MENTAL HEALTH ISSUES IN AFRICAN AMERICAN WOMEN: PERCEPTIONS AND

STIGMAS

Patricia L. Hill

MY OVERARCHING GOALS

To generate mental health literacy

To mobilize African American women to seek, understand, challenge and advocate mental health services for themselves

Build a network of culturally competent providers

To implement policies, guidelines, and laws that restrict discrimination, stigmatization, and negative portrayals in the media

Facilitate funding sources from non-profit and profit organizations

Encourage sponsorships

Coordinate intra-service/inter-service agency agreements

GOAL 1Decrease negative stigmas about mental illness

Objectives:

• Provide the appropriate factual information

• Increase mental health literacy among the African American community

• Encourage people to engage in open communication and discussion

• Train/re-train staff appropriately on laws, policies, and overall mission

Alvidrez, J., Snowden, L.R., & Patel, S.G. (2010). The relationship between stigma and other treatment concerns and subsequent treatment engagement among black mental health clients. Issues in Mental Health Nursing, 31, 257-264.

GOAL 2Change perceptions about mental health

Objectives:

• Replace false ideologies with true ideologies

• Work with local community mental health leadership, organizations, and agencies

• Employ the media to incorporate positive roles for individuals with mental issues in their advertisements, commercials, and shows

Meinhert, J.A, Blehar, M.C., Peindl, K.S., Neal-Barnett, A., & Wisner, K.L. (2003). Bridging the gap: Recruitment of African American women into mental health. Academic Psychiatry, 27(1), 21-28.

GOAL 3Acquire and sustain financial and resource support from religious and community organizations

Objectives:

• Provide incentives for support

• Implore collaboration and participation from external sources

• Maintain transparency and communication

Matis, J.S. (2002). Religion and spirituality in the meaning, making and coping experiences of African American women: A qualitative analysis. Psychology of Women Quarterly, 26, 309-321.

GOAL 4Empower African American women to advocate for themselves

Objectives:

• Provide education and ongoing training

• Provide support groups and resources

• Encourage input and feedback

• Inspire mentoring opportunities

Jones, H.L., Cross, W.E, Jr., & DeFurr, D.C. (2007). Race related stress, racial identity attitudes, and mental health among black women. Journal of Black Psychology, 33(2), 208-231.

RATIONALE The Surgeon General’s Report on Mental Health (2001): Culture, Race and Ethnicity, cited social stigma as a major reason people of color don’t seek certified counseling. For the fear of being perceived as unstable or crazy.

Counseling is still seen as a White endeavor (Sue & Sue, 2003), which operates from a White middle-class value system (Guthrie, 1976). Historically, African Americans were studied almost exclusively to illustrate a negative point or to highlight a particular pathology.

According to the Bible, God gave Abraham a promise. "I will make you into a great nation and I will bless you; I will make your name great, and you will be a blessing. I will bless those who bless you, and whoever curses you I will curse; and all peoples on earth will be blessed through you" (Gen. 12:2-3).

The bible also states, "If you harbor bitter envy and selfish ambition in your hearts, do not boast about it or deny the truth. Such 'wisdom' does not come down from heaven but is earthly, unspiritual, of the devil. For where you have envy and selfish ambition, there you find disorder and every evil practice" (James 3:14-16).

Coker, A.D. (2002). Racial tasks of African American clients: Understanding historical cultural values as a means of developing appropriate counseling interventions. Paper presented at the 36th Annual Conference, Alabama Counseling Association, Mobile, Alabama.

U.S. Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity – A supplement of Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General.

BARRIERS • Values

• Beliefs

• Religion

• Cultural norms and/or expectations

• Societal norms and/or expectations

• Gender role stereotypes

• Limited resources (financial, transportation, childcare, housing, etc.)

• Family roles

• Human service professionals’ attitudes

• Limited minority therapists

• Past historical experiments (Tuskegee, Eugenics and Fenfluramine)

Ward, E.C., & Heidrich, S.M. (2009). African American women's beliefs about mental illness, stigma, and preferred coping behaviors. Research in Nursing & Health, 32(5), 480-492

STRATEGIES• Emphasis on strengths

• Identify weaknesses and ways to either decrease or turn them into strengths

• Emphasis on improving clinical care

• Incorporate social events

• Integrate religious activities

• Identify barriers and ways to remove them

• Develop short and long term goals

• Monitor the outcomes of clinical and community prevention/intervention

• Match caregiver with client

Masterson. S., & Owen, S. (2006). Mental health service user’s social and individual empowerment: Using theories of power to elucidate far reaching strategies. Journal of Mental Health, 15(1), 19-34.

IMPORTANCE OF SOCIAL SUPPORT SYSTEMS

• Builds self-esteem

• Assists with self-perception

• Empowers the individual

• Offers comfort

• Acknowledgement

• Fosters a sense of belonging

• Increases sense of value

• Provides stability and consistency

Social support systems are important because they build rapport with the individual, the community, and mental health agencies. Decreases loneliness and isolation. Reduces the amount of stress an individual has to tolerate alone. Enables the individual to feel acknowledged, valued, and confident. Pender, N.J., Murdaugh, C., & Parsons, M.A.(2010). Health promotion in nursing practice, 6th edition. Upper Saddle River, NJ:

Pearson/Prentice-Hall.

WHY SOCIAL SUPPORT SYSTEMS ARE IMPORTANT

• Builds trust

• Power in numbers

• Connectedness with others who might have similar issues

• Information gathering

• Resources

• Encouragement

• Security

• Discipline

• Accountability

A strong support system within the African American women’s community enables the women to effectively manage the negative attitudes and stigmas associated with mental illness. African American women are deeply rooted in religion and spirituality and tend to seek external support from external sources such as family, friends, clergy, religious organizations or community agencies.

Pender, N.J., Murdaugh, C., & Parsons, M.A.(2010). Health promotion in nursing practice, 6th edition. Upper Saddle River, NJ: Pearson/Prentice-Hall.

FIGURE 1: PLOTTED INTERACTION BETWEEN RACIST STRESS APPRAISALS AND MULTICULTURALISM FOR DEPRESSION

Jones, H.L., Cross, W.E, Jr., & DeFurr, D.C. (2007). Race related stress, racial identity attitudes, and mental health among black women. Journal of Black Psychology, 33(2), 208-231.

ULTIMATE BEHAVIOR OUTCOMESDecrease in the mortality and morbidity rate of African American women

Better overall quality of life

Stress reduction

Use of appropriate coping mechanisms

Functional support systems

Open and transparent communication channels

Reduction in false perceptions

Individual, community, and clinical partnerships established and maintained

Implementation of treatment measuring tools

Implementation of protocols to report abuse, neglect, and harm to patients

REFERENCE LIST

Gary, F.A. (2005). Stigma: Barrier to mental health care among ethnic minorities. Issues in Mental Health Nursing, 26, 979-

999.

Jones, H.L., Cross, W.E, Jr., & DeFurr, D.C. (2007). Race related stress, racial identity attitudes, and mental health among

black women. Journal of Black Psychology, 33(2), 208-231.

Alvidrez, J., Snowden, L.R., & Patel, S.G. (2010). The relationship between stigma and other treatment concerns and

subsequent treatment engagement among black mental health clients. Issues in Mental Health Nursing, 31, 257-264.

Masterson. S., & Owen, S. (2006). Mental health service user’s social and individual empowerment: Using theories of

power to elucidate far reaching strategies. Journal of Mental Health, 15(1), 19-34.

Coker, A.D. (2002). Racial tasks of African American clients: Understanding historical cultural values as a means of

developing appropriate counseling interventions. Paper presented at the 36th Annual Conference, Alabama

Counseling Association, Mobile, Alabama.

REFERENCE LIST CONTINUED

Edwards, T.A., Houry, D., Kemball, R.S., & Harp, S.E. (2006). Stages of change as a correlate of mental health symptoms in abused,

low income African American women. Journal of Clinical Psychology, 62(12), 1531-1543.

Ward, E.C., & Heidrich, S.M. (2009). African American women's beliefs about mental illness, stigma, and preferred coping behaviors.

Research in Nursing & Health, 32(5), 480-492.

Greer, T.M. (2011). Coping strategies as moderators of the relation between individual race related stress and mental health

symptoms for African American women. Psychology of Women Quarterly, 35(2), 215-226.

Meinhert, J.A, Blehar, M.C., Peindl, K.S., Neal-Barnett, A., & Wisner, K.L. (2003). Bridging the gap: Recruitment of African American

women into mental health. Academic Psychiatry, 27(1), 21-28.

U.S. Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity – A supplement of Mental Health:

A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service,

Office of the Surgeon General.

Pender, N.J., Murdaugh, C., & Parsons, M.A.(2010). Health promotion in nursing practice, 6th edition. Upper Saddle River, NJ:

Pearson/Prentice-Hall.