Healthcare Inequality and Bias Exist among Minorities Living with Schizophrenia
Schizophrenia Disorder is described as a long-term mental disorder involving a breakdown in the relation between thought, emotion, and behavior which leads to faulty perception, inappropriate actions and feelings. A person living with Schizophrenia also experience withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation. There are many factors as to what causes schizophrenia but, most prominent is the abnormality in the brain particularly, the frontal part of brain. (Blanchard, Brown, Horan, & Sherwood, 2008).
People who, live with Schizophrenia disorder, may experience numerous combinations of delusions, hallucinations, and/ or extreme disordered thinking and behaviors. In order to label Schizophrenia as a diagnosis, the common symptoms must be apparent and in active phase lasting for at least six months (National Institute of Mental Health, 2009). People living with schizophrenia have psychotic symptoms, known as positive or first rank symptoms; these symptoms are identified when there is a loss of interest, second rank symptoms are the inappropriate or blunted affects, which identify the negative symptoms of the illness. Cognitive impairment is also seen as a feature in people living with schizophrenia (National Institute of Mental Health, 2009).
Usually, the onset of schizophrenia manifests between the ages of 16 and 30 years old. Studies show that usually men develop symptoms of schizophrenia at an earlier age than women; men tend to have their first episode by the age of 16 to 19 yrs. old while, women having their first episode around age 19 to 25 yrs. old. Generally, if there are no symptoms before the age of 45 years old, a person probably will not develop schizophrenia (National Institute of Mental Health, 2009).
After the first initial episode of schizophrenia, approximately 80% of those persons will recover but unfortunately, 70% will have another episode within five to seven years (National Institute of Mental Health, 2009). Subtype illnesses which are disorganized, catatonic, paranoid, schizophreniform, residual, and schizoaffective disorder are also present with Schizophrenia. Often, people who live with this illness develop a chronic illness which last over a lifetime. (National Institute of Mental Health, 2009).
Schizophrenia is suspected to be more common in minorities groups in other regions such as, Western Europe but, it is difficult to separate race or ethnicity in other countries. In the United States it is easier to measure the ethnic/racial barriers. Socioeconomic status of family origin in the United States is suspected to play a major part in the development of this mental illness. In an isolated case study followed over the years of 1981-1997, proved that 12,094 of the 19,044 live births of schizophrenia spectrum disorders, 3 times more Black American than White Americans were diagnosed with schizophrenia. The participant’s mothers were restricted to only identify as African American or White American (Bresnahan, Begg, Brown, Schaefer, Sohler, Insel, Vella at all ,2007).
Inequality and biases exist in healthcare services among minorities living with Schizophrenia. While there is no provided direct evidence that biases affects the quality of care for minority patients but, research does suggest that healthcare provider’s diagnostics and treatment decisions, as well as their feelings about patients are influenced by patients’ race or ethnicity. (Bresnahan, Begg, Brown, Schaefer, Sohler, Insel, Vella, at all, 2007).
Being that mental illnesses such as schizophrenia, can be hereditary, biases and inequality concerning healthcare access, does not only hinder the lives of minorities living with schizophrenia but, they also contribute to generations of continued poverty. Although there is no set margins, researchers have shown that social inequality and ethnicity are also a factor with people who live with schizophrenia. These studies claim that black or dark skinned people in Western regions live in less prosperous conditions than other populations. This underprivileged population of minorities are listed as having the highest rate of mental illness, crime and poverty. In 2003, the surgeon general reported and various studied documents regarding unequal treatment racial and ethnic practices; limited access and provision of optimum treatments (American Journal of Public Health, 2003).
Considering that minorities living with Schizophrenia or, any other mental illness must be healthy enough to work, bias in our health care system is a huge barrier to obtain re-habilitation potential. Due to the lack of access and financial stability, thousands of minorities living with Schizophrenia and other mental illness are deprived of basic necessities such as shelter, food, water, and clothing. They are also very likely to be victims of brutal crimes such as being physically assaulted, robbed, raped and/or killed. Schizophrenia affect’s social class after the onset, it decreases the chances of a person gaining employment. Biases occur more in minority men living with Schizophrenia than it occurs in others living with schizophrenia. It is very important for society to try to eliminate biases, including ethical biases from barriers to high-quality mental health care and to understand bias at several different levels. It is the duty of communities, network programs and practitioners to join together to help decrease the inequality and bias margins.
Ethnicity inequality and biases cause limited healthcare access therefore, hinders the holistic lives of minorities living with schizophrenia. These factors also contributes to minimizing the quality of life and, rehabilitation potential; resulting in the continuation of generational poverty.
The significant of this study is to help decrease biases and inequality in the healthcare system. This study may help influence clinicians’ diagnostic and treatment decisions in relation to minorities with schizophrenia and other mental illnesses. Although, research has established that there are biases in the healthcare access treatment, and quality of mental health care but, we do not know to what extent these disparities are attributable to bias. This study will help with measuring and possibly estimating the number of minorities with Schizophrenia disorder that have been denied or under- treated due to biases. To demonstrate access to adequate healthcare will results in better quality of life and rehabilitation potential for minorities living with Schizophrenia.
Literature review have shown racial and ethnic inequality are widespread in the diagnosis and treatment of Schizophrenia and other mental illnesses. The biases and inequality in healthcare access and treatment leaves far too many minorities living with schizophrenia medically, underserved or improperly treated. Schizophrenia and other Psychotic illnesses have been understood as disorders of adaptation to social context. Heritability is an emphasized onset that is associated with environmental factors such as early life adversity, growing up in an urban environment, minority group position and cannabis use, suggesting that exposure may have an impact on the developing social brain during sensitive periods. Therefore heredity, as an index of genetic influence, may be of limited explanatory power unless viewed in the context of interaction with social effects. Longitudinal research is needed to uncover gene- environment interplay that determines how expression of vulnerability in the general population may give rise to more severe psychopathology.
Exploratory Method: this method was chosen due to very little research was found concerning this issue.
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