I have an uncle who can be described as an unhinged, prankster big brother who was always looking for mischief. Calling him uncle almost doesn’t fit. Regardless, my uncle has played a unique and important role in my family. He has taught me many things throughout the years such as how some rules are unnecessary and that I should always find a reason to celebrate and live in the moment. However, he also taught me the effects of mental instability.
Unfortunately, my uncle has fallen victim to the stigma from the community and barely sought help. The rare times in which he did, he quickly got discouraged due to the lack of cultural competence and knowledge. Thus, never returned for a follow up appointment. It has been a little over a decade since then.
According to the National Alliance on Mental Health (NAMI), mental health includes a person’s emotional, social, and psychological well being. It also affects how we think, feel, and act and determines how we handle stress, relate to others, and make choices. Mental health is something that is of the utmost importance at every stage of life from childhood to adulthood. One in five adults in America – 43.8 million people – experience mental illness. This is 18.5% of our total population (60,532,000 of 327,200,000). According to the U.S Census Bureau, 13.4% (43.8 million) of U.S population identifies as Black/African American. Through rigorous study, it was proven that adult African Americans are 20% more likely to suffer psychological distress than their white counterparts. This is due to various factors such as historical adversity which includes slavery, sharecropping and race-based exclusion from health, educational, social and economic resources which translates into socioeconomic disparities experienced by African Americans today.
Many studies have determined that the African American view towards mental illness is highly stigmatizing, resulting in seeking low treatment especially among the older generations. Only about one-quarter of African Americans seek mental health care, compared to 40% of whites. This is due to distrust, misdiagnosis, and simply because the best interests of Black/African Americans were not in mind in the world of medicine. Throughout history, African Americans have been and continue to be negatively affected by prejudice and discrimination in the health care system. Prime examples of this would be unethical and disturbing case of Henrietta Lacks (HeLa cell) and the Tuskegee Experiments. Misdiagnosis, inadequate treatment and lack of cultural competence by health professionals cause distrust and prevent many African Americans from seeking or staying in treatment.
In my community, many people misunderstand what a mental health condition is and particularly don’t talk about this topic. The lack of knowledge leads many to believe that a mental health condition is a personal weakness or some sort of punishment from God. African Americans may be reluctant to discuss mental health issues and seek treatment because of the shame and stigma associated with such conditions. Instead we emphasize on spiritual, familial, and communal help rather than medical/therapeutic treatment. Faith and spirituality are something that is deeply rooted in the culture of African Americans and it is such a beautiful aspect as to who we are as people. However, I must note this should not be the only option one should pursue during the recovery process.
According to Georgetown University’s Health Policy Institute, cultural competence in healthcare/medicine is defined as the ability of the organization to understand and recognize factors such as race, ethnicity, nationality, language, gender, socioeconomic status, physical and mental ability into delivery and structure of the health care system. This will encourage health care providers to give the highest quality of care to every patient regardless of race, cultural background and ethnicity. Unfortunately, studies have shown that the quality of patient-physican interaction is lower among non-white patients, which is associated with lower statisfaction with health care.
A solution to this ongoing battle is for medical schools to push for change in their institutional setup, curriculum development, and in training medical practitioners. It is of the utmost importance that medical schools begin to admit students from all backgrounds who can relate, empathize and identify with diverse patients. This will encourage a lot more underrepresented minorities to seek medical treatment.
My hope is that the African American community can reap the same benefits as other races can regarding treating mental illness. It’s unjust that people similar to my uncle must experience a difficult uphill battle therefore facing struggles that plague their mind without the right help. If a change is done to benefit these people, it’ll be a brighter and more fruitful future for all.
Published on August 8, 2019
Written by Tionna Solomon, a WYA Headquarters intern from New York City