In May 2008, the United States House of Representatives proclaimed July as Bebe Moore Campbell National Minority Mental Health Awareness Month. According to the U.S. Department of Health and Human Services, Office of Mental Health, this proclamation provides health care and social service agencies with “the opportunity to raise awareness about severe mental illness in diverse communities, while highlighting avenues for wellness and recovery.”
As Pine Bluff is a predominantly African-American community, it is vitally important that we take a moment to understand the mental health needs and service challenges as they relate to communities of color.
The U.S. Surgeon General reports members of minority communities are less likely to receive diagnosis and treatment for their mental illness, have less access to and availability of mental health services and often receive a poorer quality of mental health care than their white counterparts. The Surgeon General also observes that mental illness is a leading cause of disability. Even so, nearly two-thirds of people with a diagnosable mental illness fail to seek treatment.
The National Alliance on Mental Illness (NAMI) highlights the depth of the chasm between racial and ethnic groups: “Culture biases against mental health professionals and health care professionals in general prevent many African Americans from accessing care due to prior experiences with historical misdiagnoses, inadequate treatment and a lack of cultural understanding; only 2 percent of psychiatrists, 2 percent of psychologists and 4 percent of social workers in the United States are African American.”
NAMI further elucidates the problem with the finding that African Americans are much more likely to be improperly diagnosed with Schizophrenia. Some of the misdiagnoses are attributable to a set of interrelated hurdles. In the first instance, mental illness is often more stigmatized and less understood in the African American community. When African Americans seek help, it is more often through their primary care physician than a mental health specialist. Of course, this too is complicated by the fact that almost one-third of all African Americans in the U.S. are uninsured.
We also know that various social and legal circumstances work against better mental health care in minority populations. Almost half of those persons in U.S. prisons are African American. Prison inmates are at an increased risk of developing a mental illness. Many have undiagnosed mental health issues upon entry into the prison system.
Collateral to this, exposure to violence increases the risk of developing a mental illness. According to NAMI, over 25 percent of African American children exposed to violence meet criteria for post-traumatic stress disorder.
NAMI also notes that children in foster care and the child welfare system are more likely to develop mental illnesses. African American children comprise 45 percent of the public foster care population.
Even with all of these perils, there are a number of strategies to help address the gross systemic disparities in mental health care. In specific, NAMI suggests three proven approaches:
• Programs in African American communities sponsored by respected institutions, such as churches and local community groups can increase awareness of mental health issues and resources and decrease the related stigma;
• Programs that improve enrollment rates in safety net health care providers can result in increased mental health care due to improved mental health coverage in the African American community;
• Encouragement in the community to join mental health related professions can increase the number of African American mental health care providers and increase social sensitivity among the provider community.
While mental health care is often a taboo subject, it needn’t be. Mental illness is no different than any other physical malady. As a society we need to own that fact and get past outmoded ways of thinking. As above, that task may hold special challenges in communities of color. As such, we must get to work.