African American Communities and Mental Health

African American Communities and Mental Health Mental Health America works nationally and locally to raise awareness about mental health and ensures that those at-risk for mental illnesses and related disorders receive proper, timely and effective treatment. MHA incorporates culturally competent strategies to ensure that it is effectively addressing the treatment and psychosocial needs of consumers and families with diverse values, beliefs, sexual orientations, and backgrounds that vary by race, ethnicity and/or language. Statistics The following statistics were taken from the “Mental Health: Culture, Race and Ethnicity Supplement” to the 1999 U.S. Surgeon General’s Report on Mental Health. Demographics/Societal Issues  12 percent of the U.S. population, or roughly 34 million people, identify themselves as African American, according to the 2000 Census. This figure may be lower than the actual number since African Americans are over-represented among people who are hard to reach through the census, such as those who are homeless or incarcerated. The African-American population is increasing in diversity as larger numbers of immigrants arrive from Africa and the Caribbean. Six percent of all blacks in the U.S. today are foreign born.  Fifty-three percent of all blacks live in the South, 37 percent live in the Northeast and Midwest, mostly in metropolitan areas, and 10 percent live in the West.  Historical adversity, which includes slavery, sharecropping and race-based exclusion from health, educational, social and economic resources, translates into the socioeconomic disparities experienced by African Americans today. Socioeconomic status, in turn, is linked to mental health: People who are impoverished, homeless, incarcerated or have substance abuse problems are at higher risk for poor mental health.  Racism continues to have an impact on the mental health of African Americans. Negative stereotypes and attitudes of rejection have decreased, but continue to occur with measurable, adverse consequences. Historical and contemporary instances of negative treatment have led to a mistrust of authorities, many of whom are not seen as having the best interests of African Americans in mind. Attitudes In 1996, MHA commissioned a national survey on clinical depression. The survey explored the barriers preventing Americans seeking treatment and gauged overall knowledge of and attitudes toward depression. This survey revealed that:  63 percent of African Americans believe that depression is a personal weakness, this is significantly higher than the overall survey average of 54 percent.  Only 31 percent of African Americans believed that depression was a “health problem.”    African Americans were more likely to believe that depression was “normal” than the overall survey average. o 56 percent believed that depression was a normal part of aging o 45 percent believed it was normal for a mother to feel depressed for at least two weeks after giving birth o 40 percent believed it was normal for a husband or wife to feel depressed for more than a year after the death of a spouse. Barriers to the treatment of depression cited by African Americans included: o Denial (40 percent) o Embarrassment/shame (38 percent) o Don’t want/refuse help (31 percent) o Lack money/insurance (29 percent) o Fear (17 percent) o Lack knowledge of treatment/problem (17 percent) o Hopeless (12 percent) African Americans were less likely to take an antidepressant for treatment of depression; only 34 percent would take one if it were prescribed by a doctor. Prevalence The following statistics were taken from the “Mental Health: Culture, Race and Ethnicity Supplement” to the 1999 U.S. Surgeon General’s Report on Mental Health.  African Americans may be less likely to suffer from major depression and more likely to suffer from phobias than are non-Hispanic whites. Expressions of symptoms of physical illness that cannot be explained in medical terms are more common among African Americans (15%) than among whites (9%).  While non-Hispanic whites are nearly twice as likely as African Americans to commit suicide, suicide rates for young black men are as high as those for young white men. Moreover, from 1980 - 1995, the suicide rate among African Americans aged 10 to 14 increased 233%, compared to a 120% increase among comparable non-Hispanic whites.  African Americans of all ages are more likely to be victims of serious violent crime than are nonHispanic whites. One study reported that over 25% of African American youth exposed to violence met diagnostic criteria for post-traumatic stress disorder (PTSD). Among Vietnam War veterans, 21% of black veterans, compared to 14% of non-Hispanic white veterans, suffer from PTSD, apparently because of the greater exposure of blacks to war-zone trauma. Treatment Issues The following statistics were taken from the “Mental Health: Culture, Race and Ethnicity Supplement” to the 1999 U.S. Surgeon General’s Report on Mental Health.  African-American physicians are five times more likely than white physicians to treat AfricanAmerican patients. African-American patients who see African-American physicians rate their physicians’ styles of interaction as more participatory. African Americans seeking help for a mental health problem would have trouble finding African American mental health professionals: In 1998, only 2 percent of psychiatrists, 2 percent of psychologists and 4 percent of social workers said they were African Americans.  The public mental health safety net of hospitals, community health centers, and local health departments are vital to many African Americans, especially to those in high-need populations.  African Americans of all ages are under represented in outpatient treatment but over-represented in inpatient treatment. Few African-American children receive treatment in privately funded psychiatric hospitals, but many receive treatment in publicly funded residential treatment centers for emotionally disturbed youth. Access/Insurance The following statistics were taken from the “Mental Health: Culture, Race and Ethnicity Supplement” to the 1999 U.S. Surgeon General’s Report on Mental Health.  Nearly 1 in 4 African Americans is uninsured, compared to 16% of the U.S. population. Rates of employer-based health coverage are just over 50% for employed African Americans, compared to over 70% for employed non-Hispanic whites. Medicaid covers nearly 21% of African Americans.  Overall, only one-third of Americans with a mental illness or a mental health problem get care. Yet, the percentage of African Americans receiving needed care is only half that of non-Hispanic whites. One study reported that nearly 60% of older, African-American adults were not receiving needed services.  African Americans are more likely to use emergency services or to seek treatment from a primary care provider than from a mental health specialist. Moreover, they may be more likely to use alternative therapies than are whites.