Cultural Diversity and Psychiatric Treatment: The Case of African-Americans

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Table of Contents

Review of Literature: Essential Mental Health Care Risks Associated with Race
Attitudes toward Mental Health Care among African-Americans
Most Common Mental Health Treatment Issues for African-Americans
Systematic Challenges of Mental Health Care with African-Americans
Culturally Responsive Treatment in Psychiatry
Conclusion
References

One of the main reasons why African-Americans should be viewed as a source of cultural diversity within the framework of psychiatric practice is their exposure to slavery. The numerous ways of exclusion, social, economic, and health-related, forced the African-American population to approach mental health care with disbelief and resilience. For example, Turner and Mills (2016) suggested that most socioeconomic disparities generate a belief among the African-American population that mental health is a privilege and cannot be available to people of color. Even so, mental health remains a fundamental source of influence that cannot be ignored if researchers expect to increase the likelihood of African-American individuals engaging in proper psychiatric interventions (Jones et al., 2020). The needs of this population were ignored for a prolonged period, causing African-Americans to choose incarceration, substance abuse, and homelessness instead of mental health care. There should be approaches to these intercultural differences that would make African-Americans less reluctant.

The historical legacy of African-American individuals and their role in the development of the United States of America cannot be denied. This is why the issue of racism could be seen entrenched in psychotherapeutic and psychiatric processes, especially due to the prolonged influence of rejecting attitudes and stereotypes (Kelley et al., 2019). The measurable influence of each of these factors on African-American individuals continues to increase on a daily basis because of the growing sense of mistrust. The latter is cultivated by the Black population because of how the best interests of African-Americans are almost never approached by the government and policymaking bodies. Therefore, the historical context of bias and intercultural misunderstanding seems to repeat itself. In line with Mitchell et al. (2017), increasing hardships make it almost impossible to maintain mental health in rural areas due to the limited safety net and a small number of dedicated services revolving around mental health.

Review of Literature: Essential Mental Health Care Risks Associated with Race

The most prevalent element of discussion that has to be covered when talking about essential mental health care risks in African-Americans is an inadequately low socioeconomic status paired with parenting practices. According to Fadus et al. (2020), a dysfunctional Black family could be exposed to plenty of challenges that its White counterpart would not have to go through when seeking mental health care assistance. Therefore, parent criminality, overall neighborhood status, exposure to parental rejection, and severe punishments could lead African-American children to become reluctant to psychiatric and psychotherapeutic interventions (Planey et al., 2019). The presence of disparities in mental health care is essentially the same across urban and rural territories, which also makes it safe to say that cultural challenges avert policymaking bodies from paying attention to details. Fadus et al. (2020) stated that African-American youth experience much more difficulties with impulse control, which is also a risk in numerous situations. The prevalence of mental health issues among minority communities makes it crucial to capitalize on individual interpretations of psychiatry and collect all kinds of feedback from teachers, parents, and caregivers.

Attitudes toward Mental Health Care among African-Americans

Attitudes toward mental health care that are affected by one’s cultural beliefs represent an essential problem for African-Americans. This happens mostly because of the lack of psychological openness and help-seeking behaviors (Jones et al., 2020). The fear of being exposed to stigma moves the Black community to pick coping behaviors that do not fit them, nor do they represent the actual wishes and needs of any given African-American with mental health issues. In line with Adewale et al. (2016), even if the majority of Black psychiatry patients tend to acknowledge their psychological problems, they often become too reluctant to seeking any kind of mental health services. The lack of balance between the prevalence of stigma and appropriate attitudes makes the situation even worse.

The presence of stigma is an exceptional problem for more than 1/3 of the overall US population of African-American men (Sneed et al., 2020). This concern makes it safe to say that stigma worsens African-American experiences with mental health care and embeds the idea that mental illnesses should not be treated even deeper in the minds of the Black community. Based on the information presented by Kelley et al. (2019), many study participants do not seek professional help because of the sense of consistency with cultural values that avert them from interactions with mental health care providers. There are no specific measures at the moment that could help care providers reduce the stigma and attract more African-American individuals to psychiatric interventions.

Most Common Mental Health Treatment Issues for African-Americans

Another area of cultural bias that should be discussed within the framework of the current paper is the prevalence of treatment issues that affect African-American people. For instance, the Black population is less often diagnosed with mood disorders and schizophrenia (Molina & James, 2016). This factor limits the exposure of African-American individuals to psychiatry and also restricts their outlook on the effectiveness of mental health care as a whole. The overrepresentation of the African-American community across prisons and jails is another issue because it affects therapy effectiveness and medication prescription. In line with Tobon et al. (2021), mental health conditions could become a damaging variable on a long-term scale, especially with African-Americans remaining reluctant to receiving proper care. Individuals of other races are not as affected by this particular issue because the lack of cultural competence among psychiatrists and other mental health care workers does not seem to affect treatment outcomes (Woods-Giscombe et al., 2016). Therefore, the problem revolves around the inability of the African-American population to escape the stigma and prevent their surroundings from harsh judgment. According to Walton and Shepard Payne (2016), a high percentage of Black families do not even discuss mental health because such attitudes are considered abnormal.

Systematic Challenges of Mental Health Care with African-Americans

The advent of the so-called systematic barriers became one of the main reasons for a disproportionate exposure to mental health care issues among African-Americans. Despite the Black community only constituting approximately 15% of the US population, the majority of its representatives belong to high-risk populations (Mitchell et al., 2017). The most common example of why African-American individuals are way more often affected by socioeconomic challenges than people of other ethnicities is homelessness. Given that almost half of the prison population is comprised of the Black community and almost 50% of children in the foster care system are Black, it may be safe to say that exposure to mental health issues is extremely high among African-Americans (Sneed et al., 2020). On the other hand, there is a challenge of averting mental health issues while coping with systemic neighborhood violence. According to Kelley et al. (2019), political, socioeconomic, and historical sources of influence make it harder for African-Americans to escape stereotypes and bias to seek appropriate help from psychiatrists, psychotherapists, and other related specialists.

The damage that is given to the physical and psychological health of the Black community cannot be replicated with any other racial or ethnic mix due to the unique attitudes toward mental care promoted by African-Americans. The majority of disparities that they encounter are not new and can be described as a phenomenon that has been around the United States for many generations in a row (Adewale et al., 2016). This historic bias puts African-Americans at a disadvantage that they have not been able to overcome even after the slavery era was ended during the middle of the 20^th century. This subjection to oppression does not take any overt forms nowadays, but it generates traumatic experiences for African-Americans of all ages (Woods-Giscombe et al., 2016). Even though such pain does not represent a direct systematic obstacle to proper mental health care, the intergenerational nature of culturally specific issues affects the Black community to an extent where they remain extremely reluctant to discussing trauma or engaging in psychiatric treatments.

Culturally Responsive Treatment in Psychiatry

One important step that African-American individuals have to make when exposing themselves to psychiatric interventions or any other kind of mental health service is to get acquainted with culturally responsive treatment. Here, the idea is that the given care provider recognizes the need to address certain disparities and help the Black community overcome issues from within (Sneed et al., 2020). In a sense, not all mental health care providers may have the ability to align their practice against an African-American person’s values, language, or beliefs. This is why it is crucial to emphasize the role of the Black culture among clinicians and help them distinguish specific trends and cornerstones to be respected when interacting with culture-specific issues (Molina & James, 2016). Even so, the cultural framework of psychiatric care would require both the provider and the patient to adjust to the given scenario and gain a sense of what objectives have to be achieved. Depending on one’s cultural sensitivity, the best treatment plan could be developed and deployed.

The majority of African-American individuals requesting mental health care will feel guilty and nervous due to the increasingly high impact of stigma. Irrespective of these challenges, providers should realize that deeper insight into the Black culture would speed up the treatment process and affect African-Americans in a positive manner (Jones et al., 2020). The idea should be to cope with mental health issues via constant interpersonal interactions that are free of bias, as culturally responsive care requires a respectful approach from all participants of the treatment process. A person’s cultural background remains a significant issue for the Black community because not all mental health care providers have the ability to highlight the overlapping social categorizations (gender, race, socioeconomic class) and remain mindful (Mitchell et al., 2017). Such interdependency requires a high level of awareness and the capability of both African-American patients and their psychiatrists to take the necessary steps and go beyond bias and prejudices. With the Black community, culturally responsive treatment is the only option because specific African-American beliefs have to be infused into treatment.

Conclusion

Based on the research completed within the framework of the current paper, it may be determined that the Black community is much more affected by serious mental health issues than any other population across the United States. Such experiences could range from anxiety disorders to depressive episodes turning into Major Depressive Disorder. When problems with mental health emerge, African-American individuals do not tend to approach health care providers because of an inherent unwillingness to engage in stereotypical discussions and receive biased treatment. These statistics basically prove that there are disparities that yet have to be reduced in order to create room for high-quality care services and attract marginalized populations to what they had believed to be ineffective and unnecessary. The gap between African-Americans and other races in terms of exposure to mental health care provision continues to increase. Therefore, inequalities are affecting the United States on numerous levels, including psychiatry and mental health assistance.

Additional research might be necessary to clarify the existing findings and ensure that all the factors contributing to bias and discrimination can be seen in the literature. Within the framework of the literature review, it was found that mental health was not popularized among the Black community. It caused many African-Americans to seek information regarding their health condition on their own and limit their exposure to mental health care due to the possibility of being treated in a prejudiced manner. The history of oppression and abuse averts African-Americans from approving psychiatric interventions and remaining culturally responsive. The socioeconomic burden of mental health services yet has to be addressed by researchers in the field in order to improve African-American access to nondiscriminatory care environments and enhance the healthcare system as a whole. The fear of improper mental health care experiences should be removed from the background in order to increase the rate of utilization of mental care among African-Americans and other vulnerable populations.

References

Adewale, V., Ritchie, D., & Skeels, S. E. (2016). African-American and African perspectives on mental health: A pilot study of the pre and post-colonial and slavery influences and their implications on mental health. Journal of Communication in Healthcare, 9(2), 78-89.

Fadus, M. C., Ginsburg, K. R., Sobowale, K., Halliday-Boykins, C. A., Bryant, B. E., Gray, K. M., & Squeglia, L. M. (2020). Unconscious bias and the diagnosis of disruptive behavior disorders and ADHD in African American and Hispanic youth. Academic Psychiatry, 44(1), 95-102.

Jones, A. L., Cochran, S. D., Rafferty, J., Taylor, R. J., & Mays, V. M. (2020). Lifetime and twelve-month prevalence, persistence, and unmet treatment needs of mood, anxiety, and substance use disorders in African American and US versus foreign-born Caribbean women. International Journal of Environmental Research and Public Health, 17(19), 7007-7029.

Kelley, F. R., Haas, G. L., Felber, E., Travis, M. J., & Davis, E. M. (2019). Religious community partnerships: A novel approach to teaching psychiatry residents about religious and cultural factors in the mental health care of African-Americans. Academic Psychiatry, 43(3), 300-305.

Mitchell, J. A., Watkins, D. C., Shires, D., Chapman, R. A., & Burnett, J. (2017). Clues to the blues: Predictors of self-reported mental and emotional health among older African American men.American Journal of Men’s Health, 11(5), 1366-1375.

Molina, K. M., & James, D. (2016). Discrimination, internalized racism, and depression: A comparative study of African American and Afro-Caribbean adults in the US. Group Processes & Intergroup Relations, 19(4), 439-461.

Planey, A. M., Smith, S. M., Moore, S., & Walker, T. D. (2019). Barriers and facilitators to mental health help-seeking among African American youth and their families: A systematic review study.Children and Youth Services Review, 101, 190-200.

Sneed, R. S., Key, K., Bailey, S., & Johnson-Lawrence, V. (2020). Social and psychological consequences of the COVID-19 pandemic in African-American communities: Lessons from Michigan.Psychological Trauma: Theory, Research, Practice, and Policy, 12(5), 446-448.

Tobon, A. L., Flores, J. M., Taylor, J. H., Johnson, I., Landeros-Weisenberger, A., Aboiralor, O.,… & Bloch, M. H. (2021). Racial implicit associations in psychiatric diagnosis, treatment, and compliance expectations. Academic Psychiatry, 45(1), 23-33.

Turner, E. A., & Mills, C. J. (2016). Culturally relevant diagnosis and assessment of mental illness. In Handbook of Mental Health in African American Youth (pp. 21-35). Springer.

Walton, Q. L., & Shepard Payne, J. (2016). Missing the mark: Cultural expressions of depressive symptoms among African-American women and men. Social Work in Mental Health, 14(6), 637-657.

Woods-Giscombe, C., Robinson, M. N., Carthon, D., Devane-Johnson, S., & Corbie-Smith, G. (2016). Superwoman schema, stigma, spirituality, and culturally sensitive providers: Factors influencing African American women’s use of mental health services. Journal of Best Practices in Health Professions Diversity: Research, Education and Policy, 9(1), 1124-1141.

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