Where To Get Help

Don’t be afraid to reach out if you or someone you know needs help. Learning all you can about mental health is an important first step. Reach out to your health insurance, primary care doctor or state/country mental health authority for more resources. Contact the NAMI HelpLine to find out what services and supports are available in your community. If you or someone you know needs helps now, you should immediately call the National Suicide Prevention Lifeline at 1-800-273-8255 or call 911.

Receiving A Diagnosis

Knowing warning signs can help let you know if you need to speak to a professional. For many people, getting an accurate diagnosis is the first step in a treatment plan. Unlike diabetes or cancer, there is no medical test that can accurately diagnose mental illness. A mental health professional will use the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, to assess symptoms and make a diagnosis. The manual lists criteria including feelings and behaviors and time limits in order to be officially classified as a mental health condition. After diagnosis, a health care provider can help develop a treatment plan that could include medication, therapy or other lifestyle changes.

Finding Treatment

Getting a diagnosis is just the first step; knowing your own preferences and goals is also important. Treatments for mental illness vary by diagnosis and by person. There’s no “one size fits all” treatment. Treatment options can include medication, counseling (therapy), social support and education. See more at

African American Mental Health

Check out “African American Mental Health Voices from NAMI” by Amanda Wang on Vimeo. African Americans are no different when it's come to prevalence of mental health conditions when compared to the rest of the population. However, your concerns or experiences and how you understand and cope with these conditions may be different.

Why Does Mental Health Matter?

Without mental health we cannot be healthy. Any part of the body—including the brain—can get sick. We all experience emotional ups and downs from time to time caused by events in our lives. Mental health conditions go beyond these emotional reactions to specific situations. They are medical conditions that cause changes in how we think and feel and in our mood. These changes can alter your life since they make it hard to relate to others and function the way you used to. Without proper treatment, mental health conditions can worsen and make it hard to live day-to-day life. If you feel you or a loved one might be experiencing a mental health condition, remember that these are biological brain disorders. Anyone can develop a mental health problem. It isn’t you fault or your family’s fault. Seeking treatment can help you live a fulfilled life and can strengthen you and your family for the future.

How Do Mental Health Conditions Affect the African American Community?

Although anyone can develop a mental health problem, African Americans sometimes experience more severe forms of mental health conditions due to unmet needs and other barriers. According to the Health and Human Services Office of Minority Health, African Americans are 20% more likely to experience serious mental health problems than the general population. Common mental health disorders among African Americans include:

• Major depression
• Attention deficit hyperactivity disorder (ADHD)
• Suicide, among young African American men
• Posttraumatic stress disorder (PTSD), because African Americans are more likely to be victims of violent crimeAfrican Americans are also more likely to experience certain factors that increase the risk for developing a mental health condition:
• Homelessness. People experiencing homelessness are at a greater risk of developing a mental health condition. African Americans make up 40% of the homeless population.
• Exposure to violence. increases the risk of developing a mental health condition such as depression, anxiety and post-traumatic stress disorder. African American children are more like to be exposed to violence than other children.

Issues to Consider

Below we highlight different reasons that prevent African Americans from seeking treatment and receiving quality care.

Lack of Information and Misunderstanding about Mental Health

In the African American community, many people misunderstand what a mental health condition is and don’t talk about this topic. This 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 it. Many African Americans also have difficulty recognizing the signs and symptoms of mental health conditions, leading to underestimating the effects and impact of mental health conditions. Some may think of depression as “the blues” or something to snap out of. Because of the lack of information surrounding mental health issues, it’s not always clear where to find help when you may need it. Fortunately, you came to the right place to learn about what mental health conditions are and how to access treatments and supports. Don’t let fear of what others may think prevent you or a loved one from getting better. As we said earlier, 1 in 5 people are affected by mental illness. This means that even if we don’t talk about it, most likely, all of us have one of these illnesses or know someone who is.

Faith, Spirituality and Community

In the African American community, family, community and spiritual beliefs tend to be great sources of strength and support. However, research has found that many African Americans rely on faith, family and social communities for emotional support rather than turning to health care professionals, even though medical and/or therapeutic treatment may be necessary.Faith and spirituality can really help in the recovery process but it should not be the only option you pursue. If spirituality is an important part of your life, your spiritual practices can be a strong part of your treatment plan. Your spiritual leaders and faith community can provide support and reduce isolation. Be aware that sometimes faith communities can be a source of distress and stigma if they are misinformed about mental health or do not know how to support families dealing with these conditions.Do rely on your family, community and faith for support, but it also might be necessary to seek professional help as well.

Reluctance and Inability to Access Mental Health Services

Only about one-quarter of African Americans seek mental health care, compared to 40% of whites. Here are some reasons why:

• Distrust and misdiagnosis. Historically, African Americans have been and continue to be negatively affected by prejudice and discrimination in the health care system. Misdiagnoses, inadequate treatment and lack of cultural competence by health professionals breed distrust and prevent many African Americans from seeking or staying in treatment.
• Socio-economic factors. play a part too and can make treatment options less available. According to the U.S. Census Bureau, as of 2012, 19% of African Americans have no form of health insurance. The Affordable Care Act is making it easier and more affordable to get insured.
• A lack of African American mental health professionals. Only 3.7% of members in the American Psychiatric Association and 1.5% of members in the American Psychological Association are African American.

Medications

Some studies indicate that African Americans metabolize many medications more slowly than the general population, yet we are more likely to receive higher dosages. This may result in a greater chance of negative side-effects and a decreased likelihood of sticking with treatment.

Provider Bias and Inequality of Care

Conscious or unconscious bias from providers and lack of cultural competence results in misdiagnosis and poorer quality of care for African Americans.African Americans, especially African American women, are more likely to experience and mention physical symptoms related to mental health problems. For example, you may describe bodily aches and pains when talking about depression. A health care provider who is not culturally competent might not recognize these as symptoms of a mental health condition. Additionally, African American men are more likely to receive a misdiagnosis of schizophrenia, when expressing symptoms related to mood disorders or PTSD.Given this bias and the negative impact they have on our care, it is easy to understand why so many African Americans mistrust health professionals in general and avoid accessing care. While you have a reason to doubt whether professionals will mistreat you or not, don’t let this fear prevent you from seeking care. The section below gives ideas on how to find the right provider for you.

Finding the Right Provider for You

Cultural Competence in Service Delivery

Culture—a person’s beliefs, norms, values and language—plays a key role in every aspect of our lives, including our mental health. Cultural competence is a doctor’s ability to recognize and understand the role culture (yours and hers) plays in treatment and to adapt to this reality to meet your needs. Unfortunately, research studies have shown lack of cultural competence in mental health care. This results in misdiagnosis and inadequate treatment. African Americans and other multicultural communities tend to receive poorer quality of care. However, you can improve your odds of getting culturally sensitive care.While we recommend you do directly to a mental health professional since this is their area of expertise, if you do not feel comfortable right away, a primary care doctor is a great place to start. The primary care doctor may be able to start the assessment process to determine if you have a mental health condition or assist you in getting a referral to a mental health professional.Unfortunately, while you may prefer finding an African American mental health professional, this is not often possible since there are a small percentage of African American providers. Thankfully, professionals are increasingly required to learn how to effectively treat people from diverse backgrounds. However, as mentioned before, many providers still lack cultural competence and do not know how to effectively treat African Americans.When meeting with your provider, ask questions to get a sense of his level of cultural sensitivity. Do not feel bad about asking questions. Providers expect and welcome questions from their patients since this helps them better understand you and what is important to you. Your questions give your doctor and health care team important information about you, such as your most important health care concerns. Here are some questions you could ask:

• Have you treated other African Americans?
• Have you received training in cultural competence or on African American mental health?
• How do you see our cultural backgrounds influencing our communication and my treatment?
• How do you plan to integrate my beliefs and practices in my treatment?

Your mental health provider will play an important role in your treatment, so make sure you can work with this person and that you communicate well together. Mention your beliefs, values and cultural characteristics. Make sure that she understands them so that they can be considered in the course of your treatment. For example, mention whether it is important for you that your family be part of your treatment. If finances are preventing you from finding help, get in contact with a local health or mental health clinic or your local government to see what services you qualify for. You can find contact information online at findtreatment.samhsa.gov, or by calling the National Treatment Referral Helpline at 800-662-HELP (4357).

Resources

NAMI’s Sharing Hope Program

Sharing Hope is an hour-long program to increase mental health awareness in African American communities by sharing the presenters’ journeys to recovery and exploring signs and symptoms of mental health conditions. The program also highlights how and where to find help. Sharing Hope: An African American Guide to Mental Health provides mental health information in a sensitive manner through personal stories. Recovery is possible and this booklet tells you where to find more information, seek help and be supportive. You can buy hard copies through the NAMI Bookstore.See more

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.

Demographics/Societal Issues

• 13.2% of the U.S. population, or roughly 42 million people, identify themselves as African American, according to 2013 US Census Bureau numbers. (1) Another 1 percent identified as multiracial. This represents an increase from 12 percent of the U.S. population, or roughly 34 million people, who identified themselves as African American in the 2000 Census. (2) In 2007, roughly 3 million of all blacks in the U.S. were foreign born. (3)
• As of 2010, Fifty-five percent of all blacks lived in the South, 18 percent lived in the Midwest, 17 percent in the Northeast, and 10 percent in the West. (4)
• 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.
• Notwithstanding the 2008 election of our first African American President, racism continues to have an impact on the mental health of 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 African Americans in mind.

Prevalence
According to the US HHS Office of Minority Health: (5)

• Adult blacks are 20 percent more likely to report serious psychological distress than adult whites.
• Adult blacks living below poverty are two to three times more likely to report serious psychological distress than those living above poverty.
• Adult blacks are more likely to have feelings of sadness, hopelessness, and worthlessness than are adult whites.
• And while blacks are less likely than whites to die from suicide as teenagers, black teenagers are more likely to attempt suicide than are white teenagers (8.2 percent v. 6.3 percent)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).

Attitudes
Historically, attitudinal barriers have led to roadblocks to accessing services and treatment. In 1996, MHA commissioned a national survey on clinical depression. The survey explored the barriers preventing Americans seeking treatment and gauged overall knowledge of and attitudes toward depression. This survey revealed that:

• 63 percent of African Americans believe that depression is a personal weakness, this is significantly higher than the overall survey average of 54 percent.
• Only 31 percent of African Americans believed that depression was a “health problem.”
• African Americans were more likely to believe that depression was “normal” than the overall survey average.
  • 56 percent believed that depression was a normal part of aging
  • 45 percent believed it was normal for a mother to feel depressed for at least two weeks after giving birth
  • 40 percent believed it was normal for a husband or wife to feel depressed for more than a year after the death of a spouse.
• Barriers to the treatment of depression cited by African Americans included:
  1. Denial (40 percent)
  2. Embarrassment/shame (38 percent)
  3. Don’t want/refuse help (31 percent)
  4. Lack money/insurance (29 percent)
  5. Fear (17 percent)
  6. Lack knowledge of treatment/problem (17 percent)
  7. Hopeless (12 percent)
• African Americans were less likely to take an antidepressant for treatment of depression; only 34 percent would take one if it were prescribed by a doctor. Many of these problems persist to this day. As Doctor William Lawson of Howard University (and MHA’s District of Columbia affiliate) pointed out in an NPR interview in 2012, “Many African-Americans have a lot of negative feelings about, or not even aware of mental health services. They may not be aware of the symptoms of many mental disorders, or they may believe that to be mentally ill is a sign of weakness or a sign of a character fault.” (6)

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.

• African-American physicians are five times more likely than white physicians to treat African-American patients. African-American patients who see African-American physicians rate their physicians’ styles of interaction as more participatory. African Americans seeking help for a mental health problem would have trouble finding African American mental health professionals: In 1998, only 2 percent of psychiatrists, 2 percent of psychologists and 4 percent of social workers said they were African Americans.
• The public mental health safety net of hospitals, community health centers, and local health departments are vital to many African Americans, especially to those in high-need populations.
• African Americans of all ages are underrepresented in outpatient treatment but over-represented in inpatient treatment. Few African-American children receive treatment in privately funded psychiatric hospitals, but many receive treatment in publicly funded residential treatment centers for emotionally disturbed youth.But African Americans today are overrepresented in our jails and prisons. People of color account for 60 percent of the prison population. Blacks 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.) (7)

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:

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

And while implementation of the Affordable Care Act will close this gap somewhat by 2016, in 2011 20.8 percent of blacks were uninsured, versus 11.7 percent of whites. (8) Educational Materials MHA has developed unique materials for African Americans.

Brochures

• Depression and African Americans: Not Just the Blues
• What is Bipolar Disorder? A Guide to Hope and Recovery for African Americans Fact Sheets
• Bipolar Disorder and African Americans
• Clinical Depression and African Americans

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

• Capstone Institute/Center for Research on the Education of Students Placed at Risk, Howard University: http://www.capstoneinstitute.org
• National Black Nurses Association:http://www.nbna.org/
• National Medical Association: http://www.nmanet.org/
• Lee Thompson Young Foundation: http://www.leethompsonyoungfoundation.org/

Sources

1. http://quickfacts.census.gov/qfd/states/00000.html
2. “Mental Health: Culture, Race and Ethnicity Supplement” to the 1999 U.S. Surgeon General’s Report on Mental Health.
3. http://www.census.gov/prod/2010pubs/acs-11.pdf
4. http://www.census.gov/newsroom/releases/archives/2010_census/cb11-cn185.html
5. http://minorityhealth.hhs.gov/templates/content.aspx?lvl=3&lvlID=9&ID=6474
6. http://www.npr.org/2012/08/20/159376802/behind-mental-health-stigmas-in-black-communities
7. 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/
8. http://aspe.hhs.gov/health/reports/2011/cpshealthins2011/ib.shtml#_Toc303600552

LINKS

• American Psychiatric Association
• DBSA Depression and Bipolar Support Alliance
• NAMI- National Alliance on Mental Illness
• National Institute of Mental Health
• Mental Health America
• Nesiwangu

Disclaimer: Links are provided as a convenience and are not under our control or intended as an endorsement.