AccountingQueen
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Mental Health Taboo
Jessica Hall
Grand Canyon
Dr. Grant
RSD-881
May 3, 2017
Literature review
Anglin, D. M., Alberti, P. M., Link, B. G., & Phelan, J. C. (2008). Racial differences in beliefs about the effectiveness and necessity of mental health treatment. American Journal of Community Psychology, 42, 17–24. doi:10.1007/s10464-008-9189-5. Retrieved from http://eds.a.ebscohost.com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?sid=046e4915-2cb6-4c7c-b811-dc4710faffb8%40sessionmgr4007&vid=0&hid=4103
The perception of different racial groups on the effectiveness as well as the necessity of mental health directly influences the health seeking behaviors of these groups. The study carried out by Anglin, Alberti, Link & Phelan (2008) aimed at providing evidence to support the racial differences in beliefs on the effectiveness and the necessity of seeking mental health treatment to determine the psychological barriers to mental health treatment. The study focused on two major racial groups that is the Caucasians and the African Americans. The study sampled 82 African Americans and 583 Caucasians (Anglin et al., 2008). The study concluded that Caucasians believed that mental health treatment was necessary and effective when facing mental health problems while the Africans Americans identified that mental health treatment was effective but not necessary to address mental health problems. The African Americans identified that mental health problems would go away on their own. This identifies that the belief in the effectiveness of treatment was not related to utilization of mental health services. This identifies that the main barrier to mental health seeking behavior among African Americans is cultural and contextual rather than lack of awareness on the efficiency of these services. Anglin et al. (2008) noted that changing conceptions of mental illness was key to promoting utilization of mental health services among African Americans.
Cruz, M., Pincus, H. A., Harman, J. S., Reynolds, C. F., III, & Post, E. P. (2008). Barriers to care-seeking for depressed African Americans. International Journal of Psychiatry in Medicine, 38, 71– 80. Retrieved from http://journals.sagepub.com/doi/abs/10.2190/PM.38.1.g
The aim to understand the various barriers that limit care seeking behaviors among depressed African Americans. The study aimed to address findings from other studies that identified that African Americans utilized mental health services at half the rate of the Caucasians. The population studied included African Americans from low income areas. The study enrolled 53 African Americans with 43 completing the study (Cruz, Pincus, Harman, Reynolds & Post, 2008). A survey was implemented to collected data from the respondents. The study concluded that several barriers limited care seeking among African Americans which were denial and shame as well as the complex interrelationship between public stigma and depression. Stigma was identified as the most frequent response. The internal barriers such as shame and denial were identified as the greatest barriers to mental health treatment among African Americans experience depression. The most unique aspect of the study was the use of a qualitative analytic method that used four raters to determine to effectively outline the barriers faced by the African Americans in seeking mental health treatment. Cruz et al. (2008) noted that future research should focus on assessing the relationship between factors such as denial and health seeking behavior to determine ways of modifying these behaviors and enhancing care seeking behaviors among low income African Americans.
Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC psychiatry, 10(1), 113. Retrieved from https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-10-113
The changes experienced from adolescent to young adulthood create various situations in the life of the youths thus leading to the development of mental disorders. The study sought to assess the barriers as well as the facilitators of mental health help seeking behaviors among young people. The study sampled African Americans and Caucasians youths between the ages of 11 and 31 (Gulliver, Griffiths & Christensen, 2010). Qualitative and quantitative research was collected through the use of surveys, interviews and focus groups. The study concluded that the most important barriers to seeking help on mental health disorder among youths is due to the perceived stigma, inability to recognize symptoms as well as a preference for self-reliance. Positive past experiences coupled with social support have been identified as key facilities to mental health seeking behavior (Gulliver et al., 2010). The unique feature in this study is that it implemented a longitudinal study on barriers to help seeking with specific focus on adolescents and young adults providing a new angle to viewing the issue of mental health taboos. An important statement outlined by the authors is that the strategies to enhance help seeking behaviors need to be focused on improving health literacy the reduction of stigma and taking into account the need for self-reliance among young people especially from minority groups such as African Americans.
McMiller, W. P., & Weisz, J. R. (1996). Help-seeking preceding mental health clinic intake among African-American, Latino, and Caucasian youths. Journal of the American Academy of Child & Adolescent Psychiatry, 35(8), 1086-1094. Retrieved from http://www.sciencedirect.com/science/article/pii/S089085670962503X
Mental health seeking behaviors are influenced by cultural and contextual experiences of the people and thus each racial group approaches the issue of mental help based on the culture and the content they are currently in. The study focused on understanding help seeking behaviors that influence the uptake of mental health services among Latino, African-Americans and Caucasian youths. The study sampled 192 clinic-admitted families with parents answering the surveys to determine their approaches to mental health problems facing their children (McMillen & Weisz, 1996). The study concluded that African American as well as Latino families were less likely to seek help from professionals when faced with health problems facing their youths. These racial groups were 0.37 as likely as the Caucasian families to seek help from professional agencies (McMiller & Weisz, 1996). The uniqueness of the study is that it goes further to identify the avenues used by groups such as Latino and African Americans that rarely seek mental health treatment by identifying that these groups seek community resources such as ministries and religious leaders as well as family members. The researchers noted that mental health seeking behavior is only limited among Latinos and African Americans after the failure of the alternative interventions through family members and community resources which is a critical statement that identifies that minorities only seek mental health treatment as a last resort.
Neighbors et al. (2007). Race, ethnicity, and the use of services for mental disorders: Results from the National Survey of American Life. Archives of General Psychiatry, 64, 485– 494. Retrieved from http://scholar.harvard.edu/files/davidrwilliams/files/2007-race_ethnicity_and-williams_0.pdf
Although mental health services have been provided in almost all locations within the country there are inequalities based on ethnicity and race of those who use these services. The focus of the study was to understand how ethnicity and race influence the use of services for mental disorders. The study includes 1621 Caribbean blacks and 3570 African Americans over the ages of 18 (Neighbors et al., 2007). The study analyzed the use of the mental health services provided based on the visits of the sampled participants. The study concluded that the extreme underuse of mental health services among black Americans was due to the inability to identify symptoms of mental disorders as well as the innate belief that mental health issues can be resolved with time. The black Americans also identified the use of clergies to manage mental health problems rather than the use of professionals. The most unique aspect of the study was its ability to divide the black community into its constitute makeup denoting the Africans Americans and the Caribbean blacks to determine any difference in their health seeking behaviors. The study h identified no significant difference between the health seeking behaviors of these two groups. Neighbors et al. (2007) noted that “Mental health care professionals must incorporate knowledge about ethnic differences in idioms of distress and how to overcome feelings of mistrust into their therapeutic approach.” This statement identifies the importance of understanding cultural differences and how they affect behavior thus enhancing the ability of mental health professionals to address the needs of the patients.
Snowden, L. R. (2001). Barriers to effective mental health services for blacks.
Mental Health Services Research, 3, 181–187. Retrieved from https://link.springer.com/article/10.1023%2FA%3A1013172913880
Snowden (2001) noted that many marginalized African Americans suffer from various mental health problems with the current mental health services being underutilized by the group. The study carried out by Snowden (2001) therefore sought to assess the barriers limiting the use of effective mental health services among the African Americans. The study sampled African Americans from low income areas to identify the reasons that limit them from utilizing mental health services. The study identified that few African Americans experiencing mental health problems seek professional help and those who do are at an elevated risk of dropping out before the treatment is complete. The study concluded that the factors that limit the utilization of mental health services to be stigma, the lack of resources, opportunities for treatment and limited knowledge on the efficacy of the mental health programs (Snowden, 2001). Important and unique information provided by the study is the identification that African Americans seek more general medical sector services but are inclined to pursue sociality and voluntary care as compared to other groups. An important statement raised by Snowden (2001) is the need to identify the differences in need based on cultural orientation, social standing and location to promote the implementing of culturally specific programs designed to benefit the African Americans.
Thompson, V. L. S., Bazile, A., & Akbar, M. (2004). African Americans' perceptions of psychotherapy and psychotherapists. Professional Psychology: Research and Practice, 35(1), 19. Retrieved from http://eds.b.ebscohost.com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?sid=557382a0-064b-42c8-848b-30a6dcb876aa%40sessionmgr104&vid=8&hid=103
Attitudes and perceptions towards mental health and its professions defines help seeking behaviors. The inequalities in services utilization based on race and ethnicity identify the need to understand the perception of groups such as African Americans on mental health. The study aimed to assess the perceptions of African Americans regarding psychotherapy and the psychotherapists to understand the reasons for service underutilization among the African American population (Thompson, Bazile & Akbar, 2004). The study utilized data collection tools such as surveys and interviews to understand the perceptions of African Americans on psychotherapy and physiotherapists. The beliefs and the attitudes of 201 African Americans regarding barriers to treatment, psychotherapist and psychotherapy was explored. The study concluded that psychotherapy was effective at addressing mental health problems but the psychotherapists were insensitive to the experiences of the African Americans. The batteries to utilization were identified as stigma, lack of affordability, lack of trust, the lack of cultural understanding, limited knowledge and impersonal services. Information that should be recalled is the statement by Thompson et al. (2004) noting that cultural competency was key to bridging the gap between the African Americans and utilization of mental health services. Thompson et al. (2004) noted that “there is need for a therapeutic approach that emphasis the interpersonal relationship evidenced in African American community”. The statement identifies the need of cultural sensitive and patient centered approach to addressing the mental health needs of African Americans and promote engagement in the treatment program.
Vogel, D. L., Humdinger-Edwards, S. R., Hammer, J. H., & Hubbard, A. (2011). “Boys don't cry”: Examination of the links between endorsement of masculine norms, self-stigma, and help-seeking attitudes for men from diverse backgrounds. Journal of Counseling Psychology, 58(3), 368. Retrieved from http://citeseerx.ist.psu.edu/messages/downloadsexceeded.html
Conformity to dominate masculine roles can be identified a critical barrier to the help seeking behaviors among men from different background. The masculine roles tend to reinforce perceptions that seeking help especially mental help as a sign of weakness thus encouraging denial and promoting the psychological inability to identify mental health problems. Vogel, Heimerdinger-Edwards, Hammer & Hubbard (2011) focused their research on understanding the link between the endorsement of masculine norms, self-stigma and the help seeking behaviors of men from various backgrounds. The study sampled 4773 men from majority and minority populations with the participants being recruited through internet websites and online surveys sent to the participants for data collection. The study concluded by noting that the reinforcement of dominant masculine roles and self-stigma resulted in unfavorable attitudes towards seeking help and promoted self-reliance. The study therefore identified that cultures that promoted greater effort on male masculinity such as African Americans saw increased negative attitudes toward health seeking behaviors (Vogel et al., 2011). Valuable information to recall is that the cultural factors that seek to impose masculine roles create a negative attitude towards seeking help especially among minority gripes with strong cultural values. The statement that cultures with high levels of self-efficacy such as Latin and African American cultures enhance the perceived notion that seeking help as a sign of weakness which best explains why African Americans underutilize mental health services.
Ward, E. C., Clark, L. O., & Heidrich, S. (2009). African American women’s beliefs,
coping behaviors, and barriers to seeking mental health services. Qualitative
Health Research, 19(11), 1589 – 1601. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2854663/
Due to limited knowledge on the perceptions and attitudes of African American women on mental illness a qualitative study was carried out to evaluate the beliefs, barriers to seeking mental health services and coping behaviors of African American women (Ward, Clark & Heidrich, 2009). Purposive sampling procedures were implemented to recruit 15 black women from there major age groups that were the young, the middle aged and the old. Interviews were conducted and data was analyzed to gain an understanding of the belief, coping behaviors and factors that limited approaching mental health services to seek help (Ward et al. 2009). The study concluded that the women had knowledge of mental illness such as its cause, negative outcomes and coping strategies that could be implemented to promote recovery. The limitations to help seeking behaviors included lack of awareness of the mental illness, stigma and poor access to care. Stigma was however identified as a key barrier to seeking help with the use informal coping mechanism such as church, family and friends being used by more women. The unique information identified in this study was that the African American women held stronger beliefs that family issues should not be discussed outside the family which a major taboo is thus helping to identify why African Americans do not seek mental health services. An important statement highlighted by Ward et al. (2009) is that individual level barriers play a significant role in limiting health seeking behaviors as they influence how the individual views the problems and the systems in place to help with the problem.
Whaley, A. L. (2001). Cultural mistrust and mental health services for African Americans: A review and meta-analysis. The Counseling Psychologist, 29(4), 513-531. http://journals.sagepub.com/doi/abs/10.1177/0011000001294003
The underutilization of the mental health services as identified by Whaley (2001) is due to cultural mistrust. Marginalized African Americans for instance hold greater cultural mistrust on mental health services as it is viewed as problem specifically affecting Caucasians. The fact that the field of mental health services is dominated by Caucasians has done little to address the issue. The focus of the study was to determine the correlation between the cultural mistrust among African Americans and their behaviors and attitudes towards mental health services. A meta-analysis of African Americans responses on beliefs and attitudes about mental health services was carried out (Whaley, 2001). The analyses identified that the negative effect of cultural mistrust among blacks when it comes to interracial situations are not unique to psychotherapy and counselling but rather represent a broader perspective. It also noted that cultural mistrust leads to negative perceptions on mental health services and this reduced underutilization of those services. The study provided in-depth ifnormtaion on the perceptions of African Americans on mental health issues noting that cultural mistrust influences negative beliefs about mental health services leading to underutilization of those services. An important statement noted by Whaley (2001) is that the cultural mistrust of the African Americans is derived from the negative experiences throughout history and this identifies the need for mental health professionals to form interpersonal relationships that enhance trust between the professionals and these clients.