,

AFRICAN AMERICAN MENTAL HEALTH 23

difficulty in finding culturally responsive mental health providers, less adequate insurance, past

and recent history with discrimination in the mental health system and financial burden. Another,

a fear that these experiences will be repeated is all suggested by other research.

Summary

It is clear that systematic barriers heavily impact mental health in the Black community.

Although there has been a progression in mental health recently, a significant stigma associated

with mental health concerns is still prevalent. In the African American community, there is often

difficulty acknowledging psychological difficulties, but useful strategies, including religious

coping and methods such as prayer and pastoral guidance, often are the most preferred coping

mechanism. Destigmatizing mental health can be reached by assisting people, especially in the

African American community, to better understand that mental health is an essential part of

well-being. Culturally responsive mental health services are one way of addressing the

disparities in psychological wellbeing in the African American community. Stigma and judgment

prevent African Americans from finding treatment for their mental illnesses. Research indicates

that African Americans believe that mild depression or anxiety would be considered “crazy” in

their social circles. In the African American community, spiritual beliefs, community, and family

are heavily relied on for support and strength. Although research has found that many

African-Americans depend on faith, social communities, and family for emotional support rather

than seeking proper health care professionals, even though medical and therapeutic may be

necessary. African Americans may be hesitant to receive treatment because they fear it may

reflect poorly on their families. A cultural change is necessary to create a climate in which loved

ones and friends can receive non-judgmental support for a mental health condition.

AFRICAN AMERICAN MENTAL HEALTH 24

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

AFRICAN AMERICAN MENTAL HEALTH 25

Breland-Noble, A. M., Al-Mateen, C. S., & Singh, N. N. (2016). ​Handbook of mental health in

African American youth​. Cham [u.a.: Springer.

Bureau of Labor Statistics. (2014). Occupational outlook handbook, 2014-15 edition. Retrieved

from ​http://www.bls.gov/ooh/community-and-social-service/social-workers.htm#tab-6

Clark, E. J. (2002, July 19). Testimony submitted to the President's New Freedom Commission

on Mental Health. Retrieved from

http://www.socialworkers.org/pressroom/events/nfcmh.asp?print=1

Center for Disease Control and Prevention . (2017). ​Health, United States, 2017 – Data Finder​.

Retrieved from Center for Disease Control and Prevention :

https://www.cdc.gov/nchs/hus/contents2017.htm#Table_046

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​.

AFRICAN AMERICAN MENTAL HEALTH 26

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 27

Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the

Surgeon General.

Office of the Surgeon General (US); Center for Mental Health Services (US); National Institute

of Mental Health (US).

Rockville (MD): ​Substance Abuse and Mental Health Services Administration (US)​; 2001 Aug.

Metzl, J. (2010). ​The protest psychosis: How schizophrenia became a black disease​. Boston:

Beacon Press.

Neighbors, H. W. (1996). ​Mental health in black America​. Thousand Oaks: SAGE Publ.

Qualitative and Mixed Methods in Mental Health Services and Implementation Research

Lawrence Palinkas - ​https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212209/

Staff, G. T. (2016, April 18). The Important Role Social Workers Play in Mental Health.

Retrieved December 1, 2019, from

https://www.goodtherapy.org/blog/the-important-role-social-workers-play-in-mental-health-1214

157​.

Stigma Regarding Mental Illness Among People Of Color

AFRICAN AMERICAN MENTAL HEALTH 28

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​.

AFRICAN AMERICAN MENTAL HEALTH 29

Appendix A

Appendix B