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Black & African American Communities and Mental Health

Mental Health America works nationally and locally to raise awareness about mental health.  We believe that everyone at risk for mental illnesses and related disorders should receive early and effective interventions. Historically, communities of color experience unique and considerable challenges in accessing mental health services.

Prevalence Mental Health Issues Black and African Americans

 

 

Demographics/Societal Issues

  • 13.2 % of the U.S. population, or roughly 45.7 million people, identify themselves as Black or African American, according to 2014 U.S. Census Bureau numbers. Another 2.5% identified as multiracial. This represents an increase from 12.6 percent of the U.S. population, who identified themselves as Black/African-American in the 2010 Census. [1]

  • As of 2010, Fifty-five percent of all Black/African American people lived in the South, 18 percent lived in the Midwest, 17 percent in the Northeast, and 10 percent in the West. [2]

  • Historical adversity, which includes slavery, sharecropping and race-based exclusion from health, educational, social and economic resources, translates into socioeconomic disparities experienced by African Americans today. Socioeconomic status, in turn, is linked to mental health: People who are impoverished, homeless, incarcerated or have substance abuse problems are at higher risk for poor mental health.

  • Despite progress made over the years, racism continues to have an impact on the mental health of Black/African Americans. Negative stereotypes and attitudes of rejection have decreased, but continue to occur with measurable, adverse consequences. Historical and contemporary instances of negative treatment have led to a mistrust of authorities, many of whom are not seen as having the best interests of Black/African Americans in mind.

Prevalence

According to the US HHS Office of Minority Health [3]:

  • Adult Black/African Americans are 20 percent more likely to report serious psychological distress than adult whites. 
  • Adult Black/African Americans living below poverty are three times more likely to report serious psychological distress than those living above poverty.  
  • Adult Black/African Americans are more likely to have feelings of sadness, hopelessness, and worthlessness than are adult whites.
  • And while Black/African Americans are less likely than white people to die from suicide as teenagers, Black/African Americans teenagers are more likely to attempt suicide than are white teenagers (8.3 percent v. 6.2 percent).

Black/African Americans of all ages are more likely to be victims of serious violent crime than are non-Hispanic whites, making them more likely to meet the diagnostic criteria for post-traumatic stress disorder (PTSD). Black/African Americans are also twice as likely as non-Hispanic whites to be diagnosed with schizophrenia. [4]

Attitudes

According to a study conducted by Ward, Wiltshire, Detry, and Brown in 2013 [5]:

  • Black/African Americans hold beliefs related to stigma, psychological openness, and help-seeking, which in turn affects their coping behaviors. Generally speaking, the participants in this study were not very open to acknowledging psychological problems, but they were somewhat open to seek mental health services.
  • Thirty percent of participants reported having a mental illness or receiving treatment for a mental illness
  • Black/African Americans men are particularly concerned about stigma.
  • Cohort effects, exposure to mental illness, and increased knowledge of mental illness are factors which could potentially change beliefs about symptoms of mental illness.
  • Participants appeared apprehensive about seeking professional help for mental health issues, which is consistent with previous research. However, participants were willing to seek out some form of help.

Treatment Issues

The following statistics were taken from the “Mental Health: Culture, Race and Ethnicity Supplement” to the 1999 U.S. Surgeon General’s Report on Mental Health.

  • Black/African Americans physicians are five times more likely than white physicians to treat Black/African Americans patients. Black/African Americans patients who see Black/African Americans physicians rate their physicians’ styles of interaction as more participatory. Black/African Americans seeking help for a mental health problem would have trouble finding Black/African Americans mental health professionals: In 1998, only 2 percent of psychiatrists, 2 percent of psychologists and 4 percent of social workers said they were Black/African Americans.
  • The public mental health safety net of hospitals, community health centers, and local health departments are vital to many Black/African Americans, especially to those in high-need populations.
  • Black/African Americans of all ages are underrepresented in outpatient treatment but over-represented in inpatient treatment. Few Black/African Americans children receive treatment in privately funded psychiatric hospitals, but many receive treatment in publicly funded residential treatment centers for emotionally disturbed youth.

But Black/African Americans today are over-represented in our jails and prisons.  People of color account for 60 percent of the prison population. Black/African Americans also account for 14 percent of regular drug users, but for 37 percent of drug arrests (illicit drug use is frequently associated with self-medication among people with mental illnesses). [6]

Access/Insurance

Disparities in access to care and treatment for mental illnesses have also persisted over time. As noted by the Office of Minority Health [3]:

  • Only 8.7 percent of adult Black/African Americans, versus 16 percent of adult white people, received treatment for mental health concerns in 2007-2008.
  • Only 6.2 percent of adult Black/African Americans, versus 13.9 percent of adult white people, received medications for mental health concerns during 2008.
  • And while 68.7 percent of white adults with a major depressive episode in 2009 received treatment, only 53.2 percent of adult Black/African Americans did.

And while implementation of the Affordable Care Act will close this gap somewhat by 2016, in 2011 20.8 percent of Black/African Americans were uninsured, versus 11.7 percent of whites. [7]

Educational Materials

MHA has developed unique materials for Black/African Americans.

Brochures

Fact Sheets

Partnerships and Resources

The following organizations are among those that offer additional information on this subject, focusing on outreach to African-American communities:

Sources

(1) United States Census Bureau. (2014). Quick facts. Retrieved from https://www.census.gov/quickfacts/table/PST120215/00

(2) http://www.census.gov/newsroom/releases/archives/2010_census/cb11-cn185.html

(3) U.S. Department of Health and Human Services Office of Minority Mental Health. (2016). Mental health and African Americans. Retrieved from http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=24

(4) American Psychological Association. (2016). African Americans have limited access to mental and behavioral health care. Retrieved from http://www.apa.org/about/gr/issues/minority/access.aspx

(5) Ward, E. C., Wiltshire, J. C., Detry, M. A., & Brown, R. L. (2013). African American men and women's attitude toward mental illness, perceptions of stigma, and preferred coping behaviors. Nursing Research62(3), 185-194. doi:10.1097/NNR.0b013e31827bf533

(6) http://www.americanprogress.org/issues/race/news/2012/03/13/11351/the-top-10-most-startling-facts-about-people-of-color-and-criminal-justice-in-the-united-states/, 2012

(7) http://aspe.hhs.gov/health/reports/2011/cpshealthins2011/ib.shtml#_Toc303600552

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