Universidade de Nova York

Matéria publicada no site da Universidade de Nova York  no dia 29 de fevereiro de 2004 – www.journalism.nyu.edu

Posted 02.29.04
What's On Your Mind? (The Circuit)
Mental Health & African Americans

By Neil Parmar

Mental illness has long been regarded as a subject best discussed within one's immediate family. This is especially true in African-American, African, Caribbean and Asian cultures, where airing one's dirty laundry is seen as a sign of familial weakness. But a new generation of African-Americans are familiarizing themselves with research on mental illness, and is getting the necessary assistance from therapists that are proficient in cross-cultural psychology. This article will discuss issues and ailments in the field of multicultural psychology.
 
The Dangers of Depression
 
According to the National Mental Health Association (NMHA), cultural background helps determine how clients report symptoms of depression and how these symptoms are then interpreted, diagnosed and treated by clinicians. The organization notes that more than 80 percent of people suffering from depression can be treated successfully with medication, psychotherapy or a combination of both. However, many African-Americans choose instead to handle it themselves, seeking help from other family members or friends, or religion, believing that prayer and faith alone will successfully treat depression almost all or some of the time.
 
But depression is a serious medical illness, affecting more than 19 million American adults each year, including a large number of African-Americans. Untreated depression is the leading cause of suicide and second only to heart disease in causing lost workdays in the United States. It also strikes women at twice the rate of men.
 
To find out why African-Americans have historically avoided mental health professionals (although the number of minority clients has increased in recent years), the NMHA conducted a nationwide survey to capture their attitudes and beliefs regarding depression. When responses were compared to the general public there were a number of compelling findings:

* Approximately 63 percent of African-Americans saw depression as a "personal weakness" (compared to the overall survey average of 54 percent)

* Only 31 percent of African-Americans said they believed depression was a "health problem"

* Almost 30 percent of African-Americans said they would handle depression themselves if they were feeling down, and close to 20 percent said they would seek help for depression from friends and family

* Only 33 percent of African-Americans said they would take medication for depression (compared to the overall survey average of 69 percent)

Why Some African-Americans Avoid Getting Help
 
Although psychologists profess that there is absolutely nothing wrong with being depressed, choosing not to seek formal help from mental health professionals may prove dangerous for a person over an extended period of time. Still, the NMHA contends that African-Americans should not be blamed wholeheartedly for distrusting the U.S. medical system. Instead, the group acknowledges that cultural differences have created an unhealthy-and possibly deadly-wedge between clients who need professional treatment and psychologists who are willing to provide that help.
 
According to the NMHA, African-Americans have significant mistrust of mental health professionals based in part on a historical higher-than-average institutionalization for African-Americans with mental illness.  Many African-Americans also distrust the United States health-care system because it has historically mistreated them.  In addition, cultural barriers, influenced by language and values in the doctor-patient relationship, have created problems, as have socioeconomic factors, such as limited access to medical care for African-Americans.
 
But the field of psychology is changing and professionals have begun studying cross-cultural research and incorporating culturally sensitive methods when conducting therapy sessions. Moreover, organizations like the International Association for Cross-Cultural Psychology (IACCP) and the American Psychological Association (APA) have advanced culturally sensitive practices by providing mental health professionals with access to various resources and training to better understand the African-American culture before diagnosing and treating such illnesses as depression.
 
Some Tips for Identifying Depression
 
If you have been experiencing five or more of these symptoms for two weeks or more, you may have clinical depression and should see a doctor or qualified mental health professional for further evaluation:

* Persistent sad, anxious or "empty" mood

* Sleeping too much or too little, middle of the night or early morning waking

* Reduced appetite and weight loss, or increased appetite and weight gain

* Loss of pleasure and interest in activities once enjoyed, including sex

* Restlessness, irritability

* Persistent physical symptoms that do not respond to treatment (such as chronic pain or digestive disorders)

* Difficulty concentrating, remembering or making decisions

* Fatigue or loss of energy

* Feeling guilty, hopeless or worthless

* Thoughts of suicide or death

Treatment Tip: To locate a free and confidential local depression screening site, call the National Mental Health Association 1.800.520.6373 or log on to www.depression-screening.org
 
Multicultural Research
 
The APA has also been at the helm of major psychological research, which has significantly changed the way African-Americans have been diagnosed and treated in clinics across the nation.
 
In April 2002, the APA conducted the National Survey of American Life-the first of its kind-in order to shed new light on ethnic health disparities. The survey found that the prevalence of certain mental health disorders, including major depression, panic disorder, social phobia and generalized anxiety disorder, was no greater among African-Americans than among whites. However, it was conducted partly in response to numerous studies that previously found African-Americans had less access to high-quality mental health services and sometimes chose not to seek help, especially in the case of depression.
 
Flying Overseas? Prepare Psychologically!
 
In an attempt to address cultural differences in patients, the IACCP has scientifically tested how well psychological theories can be generalized to different cultures. But this professional watchdog does not limit itself to shrinks and their academia; it also promotes the work of psychologists who directly assist African-Americans who want to broaden their horizons and learn about new cultures.
 
Andrea Sebben, an IACCP member and a cross-cultural psychologist who is stationed in Brazil, offers intercultural training programs for students preparing for exchanges or businesspeople interested in working abroad. She also helps those who have recently finished school and want to pursue postgraduate degrees in foreign countries. Sebben notes students who manage enterprises or are employed by large corporations can also benefit from consultation. Her program is an extension from both a United Nations Educational, Scientific and Cultural Organization (UNESCO) program known as Culture For Peace (which concerns intercultural education) and from concepts based in cross-cultural psychology that help clients gain insight on what makes people change their behavior.
 
Sensitivity training is especially valuable for those who travel overseas seeking business deals and often find themselves offending prospective clients or experiencing massive culture shock. For this reason, Sebben facilitates intercultural communication with clients and engages clients in discussions surrounding research on intergroup conflict and issues of maintaining status control in international relationships.
 
Resources for Busting the Blues and Beating Depression
 
American Psychological Association
Web: http://www.apa.org/pubinfo/depression.html
 
National Mental Health Association
Phone: 1.800.969.NMHA
Web: http://www.nmha.org/ccd/index.cfm
 
Mental Health Resources Specifically for African-Americans
 
Black Psychiatrists of America
Web: www.blackpsychiatristsofamerica.com
 
Black Women's Health
Web: http://www.blackwomenshealth.com/depression.htm