African Americans Attitude and Access Mental Health Utilization

African American’s Attitude and Access to Mental Health Utilization

Context of the problem.

African Americans, also known as Afro-Americans, are the American ethnic group with partial or total ancestry from any black ancestry in Africa. The term African American signifies the descendants of enslaved Africans in the United States, while some are also immigrants from Africa. African Americans compose the second-largest racial group and a third of the largest ethnic group in the United States. On the other hand, mental health is defined as behavioral, emotional, and cognitive well-being. It is generally about how people feel, behave, and think—looking after mental health enables one to enjoy life. This can be achieved through balancing between life responsibilities, activities, and efforts to attain psychological resilience. Situations like anxiety, stress, and depression can affect an individual’s mental health (Conner et al., 2010).

In general, mental health conditions occur in African Americans at less frequency than white Americans. However, African Americans experience in the United States to be characterized by violence and trauma more than their white counterparts. The historical oppression, violence, and dehumanization against African Americans recently evolved into racism (Eisenberg et al., 2007). Also, the mistrust of the medical systems affects the help-seeking behavior of African Americans. However, according to MHA screening data, the African American population that screen positive for depression self-identify to seek help more than any other general population. Regrettably, the African American providers known for providing adequate and appropriate care to African American health seekers form the minor portion of behavioral health providers workforce. As a result of the above factors, African Americans are likely to undergo persistent and chronic instead of episodic mental health conditions (Alvidrez, 1999).

Depression is one of the most widespread cognitive illnesses affecting more than 6 million men and 12 million women in the United States within one year. Also, according to the National Institute of Mental Health, African American women have a higher prevalence of mental health conditions at 13.1% compared to African American men at 7.0% (Conner et al., 2010). However, the low depression prevalence in African American men is unclear because, according to research, African American men have made less economic gains than African American women because low education and income are considered risk factors for depression. According to Lincoln, Watkins, Taylor, and Chatter’s report, African American men with income levels below the poverty line and formal education below 12 years indicated more symptoms of depression than men and women with higher income and formal education (Diala et al. 2000).

Studies examining African American attitudes towards mental illness and seeking services of mental health indicates mixed results. For instance, according to a seminal report on mental health: race, ethnicity, and culture, African Americans consider mental illness very stigmatizing, leading to a response in seeking treatment. Similarly, a qualitative study of beliefs and attitudes on mental health within older African American adults indicates that African Americans treat mental illness, specifically depression, as a weakness (Thompson et al., 2004).

However, contrary to the above findings, African Americans have indicated positive attitudes toward mental health services, though the positive attitudes do not translate to treatment seeking. For example, in one of the studies, African Americans were more likely to believe that health professionals could treat mental illness. Nonetheless, there was also a belief by African Americans that problems of mental health could improve on their own, thus, hindering the use of mental health services as a coping strategy. Also, according to Diala et al., African Americans have more positive attitudes in seeking mental health services than Caucasians. Equally, (Ward et al. 2009) established that African American women use religious coping with handling mental illness, though indicate the option of seeking professional healthcare services. Subsequently, around 90.4% of African Americans use religious coping in handling issues of mental health. According to a qualitative study by Conner et al. 2010, many African Americans use religious copings like prayer and establishing relationships with God to cope with depression (Diala et al., 2000).

Historically, the first African Americans entered the USA as slaves where they were forced to live in social and physical conditions where their health had very little or no value. As a result, African Americans suffered mental, social, and physical brutalization for more than 250 years (Alvidrez, 1999). Even at the end of slavery, African Americans could still not live healthy lives. They were subjected to systematic oppression and discrimination for another 150 years since abolishing slavery, and it continues to date. Accordingly, the harsh history seems to have resulted in two outcomes: African Americans who survived the subjection may be the most resilient and most substantial; however, the current racial discrimination African Americans continue to suffer significantly contributes to their poor health status as a whole.

Consequently, the first comprehensive review of health inequality endured by African Americans was provided in 1984 by Margaret Heckler. She was then the secretary of health and human services after being dissatisfied with how health inequalities were reported to congress. The foundation to eliminate such health disparities was laid through health promotion, education, and access to healthcare services through that report. Accordingly, one of the most significant outcomes of the Heckler report was the formation of the Office of Minority Health in 1986 to enhance the health of the ethnic minority groups through health policies development and programs that eliminate health inequalities. Nevertheless, even after the publication of the Heckler Report, African Americans still experience unacceptable health inequalities and a lack of power over actions and policy that could bring changes to such inequalities (Diala et al., 2000).

Also, in the 1980s, the Epidemiologic Catchment Area study sampled residents of St. Louis, Los Angeles, and Baltimore. It assessed samples from both institutions and communities at large like jail, mental hospitals, nursing homes, and residential alcohol or drug treatment facilities. Recently, the National Comorbidity Survey conducted a similar study. The Epidemiologic Catchment Area results indicated that African Americans were more likely to suffer from a phobia than whites but less likely to be depressed. On the other hand, the National Comorbidity Survey results indicated that African Americans are less likely to suffer from depression (Smith, 2009). The studies also indicated differences in mental illness rates. For instance, anxiety disorder, phobia, and depression prevalence rates were higher in African American women than in African American men. However, based on the studies’ findings, it is difficult to tell whether there is a difference in the rate of mental illness between African Americans and Whites. According to ECA, there were higher lifetime disorders in African Americans than whites (Diala et al. 2000).

Nonetheless, the African Americans were eliminated considering the differences in marital status, age, socio-economic status, and gender. Subsequently, according to ECA, the African Americans in the community seem to be more victims of mental illnesses than whites. However, the difference is due to demographic composition differences of the groups and their social positions (Rastogi et al., 2012).

On the contrary, according to NCS, African Americans residing within the community exhibited a lower prevalence of lifetime mental illness than white Americans within communities irrespective of their differences in socio-economic and demographic status. Those major epidemiological surveys seem to conclude that the Whites’ mental illness rates are similar to that of African Americans. Nevertheless, this is also open to challenges due to the overrepresentation of African Americans in high-need populations. Notably, during the surveys, people who live in places like prisons, poor rural areas, psychiatric hospitals, and the inner city are inaccessible to researchers conducting household surveys. When these high-need groups are counted, there is a probability of establishing higher rates of mental illness among African Americans (Rastogi et al., 2012).

Statement of Purpose.

African Americans and whites both have biological similarities; therefore, proper medication is appropriate for both groups in treating mental illness. From earlier studies, African Americans and whites living in communities exhibit similar mental illnesses and distress symptoms. However, some quotas have not entirely accepted this finding due to economic differences and income levels between Whites and African Americans. This research will therefore evaluate if the economic status of African Americans influences their access to mental health care. Thus, adopting appropriate policies to ensure universal access to mental health care is guaranteed to all citizens (Alvidrez, 1999).

Moreover, according to Williams et al. 2007, low education correlates with MDD. For instance, the study found that African Americans below 12 years of formal education had more depression than counterparts with formal education. Therefore, establishing this will inform various stakeholders on the appropriate measures to help African Americans without education and access to mental health care. Furthermore, this study will add to the literature by establishing how age, education, and income disparities among African Americans have influenced their mental well-being as a population (Thompson et al., 2004).

Literature gaps

The low depression prevalence in African American men remains unclear because, according to research, African American men have made fewer economic gains than African American women. After all, low education and income are considered risk factors for depression. According to Lincoln, Watkins, Taylor, and Chatter’s report, African American men with income levels below the poverty line and formal education below 12 years indicated more symptoms of depression than men and women with higher income and formal education. This area, therefore, needs more research to bridge the gap (Lipson et al., 2018).

Moreover, more research is needed on how attitude may facilitate or be a barrier to seeking treatment among African Americans. Take, for instance, establishing how psychological openness may impact decision-making in seeking professional mental health care. In addition, finding how psychological openness influences coping responses, continuity of professional treatment, and treatment adherence (Diala et al. 2000).

Significance of the Study

African Americans have made considerable strides in income, education, plus other indicators of social well-being. Their progress in social standing is recognized, proving their adaptive and resilient traditions of African American groups in the face of racism, discrimination, and slavery. These contributions have come from different African American groups and communities such as the Caribbean, Immigrants from Africa, and elsewhere. This research will therefore evaluate if the economic status of African Americans influences their access to mental health care. Thus, adopting appropriate policies to ensure universal access to mental health care is guaranteed to all citizens (Matthews et al. 2006).

Definition of Terms

Attitude is defined as a psychological feeling or state that informs an individual to respond or react negatively or positively towards a situation, individual, or object under consideration. Attitude to professional mental health care may rely on cultural belief, personal experience, age, income status, and social group to which an individual belongs may be negative, neutral, or positive (Eisenberg et al. 2007).