In addition, many African Americans might be hesitant to seek mental health services as they may worry that mental health care practitioners will not be culturally competent to treat their specific issues given that less than 2 percent of American Psychological Association members are African American (American Psychological Association, 2016). It is known that African Americans have been and continue to be affected by prejudice and discrimination in the health care system, misdiagnosed, and provided with inadequate treatment which can be contributor factors to their mistrust. As previously mentioned, compared with whites with the same symptoms, African Americans are more frequently diagnosed with schizophrenia, this misdiagnosis can be attributed to the differences in how African Americans express symptoms of emotional distress, which can be implied that they are not being understood due to the cultural differences. When analyzing the way physicians communicate with their patients, research illustrates it differs for African Americans and whites. For instance, one study found that “physicians were 23% more verbally dominant, and engaged in 33% less patient-centered communication with African American patients than with white patients” (American Psychological Association, 2016, p.1). Additionally, studies illustrate that African Americans tend to prefer psychotherapy over medications for depression treatments as studies have also indicated that “they metabolize many medications more slowly than the general population, however primary care providers are more likely to prescribe higher dosage of antidepressants, which may result in greater negative side effects and a decreased likelihood of sticking with treatment” (Vargas, n.d., p.3). Given these circumstances, it is imperative for mental health practitioners to fully understand their client’s past and their culture including their community’s significant history, disparities and stigma, to provide the highest quality of care.
It is evident that there is a great need in the African American community to educate them about mental illness, eliminate any health disparities and to put an end to the stigma related to mental illness. In trying to accomplish this, Each Mind Matters was created as a mental health movement that consists of millions of people and thousands of organizations who work together to advance mental health, and with a vision to improve mental health and equality. Their main goal is to strengthen the voices of all people who want to end the stigma and through this, create a community where everyone feels comfortable reaching out for support. For Each Mind Matters, it is important to reach California’s diverse populations, therefore they have worked with people from different cultures in efforts to create a variety of resources that take into consideration cultural and language diversity of the state. This movement was made possible through the Mental Health Service Act (MHSA), which was passed in November 2004 and helped “provide funding and framework needed to transform the community mental health system from a crisis-driven system to prevention and wellness and to expanded services to reach underserved populations and all of California’s diverse communities” ( Each Mind Matters, 2018,p.2 ).
Through the creation of Each Mind Matters, a numerous of programs were developed in efforts to create more resources within the African American community. Mental Health Friendly Communities provides culturally focused trainings and resources that focus on the mental health issues that many African Americans tend to face. By providing such trainings, the program is able to engage communities through guiding them to obtain services that will eventually lead to mental wellness. Given that many African Americans turn to faith-based institutions for information and support when faced with mental illness, Mental Health Communities collaborate with faith-based organizations, mental health providers as well with African American community and present workshops to help develop partnerships among one another and to learn about the faith based community among African Americans. The Mental Health Friendly Communities training team tend to consist of ministers, pastors, and spiritual specialists and their job consist of developing a cultural curriculum that provides training and technical assistance to mental health practitioners, the African American community or whoever wants to participate in Alameda County (Mental Health Friendly Communities, n.d.).
Another important program within the African community is the California Black Health Network. This organization works toward improving the health status of African Americans in California through reducing health discrepancies through legislative, administrative, and media advocacy. California Black Health Network attempts to do this by leading and facilitating assemblies all throughout California with their purpose to discuss any health disparities in the African American community and address any legislative bills that will impact their community to then educate them on how bring awareness and/or advocate for change. Their main objective is to encourage African Americans to participate in policy making and advocate for policy changes to increase the participation of underrepresented minorities in education and health care delivery. The California Black Health Network also collaborate with decision-makers throughout the state, to help advocate for policies and programs that would help improve social, economic, and environmental conditions among African Americans to help ensure their wellbeing (California Black Health Network, 2016).
As previously discussed, one of the biggest barriers for African Americans in seeking mental health services is feeling marginalized and treated unequal when compared to their white counterparts, and therefore prefer seeking services from a professional from their same cultural background. However, this is a significant obstacle that many are face with as there are not many African American mental health professionals. In efforts to bring a solution to this, the California Reducing Disparities Project ( CRDP) developed the African American Mental Health Providers Directory for California Residents, which collected a list of over 200 African American mental health professionals. To make this resource feasible, the directory is alphabetical order by practitioners in each region with a short description of their clinical expertise as well as their contact information (Smith, Hall-Burks, Lewis, ; Jackson, 2012). Through creating this directory, the intention was to increase the number of African Americans seeking mental health services with the idea that they would be more open to treatment given that they were being treated from a professional within their same cultural background. In addition to creating a statewide policy proposal that would help recognize solutions for the underserved and inappropriately served communities, CRDP also aims to provide funding to apply practices and strategies to help demonstrate community-defined evidence to decrease mental health disparities. This is an evidence model that uses culture and the community to help encourage research as well as policymakers to use practices that may or may not have been measured empirically but rather achieved a level of acceptance by the community. CRDP has awarded $60 million in contracts and grants and will be funded over four years and will be assessed to demonstrate the effectiveness of this community-defined evidence in reducing disparities (California Reducing Disparities Project, 2018).
Even though, there are programs already implemented to help the African American community combat mental illness, I believe there is a lot more that can be done. It all starts with decreasing the high poverty rate among African Americans. One way of doing this would be to promote the federal government to invest in job-creation strategies. For example, building new libraries, neighborhood parks, community centers, and/or shelters would not only help the community, but also create jobs. Developing new agencies and/or organizations that only hire people with a disability, and that provide job duties that will be easy enough for individuals with certain mental diagnoses will also provide them with employment. By doing so, this would also decrease the discrimination that many face when seeking unemployment and often time are not given the opportunity due to their mental health condition. If more money was invested in creating trade schools for low income families and within their community, this could possibly increase their chances of enrolling and obtaining a certification and seek employment. However, in order for this to work, raising the minimum wage would also be necessary given that with today’s minimum wage, it is almost impossible to make a living and simply adds to people’s stress levels and frustration.
If more professionals were culturally competent, it would increase the likelihood of African Americans seeking mental health services. Therefore, investing in cross-cultural trainings would help employees, and not just mental health professionals work with clients from diverse populations, and as a result avoid making them feel stigmatize. As previously mentioned, organizations have been created to help mental health professionals learn about the different cultures to help them provide better services, however such programs vary from organization and may not required. Therefore, I feel that in the field of mental health, every employee upon hiring and at least once a year should be mandated to attend such trainings. In addition, organizations similar to Every Mind Matters, should be implemented all over the world to help reach a vast majority of mental health professionals. If African Americans felt comfortable and at ease when seeking mental health services, they might also be more open to working with clinicians, and/or psychiatrists who may not be from their same cultural background and receptive to taking the professional’s advice in taking their medication as they would trust them and not feel they are being discriminated. However, in order for this to happen, professionals need to be able to provide culturally appropriate interventions and outcomes, and also acknowledge the historic nature of racism and discrimination and its impact on African Americans when developing treatment plans.
In efforts to get the African community to seek mental health services when needed, it is necessary to provide them with information to help improve their understanding of mental illness, stigma and treatment options. Given that many African Americans have a close partnership with their local church and often times are religious, it would be beneficial to partner with local African-American pastors to help get the message out and provide accurate information to their communities. Furthermore, if more money was invested towards creating community navigators whose job responsibility would be to outreach to low income communities where minorities might reside, it would help increase awareness. There might be similar jobs already implemented, however from personal experience such jobs are usually the first to be cut during budgets cuts. More is needed to be done because what is already implemented is not enough as the statistics prove this.