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Mental ilness is misunderstood and often ignored in the Black community because of the stigma associated with it. This stigma can be an obstacle for those dealing with a mental disorder. This paper examines the mental health stigma in the Black community and explains several reasons that prevent Afican Americans from seeking quality treatment and care for mental ilness. Using case studies and statistics from scholarly books and articles, research is presented on the importance of mental health, the impact of mental illness on the African American community, the way African Americans view and react to mental illness, the various reasons that make African Americans reluctant to seek treatment, and solutions to solving this issue.
The population discussed in this study are all adult African American men and women residing in the United States, from lower class to upper class, who suffer from mental illness. The demographics consists of age, gender, and race.
The qualitative and quantitative method was used for this research.
Using research found from Google Scholar, PsycINFO, EBSCO, and many others, this research study determines what causes African Americans to avoid seeking professional help for mental illness.
Mental illness is a tough issue. It is not something that can be applied towards just one group of people. A group's race, background, traditions, and values play an important role in the way they react to and handle mental illness. African Americans deal with mental illness differently than any other race. In fact, African Americans are as susceptible to mental ilness as White people (Clifton, 2015).
According to the 2014 United States Census, out of 7 million people in America, 16 percent identify as Black or African American. Of that 16 percent, 4 percent of those individuals had a mental disorder (Substance Abuse and Mental Health Services Administration, 2014). The myth that African Americans should not wory about seeking help for mental health because Black people are strong and can overcome anything is killing the African American community.
Black people feel that they are already labeled and experience obstacles due to the color of their skin, so adding mental illness to the list is another hardship that they do not need. Ihe misconception that it someone is diagnosed with a mental iliness means they are "Crazy" or "looney uded the minds of thousands of individuals.
Many Black people have a mask on that they refuse to take off because they feel they will be embarrassed or become vulnerable to the world. Thne stigma is the core component or the African American response therefore, making African Americans less likely to seek help for mental illness. The silence associated with the stigma is loud. very few studies have been conducted on the impact of mental ilness in the Black community. In addition to the lack of information on the impact of mental illness in the Black community, the Black community are not given solutions to this issue, because people do not want to believe that there is even an issue in the first place. The blame for the Black mental health problem cannot be put solely on the
health care system. Knowledge on mental health and how to deal witlh mental disorders begins within the community.
When most people think of health, physical health is the first thing that comes to mind. Although getting your blood pressure checked regularly, yearly checkups, and maintaining a healthy weight is essential, one must not forget the importance of mental health. Good mental health can be obtained the same way good physical health is obtained; eating healthy, exercising. and minimizing stress levels. Mental health is defined as the psychological, emotional, and social wellness of an individual. Mental illness influences how people think, feel, and act. It dictates how people manage stress, identify with others, and make important decisions. Furthermore, mental health supports and allows people to have and maintain healthy relationships, handle life's daily struggles, and have a peace of mind. Mental health is essential at every phase of life, from childhood and youth through adulthood. According to the Rhode Island Psychological Association, without mental health, a person cannot be healthy. When the brain does not function normally, every other part of the body is affected. Therefore, if someone does not have a healthy mind state, it is difficult for them to live up to their fullest potential.
Everyone experiences ups and downs caused by occurrences in life. Mental health is a complex topic because many people do not understand the effects that could possibly occur if it is not well maintained. A person should seek treatment when they feel they can no longer control their feelings and mood. There are different mental health conditions that can cause distinct changes in the way people think, and act. These changes can alter a person's life make it difticult for them to function accordingly. Seeking treatment can help a person cope with their illness and perhaps, help others deal with it, as well. Without adequate treatment, mental health conditions can worsen and make it extremely challenging for a person to live a normal life.
Anyone can develop a mental illness at any given time in their life. Mental illness does not have a set onset date and time or an expiration date. African Americans tend to encounter more serious symptoms associated with mental illness because of the lack of resources and barriers. According to the American Psychiatric Association, mental health disorders are common in the United States. Every year, about 45 million people suffer from at least one diagnosed mental disorder. However, African American adults are more than 15 percent more likely to experience severe psychological trauma than any other ethnicity.
Common mental illnesses among African Americans include suicide, especially in Black men, attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), and major depression (Mental Health America, 2016). According to a 2010 study conducted by the CDC, African Americans have the highest rate of depression (13 percent), compared to Hispanics (11 percent), and Whites (8 percent). Nevertheless, most Black people seem to think that mental illness is something that you can just "shake" or something that will go away with time. In fact, more than 50 percent of African Americans believe that depression is a sign of weakness (Mental Health America, 2016).
Black people are more susceptible to certain factors that increase the risk of developinga mental disorder. Those factors include lhomelessness and exposure to violence. A Homeless person is more likely to developa mental disorder than a person with shelter. Black people make up about 40 percent of the homeless population in America (Minorities and Homelessness, 2009). Being exposed to violence such as witnessing someone being shot and killed or being beaten puts a person at greater risk for developing a mental condition like PTSD, depression, or anxiety disorder. For instance, recently, many urban areas in Chicago have witnessed the murder rate increase.
Hundreds of people have been severely impacted by the violence and have not received the support and counseling that they need to overcome their traumatic experiences. In the book, "Death and Dying" written by psychiatrist Elisabeth Kubler-RoSs, the stages of grief are outlined. The five stages of griet are anger, denial, depression, bargaining, and acceptance (Kubler-Ross, 2009). These are the stages that most people experience when they are dying However, these series of emotions can occur when someone loses someone close to them. when grief and or loss is not properly address, more loss can occur, an individual can have anxiety attacks, develop a mental disorder, and abuse alcohol and drugs. The grieving stage is a sensitive time for anyone dealing with a loss.
Black mental health differs from White mental health. White people manage mental completely different than African Americans. For instance, the 2010 National Healthcare Quality Report states that White people seek and receive treatment or therapy for mental health issues at twice the rate as African Americans.
Black people have experienced psychological, as well as physical trauma that White people have not experienced. The experiences or trauma that certain races or ethnic groups have endured usually determine the mental state that the group is in. For African Americans, slavery or even racism as a whole can be named a culprit. Slavery was a traumatic experience that many Black people do not like to talk about. Slavery brings up feelings of dlisgust, degradation, pain, and anger. lt has been over one hundred years since slavery ended, yet the scars of slavery are pretty evident and may have been passed down from generation to generation.
Moreover, a study recently published in 2016, focused on the genetic makeup of African Americans (Baharian et al., 2015). The study, conducted by a team of researchers at McGill University in Montreal, consisted of more than 3,700 African Americans from across the United States. Each person participated in two studies; the llealth and Retirement Study and the Southern Community Cohort Study. The Health and Retirement Study was comprised of older Black people from urban and rural areas across the U.S. and the Southern Community Cohort Study was made up of Black people in the South that live in areas that have a disproportionate amount of high risk diseases. Both studies represent a geographically broad sampling, which is important in identifying the patterms of the genetic history of the Black race.
In conducting the research, the researchers looked at the portion of Black genetics that could be traced back to Africa. That data revealed that for most Black people, their DNA comes from their African ancestors. Also, according to the results, most African Americans have some European ancestry or White background. The results also showed that African American living in the South have slightly more African DNA (83 percent) than those who do not live in the South (80 percent). The researchers suggested that Black people living in the South have more African DNA because a vast majority of African slaves were sexually exploited prior to the Civil War.
Therefore, the slaves that were sexually exploited before the Civil War influenced the DNA of almost all African Americans today (Baharian et al., 2015). This study proves that a race's genetic makeup is a result of history. Therefore, the pain and anguish that African slaves endured is inde in the genetic makeup of African Americans today. When anger IS internalized and unresolved, it becomes an issue. The anger that African slaves felt in 1800 has been passed down from generation to generation and has yet to be resolved.
The stigma associated with mental health makes it much tougher for African Americans to seek help. Black people do not see "shrinks" is a common misconception among the Black community. In fact, only an estimated 25 percent of African Amnericans actually seek treatment from a professional compared to about 40 percent of White people (National Alliance on Mental Illness, 2017). Reasons that Black people are reluctant or simply do not reach out for mental health treatment include lack of information or community resources about mental health, religious beliefs, socioeconomic factors, provider bias, as well as the effectiveness of medications.
According to the American Psychological Association, Black people have limited access or absolutely no access to treatment for mental and behavioral issues (American Psychological Association, 2017). Therefore, Black people do not know where to go in order to receive mental health care. Limited access or no access to mental health care leads to the increase of symptoms, criminal activity, and arrests (Cuellar et al.,). The Black community does not talk about mental health because of the stigma associated with it. This stigma comes from a lack of knowledge or understanding about mental illness. This misunderstanding leads Black people to think that mental illness is a sign of weakness and a punishment from God. Furthermore, African
Americans do not know the signs and symptoms of mental illness. Because of this, many individuals just "brush it off and continue to live their lives and suffer in silence.
The Black church has played an important role in the lives of Black people for decades. Essentially, Black church services operate like counseling services. In fact, unlike any other racial groups, many African Americans prefer to rely on the church and their religion for support through life's obstacles, especially in regards to mental health, rather than seek professional help (Avent & CashwelI, 2015). These obstacles include dealing with racism (overt and covert), economic struggles, as well as family issues. According to the Pew Research Center, more than 70% of African Americans identify religion as a pivotal part of their lives. The rest of the population did not. A majority of Black church-goers attend an all Black church (Pew Research Center, 2009).
Many Alican Americans wOrship God as a way to cope and rely on their religious and spiritual beliefs to overcome trying times (Bell-Tolliver & Wilkerson, 2011; Whitley, 2012). The involvement of the church began during slavery. During slavery, slaves gravitated towards church and depended on their belief in God to express themselves spiritually and religiously because they were not content with their present situation and wanted a change.
However, many slave owners forbade slaves to assemble in groups more than five at a time without supervision from a slave owner. They feared that slaves would read the bible and gain strength and eventually, psychological freedom. These rules and beliefs made slaves uncomfortable and put a damper on their ability to conduct worship services at their own leisure. Even though slaves were aware of the repercussions they could possibly face, they still gathered in non-visible areas like the woods and swamps (Frazier, 1963). Slaves joined together and established their own church services on Sunday mornings to escape discrimination and White dominance. These gatherings laid the foundation for what is known as the Black Church today.
The church became a sacred ground and a place for fellowship; something that was not given on the plantation. Slaves endured a tremendous amount of pain and rauma and of course, there were no counseling services available. So, religion was all that slaves could lean on. Given the historical significance that the Black church has had in the lives of African Americans, church is still considered a support system and Black people would rather depend on a pastor than a psychologist.
In addition to members of the black community being encouraged to embrace religion Over professional mental health care treatment, many Black people do not seek quality mental health care because ot financial 1Ssues. Most simply cannot afford to see a counselor or get their hands on the necessary medications to treat their diagnosis. The cost ot mental health care is high. According to GoodTherapy.org. the average psychologist, counselor, or psychiatrist charges between S60-300 per one hour session.
Counselors usually recommend that a patient see them at least once a week. Therefore, a patient would be paying hundreds of dollars a month out of pocket if they have no insurance or if the provider does not accept their insurance. There are an estimated 34 million African Americans in the U.S. 22 percent are poor, so they either have limited health insurance or no health insurance at all (American Psychological Association, 2017). Lack of insurance is a barrier to seeking mental health treatment. One - fourth of African Americans do not have health insurance. That number is 1.5 times greater compared to White people (Brown et al., 2000). Individuals with no health insurance are more likely to use emergency or primary care physicians (American Psychological Association).
The results of a survey that included almost 100,000 adults showed that individuals with mental illnesses eventually seek professional help, but wait a long time before doing so. For mood disorders, the average delay is eight years and for anxiety disorders, at least nine years. People who wait a significant amount of time to seek help are often young, old, male, poor, illiterate, and minority (Kassam, Thornicroft, & Rose, 2007).
Nonetheless, when African Americans decide to seek professional treatment, they prefer to see an African American professional rather a professional that does not look like them, so that they can teel comfortable, be better understood, and treated accordingly. Historically, Black people have been negatively affected by White people in the medical field. Some Black people do not trust White people to provide them with medical care because of experiments that have been conducted on 5lack people by White doctors and of course, slavery. It was common for White physicians to conduct experiments on African Americans because they felt that Black people were immune to pain. For example, Dr. J. Marion Sims, named the father of gynecology, carried out a series of surgical experiments on enslaved African women from 1845 to 1849. He repeatedly forced prototypes of the vaginal speculum, a medical tool that he would later develop and is used all over the world today, into the vaginas of African slave women without any kind of
anesthesia (Sims, 1852). Another example is the infamous Tuskegee Syphilis Study on African American men conducted between 1932 and 1972. The study involved 600 Black men: 399 were given syphilis, 201 were not. Researchers never informed the participants of the real purpose of the study. Instead, the men were told that they had "bad blood", which meant that they had a medical condition like syphilis, fatigue, or anemia. However, the men never received the proper treatment for their ailments and were never given the option to quit the study. In exchange for their participation in the study, the men received free medical examinations, free food, and burial assistance (CDC 2016). The men had been misled and used by White people in the medical field.
Moreover, it is difficult to find an Atrican American mental health provider because African Americans are not well represented in the mental health field. African Americans make up only 2 percent of psychiatrists, 2 percent of psychologists and 4 percent of social workers in the mental health field today (Surgeon General's Report: Mental Health, Culural, Race, Ethnicity, 2001). This causes African Americans have difficulty finding a mental health provider because they get discouraged and Just stop seeking help altogether. Furthermore, when a medical provider is of a different race or ethnicity than the patient, the patient may not receive the treatment that they are supposed to receive. The medical provider may not be educated on the disorder because they cannot relate to the patient due to cultural incompetence, which could lead to a misdiagnosis. The more educated the professional is on the illness, the better they can treat the patient. It is important that a patient is comfortable with their doctor and trusts them because this helps the doctor properly diagnose the patient so that they can receive adequate treatment.
In conclusion, African Americans have been affected by mental illness in more ways than one. A majority of African Americans choose to disregard the signs and symptoms of mental illness because of the stigma associated with it, as well as other factors such as cost, personal feelings, discrimination, and maintaining a strong spiritual connection. These factors are barriers that stop African Americans from reaching out for help. Ending the mental illness stigma in the Black community means that Black people will be healthier mentally, physically, and spiritually, which could possibly decrease violence and poverty within the Black community.
To do so, Black people are encouraged to speak up rather than continue to suffer. No one should feel ashamed or judged for experiencing any kind of symptoms associated witha mental disorder. Gaining an insight and becoming educated about mental illness is important in understanding the issue. Letting close friends and family know that they are loved and supported plays a key role in them opening up about their illhess. It takes just one conversation with a parent, sibling, or friend to enact change. In addition to opening up to friends and family about mental illness, it is important that the Black community hold the health care system (doctors, hospitals, clinics) accountable for their actions. A person should demand that a doctor or nurse explain any symptoms they are having or diagnosis that has been made. Furthermore, if anything that a doctor or medical professional is doing that does not look or feel right, it is recommended that an individual speak up and notify someone. As a community, African Americans have the power to end the stigma associated with mental illness, thus making African Americans more likely to seek help.
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