By Chris Levister
“It is unpleasant to admit, but many African Americans do not receive appropriate mental health services, even when they go to places that are suppose to help them. Why is that?”
It’s a question Dr. V. Diane Woods, Dr.P.H. has been asking for more than a decade. At the national Black Mental Health Workers Conference in Los Angeles Tuesday Dr. Woods, president of the African American Health Institute of San Bernardino County (AAHI-SBC) rolled out a 300 plus page report that paints a damning picture of how more than half of African American mental health sufferers receive little or no treatment…but account for a high rate of involuntary commitments.
One third of families have a member who is currently suffering from a mental illness, they say. It accounts for nearly half of absenteeism at work and mental illness accounts for nearly half of people on incapacity benefits. Why are some people not understood? California’s African American residents were interviewed and given the opportunity to share their real experiences with getting help with mental issues,” said Dr. Woods.
“We Ain’t Crazy! Just Coping with a Crazy System: Pathways to Eliminating Mental Health Disparities in the Black Population,” is the comprehensive report of this 2-year long African American study that sought to answer one major question: What are community practices Black people believe would help them have good mental health? As well as, how are mental issues prevented from occurring in Black people?” Respondents say the stigma associated with mental issues, according to respondents, produced shame and embarrassment, which often determined if individuals sought help. "The thought of being labeled `crazy' and not normal rendered many black people psychologically paralyzed," the report said.
“In addition, having a mental issue is embarrassing. Most people do not recognize when they need help, and when they do, most people do not feel comfortable in asking for help with a mental issue,” said Woods.
Dr. Woods is the principal investigator, for a statewide team of Black strategic planning workgroup members tasked to develop a major statewide policy initiative to improve access and quality of care, as well as increase positive outcomes for historically underserved communities and ethnic and cultural population groups. “There were 1,195 individuals who participated in the African American study. Community-based participatory research methods were used that included 15 key informant interviews, 35 focus group meetings, 43 one-on-one interviews, 635 surveys, 5 case studies, 6 small group meetings and 10 public meetings. Individuals participated from over 30 California counties.
The research was contracted to AAHI-SBC through The California Department of Mental Health (DMH), in partnership with the Mental Health Services Oversight and Accountability Commission (MHSOAC) and funded by the Mental Health Service Act, Prop 63.
AAHI-SBC is a non-profit 501 (c) 3 grassroots community-based organization. It was awarded the $411,052 contract to conduct the California Reducing Disparities Project (CRDP) for the African American population. Funds were made possible by the Mental Health Services Act (MHSA) of 2004.
The statewide initiative was called the California Reducing Disparities Project (CRDP), and focused on five populations that have the largest number of underserved individuals. The report provided important recommendations to address these shortcomings and to make quality mental health treatment a reality for all Americans. This report gave voice to thousands of African Americans who faced this grim reality. It also created an opportunity for people around the region to advocate for real change.
Mental health charities and specialists welcomed the report. Riverside psychiatrist Richard T. Kotomori Jr. M.D. specializes in Child and Adolescent Psychiatry.
“We are at an all-time low in the response of mental health services to people with severely disabling mental illness. While the Government has put money into psychological therapies, on the other hand resources are being drained from the fundamental care and treatment of people in crisis, those in need of in-patient care such as the suicidal, and those in the community where the cuts are depriving them of the few things that make their lives more tolerable, such as day centers, clubs, activities and occupation,” said Kotomori.
California psychologist Gloria Morrow contends that the distrust and stigma that blacks feel about mental-health treatment stem in part from difficulty in finding a therapist to whom they can comfortably relate. African Americans comprise less than 2% of licensed psychiatrists in California and less than 4% of mental-health providers nationally. Mental-health practitioners "don't 'get it' when they are working with people who don't look like them," she insists.
One effect is to shift sufferers into care settings not designed for recurring disorders such as depression. "We know that people are going to emergency rooms because of the stigma of going to a counselor," she explains.
They also experience difficulty in talking about their problems, especially to non-blacks. There is often a gulf of mistrust that is fed by both sides. A lack of knowledge has had a particularly negative impact on diagnosis and treatment. Blacks are more likely to be diagnosed with schizophrenia than with depression, and this is especially the case if they have manic depression. In the past, blacks have been offered antidepressant medication far less frequently than whites.
And despite evidence suggesting that blacks may metabolize psychiatric medications more slowly than whites, thus requiring lower dosages, they are often given higher dosages; as a result they experience more severe side effects than do whites, frequently prompting them to stop treatment altogether.
In 2001 former Surgeon General Dr. David Satcher released Culture, Race and Ethnicity.
A Supplement to Mental Health: A Report of the Surgeon General. This landmark report documented the lack of access and the poor quality of mental health care that people of color had been receiving when dealing with mental illness.
“Unfortunately, there has been little progress in overcoming barriers to treatment and in improving access and quality of care for communities of color,” said Woods. “Much still needs to be done to make access and recovery from mental illness a reality for all Americans.”
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