Background
In the United States, there is an unconscious idea of the type of people who struggle with mental illness. We have unknowingly created a schema for people who have mental illness – one that does not extend to minority populations. According to the National Institute for Mental Health, “members of ethnic and racial minority groups in the U.S. are less likely to have access to mental health services, less likely to use community mental health services, more likely to use inpatient hospitalization and emergency rooms, and more likely to receive lower quality care.” This statement highlights a growing disparity in mental health care that is often the result of poverty; mental health resources are often associated with higher income neighborhoods because of the expense that it is to seek mental health care.
How To Proceed: Psychological Treatment of Ethnic Minority Populations
In 2002, Dr. Derald Wing Sue, a professor at the Teachers College at Columbia University, sought to shed some light on the need for cultural competence in mental health practices in America. He studied four Ethnic Minority Psychological Associations to try to understand more clearly the ways that Psychologists and mental health providers can better understand the needs of minority populations. In his book, he looks specifically at The Asian American Psychological Association (AAPA), the Association of Black Psychologists (ABPsi), The National Latina/o Psychological Association (NLPA), and The Society of Indian Psychologists (SIP).
Sue begins his article by examining the diversification of the United States. What was once a country that prioritized the needs of citizens homogenously, the United States is becoming an increasingly diverse nation through the multitude of immigrants of visible racial and ethnic minorities and the higher birth rates associated with this flux of immigrants. The U.S. Census Bureau predicts that minorities will become the majority by the year 2050, which makes it nearly impossible for mental health practitioners not to confront minority groups in their careers. This statistic and the need for greater mental health intervention in minority groups has been brought to the attention many health care professionals in 2001 at the annual American Psychological Association convention. The Surgeon General of the United States presented key points that summarize the cry for mental health intervention: the mental health needs people of color are still not being met. According to the Surgeon General, we must increase our cultural competence in the delivery of services and understand the cultural and sociopolitical circumstances that effect minority groups. The DSM has even expanded to include sections on cultural variations in clinical settings, tools for clinicians to evaluate and understand the ways that individuals are beholden to their minority status.
Substance Abuse and Mental Illness
Despite many efforts to bring awareness to the minority groups in Mental Health disparities – specifically in ways that Dr. Sue described – there is still a relatively high rate of minority individuals struggling with mental illnesses. This may be in part to co-morbidity that exists in many populations with mental illness and substance abuse.
In 2016, the Substance Abuse and Mental Health Services Administration produced these statistics on several minority group populations. Though the rates of mental disorders are usually low among African Americans, 16.3% were reported for having mental illnesses while 3.8% of African American adults are reported to have both substance abuse disorder and mental illnesses. African Americans make up about 14.2% of the total population with about 44.5 million African Americans in the United States at the time of this survey.
Hispanics and Latinos make up about 30% of the total population of the U.S., about 52 million in the world. About 15.6% of Latino and Hispanic adults have had a mental illness, with 3.5% of adults using serious mental illnesses. About 3.3 percent of this population had mental health and substance use disorders that exist at the same time.
When looking at these statistics, there are multiple circumstances to consider. Firstly, it is imperative to consider the percentages of minority groups that exist in poverty. The socioeconomic circumstances are crucial in their access to mental health resources. Additionally, many of these circumstances are results of a lack of education — whether that be lack of funds to access an education or no suitable options for education to take place. This is part of the cycle that perpetuates the overlap between substance abuse and mental illnesses.
Case Study: Willow Weep for Me
In the memoir Willow Weep For Me, author Meri Danquah articulates an opinion that we often don’t hear. She is able to bring to light her experiences struggling through depression as a black woman – how her experiences are often invalidated and excluded. Her experiences speak to the struggles of three very different communities: the African American, female and mentally ill community. Meri Danquah describes this intersectionality:
“The illusion of strength has been and continues to be of major significance to me as a black woman. The one myth that I have had to endure my entire life is that of my supposed birthright to strength. Black women are supposed to be strong – caretakers, nurturers, healers of other people – any of the twelve dozen variations of Mammy. Emotional hardship is supposed to be built into the structure of our lives. It went along with the territory of being both black and female in a society that completely undervalues the lives of black people and regards all women as second-class citizens. It seemed that suffering, for a black woman, was part of the package. Or so I thought.”
This passage suggests the ways in which society views the suffering body as well. If the suffering body fits into multiple categories of suffering at once, there is some sort of cognitive dissonance that occurs there. In addition to little action taken, there is often little support from minority communities to address mental health. As Danquah mentioned, there is a preconceived notion from the people around her that she is supposed to endure hardship as a black woman. This inhibits many people from seeking treatment; they often feel weak if they are not able to deal with their given circumstances. It is important to remember that the stigma of mental illness propels this idea as well.
Conclusion
Mental illness exists in all populations; regardless of age and race, mental illnesses are extremely prevalent. When understanding the ways that mental illness plagues minority populations, it is imperative to understand the socioeconomic and cultural struggles of that community. To bring mental health reform communities of minority groups will require a deep understanding of the conditions barring them from getting access to mental health services, or their biases to abstain from mental health care. It is also important to address substance abuse disorder and how they may increase mental health disorders in communities – the comorbidity that exists between these two disorders.
It is equally important for each member of any community to be a responsible participant in understanding the basics of mental illness. Recognizing the warning signs and working to provide support within communities that may not be understood by mental health professionals is equally as crucial. Conversely, it is imperative to seek the help of mental health professionals and try to explain and articulate the way that minority communities are being negatively affected by mental illness in a way that the majority population may not be attuned to. The reform to mental health care can only occur if there is a wider spread understanding and awareness of the way that mental health disorders are affecting minority populations.
Citations:
CDC. Retrieved March 27, 2017, from https://nccd.cdc.gov/PRCResearchProjects/Search/SearchResults.aspx#modalIdString_gvSearchItemsList
Danquah, M. N. (1998). Willow Weep For Me. New York, NY: W.W. Norton & Company.
National Institute of Mental Health (2015). Minority Health and Mental Health Disparities Program. Retrieved March 25, 2017, from https://www.nimh.nih.gov/about/organization/gmh/minority-health-and-mental-health-disparities-program.shtml
National Institute of Health (2014, February 14). Racial and Ethnic Disparities in Mental Health Care: Evidence and Policy Implications. Retrieved March 27, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928067/
Sue , D. W., PhD. (2002). Psychological Treatment of Ethnic Minority Populations. Retrieved March 28, 2017, from https://www.apa.org/pi/oema/resources/brochures/treatment-minority.pdf
Substance Abuse and Mental Health Services Administration (2016, February 16). Racial and Ethnic Minority Populations. Retrieved March 27, 2017, from https://www.samhsa.gov/specific-populations/racial-ethnic-minority
« Back to Glossary Index