Disparities with Mental Health among African American Youth

Introduction

African American youth continue to face various disparities with regard to their mental health challenges. For instance, black American youth are less likely to receive mental health treatment as compared to white adolescents. According to Lindsey et al. (2012), the said unwillingness to offer treatment is usually not due to financial reasons. Rather, is due to the fact that they are black. Essentially, black Americans with mental health challenges often receive negative perceptions from providers. In addition, the mental health problems that they experience makes them stigmatize themselves (Linsey et al., 2012). Wallace (2012) suggests that when African American youth do receive treatment, their mental health disorders are often diagnosed incorrectly or misdiagnosed, undertreated, or mistreated. In addition, research on mental health research has also been carried out on this front. Apart from receiving minimal attention in as far as their mental health is concerned, it would be prudent to note that African American youth are less likely to utilize mental health resources. Essentially, black adolescents underutilize services available for mental health. According to Planey et al. (2019), underutilization of resources by black Americans with mental health problems happens to be problematic owing to the fact that the prevalence of African American adolescents who endure behavioral and mental health challenges is high. Findings from the National Comorbidity Survey - Adolescent Supplement indicate that almost half of black American participants had endured a mental health problem before eighteen years of age (Planey et al, 2019). Despite the said prevalence, it is important to note that only one quarter of black American youths receive treatment when it is needed. Planey et al (2019) found that black American youths with major depressive disorder were less likely to visit a mental health unit and talk to a mental health professional compared to their white counterparts.

Apart from the disparities that African Americans receive in mental health facilities, it would also be prudent to note that youths who are underserved in mental health services are also likely to be discriminated against in schools. Green et al (2020) found that most schools provide mental health services to students. It is important to note that although African American youths do receive mental health services in schools, in some instances, they receive the said services in separate settings from their white peers (Green et al, 2020). In addition, some schools could tie the said services to certain negative outcomes such as trauma-informed practices (Joseph et al, 2020). Essentially, students of color face unique trauma experiences which expose them to externalizing behaviors. As a result, the said students are excluded from school and are at a greater risk of academic underperformance, future incarceration, fractured relationships, crime, and mental health strains (Joseph et al, 2020). Moreover, the psychological well-being of youth of color is largely affected owing to the said trauma experiences. The purpose of this paper is to determine the mental health disparities that African American youth experience so as to address the said disparities and improve the psychological well-being of black youths, as well as their academic performance. The study will also include some facilitators to seeking mental health services among African American youths. However the study will primarily focus on the disparities of mental health among the said group. Findings from this research will have a meaningful impact owing to the fact that they will help reinforce the need to eliminate the barriers associated with access to mental health services among African American youths. Enhanced access to the said services is likely to result in better academic performance among the said youths.

Method

Search Strategy

The study utilized a systematic review approach to locate relevant research studies for the present research, i.e. in relation to determining the disparities that African American youths with mental health problems experience owing to their race. Databases used to search for the articles were: PUBMED, EMBRACE, and CINAHL (Cumulative Index to Nursing and Allied Health). Key words used for the study were: mental health, disparities, youth, and African American. The study also used Boolean operators so as to extract the studies included. For instance, disparities or barriers, and mental health or mental illnesses or mental disorders, and African American or black American or people of color, and youth or adolescent were used. The search was limited to articles which were published between 2012 and 2020.

Inclusion Criteria

The journal articles selected for this study had to meet certain inclusion criteria. First, the articles had to report on disparities related to seeking or receiving mental health services among African Americans. Second, the articles had to report specifically on black American youths who were 18 years of age or below. Third, the articles included in the study had to report on the barriers that prevent African American youths from seeking treatment in out-patient mental health service systems. In addition, the articles had to report on the experiences that the said youths endure as well as the experiences of their families and caregivers. The articles chosen were those written in English language.

Narrative Critical Review

A narrative critical review presents an overview of the findings from the five studies selected for this study. In a study that was conducted by Lindsey et al (2012), the authors used four focus groups that were guided by the unified theory of behavior to help them understand the perceptions and help-seeking behaviors to mental health services. The four focus groups involved two care giver groups and two adolescent groups - whereby the caregiver group had 11 participants, while the adolescent group had 16 participants. The said participants were from two elementary schools from the urban local community. The adolescent group included 8 girls and 8 boys aged 11 to 14 years. The use of focus group method was effective for this study owing to the fact that the participants had the chance to explore the facilitators and barriers to seeking help for mental health services in a broad manner. On the other hand, participants from the caregiver group included 10 male participants and one female participant aged between 31 to 67 years. The adolescent group was used so as to determine their experiences when they sought help owing to their emotional health challenges. On the other hand, the caregiver group was used for the study to determine how the said group sought mental health services for their children. Facilitators of all the focus groups were graduates in social work or psychology while social workers with PhD facilitated 1 caregiver and 1 adolescent. Discussions for the four focus groups were conducted for about one hour and a half. Data was then analyzed by use of a template analysis whereby elements of UTB construct were used. The said...…that the experiences of African American students must be incorporated when implementing decisions and policies in discipline. In addition, social workers should be trained on trauma-informed practices so that they can be able to incorporate the said practices in schools. Trauma-informed practices are especially important and they should be race-centered so as to help traumatized students. While the study provides the strategies that can be used to reduce racial biases in schools, it did not discuss the disparities in mental health which are the main purpose of the study.

Discussion

The findings herein indicate that the identified disparities are related to the use of mental health services and help seeking among youths with mental health problems. Three of the studies discussed the factors that prevent black youths from accessing or receiving care while two studies included the strategies that can be incorporated in schools so as to reduce racial disparities and increase the rate at which black youths access mental health services. Lindsey et al (2012) used four focus groups to extract data; Wallace (2012) used data from secondary data analysis; while Planey et al (2019) used a systematic review to extract data. Spirituality or religion was a major determinant to accessing care among black adolescents. Planey et al (2019) found that youths were reluctant to seeking help owing to fear of being excluded for seeking formal treatment. Like Planey et al, Wallace found that black youths who were more spiritual were optimistic about their grades and thus were more resilient to seeking help. Apart from spirituality, Wallace (2012) and Lindsey et al (2012) also found that students who had supportive relationships had positive attitudes towards seeking help. Lindsey et al (2012) and Planet et al (2019) also found that attitude and knowledge or caregiver experiences played an important role in determining whether they would seek treatment for their children. If the mental health issue was severe, then the caregiver was willing to seek treatment. Adults and caregivers were also willing to seek treatment if they had a strong therapeutic relationship with the therapist (Lindsey et al, 2012). Feeling of shame and stigma were also linked to failure to seek treatment. While Planey et al, 2012) founf that African American caregivers were more ashamed of seeking treatment for their mentally-ill patients, Wallace (2012) found that adults felt that their peers would discriminate against them if they sought treatment related to mental health.

Two studies focused on the strategies that can be incorporated in schools to reduce racial inequities. Green et al (2020) found the need to implement programs that are aimed at referring and providing schools with resources to address disparities that black youths experience. Joseph et al (2020) found that strategies such as informed care practices and multitier care practices can be implemented in schools to reduce race-based inequities in mental health.

Limitations

The five studies that were included in this study had a number of limitations. First, the systematic review only used three databases and thus other articles that are not part of the said databases have been excluded (Wallace, 2012). Second, the study also based on reports from secondary data whereby the information from YRRS was based on self-reports and could not be a guarantee of truthfulness ((Planey et al, 2019). In addition, the questions did not include the variability of services that were provided by mental health practitioners. The information used…