Things are “moving in the right direction” in terms of the treatment of mental health and mental health disparities in the Black community, health officials say.
Black Americans are 20 percent more likely to report having serious psychological distress than non-Hispanic Whites, according to statistics from the Centers for Disease Control and Prevention. And, poverty only exacerbates those conditions, as Blacks living below the poverty level, as compared to those over twice the poverty level, are three times more likely to report psychological distress.
However, it is not the “statistical prevalence of mental health conditions” among Blacks that should be the main cause for concern but that “the burden of the condition may be greater,” said Roslyn Moore, public health analyst in the Substance Abuse and Mental Health Services Administration, an agency within the U.S. Department of Health and Human Services.
For example, Moore said, Blacks are much more exposed to trauma—poverty, crime, death, discrimination and more. Yet, they are less likely to have access to quality mental health care. For example, White Americans are more than twice as likely to receive antidepressant prescription treatments as are Black Americans, according to the CDC.
The stigma associated with mental illness, lack of information and community distrust bred by a history of discrimination within health care services as well as continuing institutional biases have all been cited as barriers to equitably addressing behavioral health in Black communities. Under the Obama administration, however, aggressive steps have been taken to eliminate those barriers—beginning with increased access to health insurance under the Affordable Care Act.
“The opportunities to access health care are greater than they’ve ever been before, so more African Americans are able to access interventions that are new, different, and culturally and age sensitive. We’re able to move things that are working into the neighbourhoods faster,” Moore said. “The Affordable Care Act also supports prevention so we are not always at the point where we are far down the line of disease.”
Health care proponents and providers are also changing the way mental health is accessed, realizing, for example, that the few minorities who do seek behavioral health care prefer receiving that care in primary care settings.
“We may be looking at one of the greatest times of health care integration,” Moore said. “ the provider community is in a better position to do outreach.”
Where in the past, for instance, people were able to avoid discussions about mental health, such matters now may be broached head-on at the primary care level.
And, there have been many strides in the development of culturally-sensitive programs and interventions to address mental health in Black communities. For example:
– PLAAY (Preventing Long-term Anger and Aggression in Youth) is an intervention geared toward Black boys at risk of academic discipline or involvement in the criminal justice. It uses culturallyand age-appropriate approaches to teach stress management, gender and racial coping skills, trauma resolution and more.
– Shape Up is a program in which barbers are trained by clinicians to “be the eyes and ears in the community to identify men and boys at risk of depression and anxiety,” Moore said.
Prime Time Sister Circles is a curriculum based, 12 week, facilitated, interactive support group that is geared toward empowering and motivating Black women to change their health outcomes, including mental health.
– SAMHSA and other agencies and organizations are also undertaking initiatives to create a more culturally-diverse workforce. One example is the Historically Black Colleges and Universities Center for Excellence in Behavioral Health (HBCUCFE), which works with HBCUs in developing behavioral health curricula for students and strategies to promote behavioral health workforce development.
All of these approaches and interventions augur well for the status of mental health within the African-American community, Moore said.
“We look at the outcome of that work and know that the trends will change,” she said.