THE STRUGGLE OF BLACK MEN WITH MENTAL HEALTH STIGMA

Published by BlackState & BlackNews, redistributed in New York Amsterdam News, The National Medical Association, Trend Magazine, Suwedi, The National Black Justice Coalition, JL Family Services, and Closing the Gap in Health Care Inc.

Black men are one of the most neglected group of individuals in regards to mental health. They have not been equipped with the tools to seek support in health care systems due to systemic prejudice and discrimination. A multiplicity of factors account for this occurrence including lack of access to black providers whose services are not always heavily advertised on various platforms which leads to the question How are Black men supposed to care for themselves if the services they need are not readily available?

Given there is a small percentage of African American mental health professionals, this adds to the emotional havoc for Black men of not having a provider they can relate to. White providers are simply not equipped to cope with the emotional bags black men carry on a daily basis. Though there are health programs addressing these challenges; mental health conditions continue to plague black communities. Suicide rates amongst black youth has skyrocketed since 2017 as early as 9 years old through cyberbullying. Currently, the mental health disorders experienced in African American communities are major depression, attention deficit hyperactivity disorder (ADHD), suicide, Chronic Traumatic Encephalopathy (CTE) and Posttraumatic stress disorder (PTSD).

PROVIDER TRAINING ON CULTURAL COMPETENCY

There are no clear guidelines set forth for providing mental health resources to people in general. Behavioral health programs are subject to funding mechanisms that may be short-lived because of company reorganization or other extenuating circumstances. Providers who lack cultural competency in managing patient cases may witness a decrease in use of mental health services justifying its downsizing on a larger scale.

Black men have always been advised time and time again to remain silent on mental health issues. With the advent of addressing masculine toxicity, men have been taught from infancy to conceal their emotions. Following along the lines of norms of masculinity, these are the masks society instilled in Black men to carry in the face of rampant structural racism and violent crimes that hinders their progress in the fabric of society.

PERCEPTION OF MENTAL HEALTH TREATMENT AND CARE

One particular study explored Black men's perceptions of depression and depression care, and the main barriers identified by the men in the sample were health care costs; concerns over use of antidepressant medication; discomfort of being judged by a professional that they did not identify with culturally or socioeconomically; and norms of masculinity. I understand some may cite if others were able to pull themselves by their bootstraps, then Black men are able to as well; this is not necessarily the case given that established structures can drive people to depression further amplifying their sense of powerlessness and lack of security.

The Health and Human Services Office of Minority Health mentions that about one-quarter of African Americans seek mental health care, compared to 40% of whites. These facts tell us a grim story; black men remain the most marginalized groups in seeking support for mental health. Black men are attacked, gunned down, and suspected of misdemeanor than any other racial groups. These set of circumstances pins them as cogs in an elaborate machine that spits them out and undervalues their worth. When one looks at the various ways Black men are portrayed from social media to news outlets, their marginalization would be conducive to them feeling powerless and fearful of seeking support. The institutions that promise to protect them are the ones that ultimately induce harm by placing them on the back burner.

The Tuskegee research study is another prime example on the mistrust Black men have of health systems. They have been conditioned to know that black bodies were once used as personal property by colonizers. In addition, providers may have preconceptions fed to them on treating minority populations. This sometimes may result in a misdiagnosis or overdose in treatment plans causing more harm than good to minority populations.

These reasons can bring black men to their writ's end. Providers must understand that Black men have always worked at a deficit from their white counterparts. Religion and lack of information on mental health disseminated within black communities further exacerbates the need for more advocacy in communities out of reach for care. Additional attention needs to be taken by helping Black men identify the symptoms and ways to address the shame hindering them from seeking therapy or treatment. Prevention strategies need to be put in place to foster long term optimal health in black communities.

HOLISTIC APPROACH TO HEALTH DISPARITIES

Chronic Traumatic Encephalopathy is a degenerative brain condition that occurs when the brain sustains substantive concussive or sub concussive trauma. Black communities, who are already substantially disadvantaged in getting access to healthcare coupled with racial disparities present in the U.S. health system, may not necessarily know to seek support when they suffer from CTE. A large number of former NFL players like Dave Duerson, Chris Henry and Terry Long were among those with CTE. This is further aggravated by the fact that CTE can only be diagnosed after the death of someone.

A holistic approach should be developed to aid the recovery process. In order for us to see tangible change in our communities, faith-based leaders, politicians and other stakeholders need to get comfortable with addressing these issues throughout the spectrum. Since this is not an obsolete system, more options need to be provided especially when therapeutic treatments are needed defined by SAMHSA as “culturally and linguistically appropriate services that are respectful of and responsive to the health beliefs, practices, and needs of diverse consumers.”

POLICY RECOMMENDATIONS ON PROVIDER CARE

1. Develop policies on providing mandatory cultural competency trainings to physicians in medical school not just in primary care settings. These measures will aid medical providers to be attuned to the health disparities experienced by minorities in health care settings.

2. Improve measures to assess the health care coverage extent of mental health services in urban and rural areas.

3.  Fund cross-longitudinal research studies addressing consumers’ perceptions on mental health treatment, inappropriate antibiotic prescribing and mental health care.

4. Train providers in evidence-based delivery of care to Black Men or African American mental health; train them in cultural competency so they can identify misdiagnoses and inadequate treatment.

RECOMMENDATIONS ON PATIENT CARE

1.  Patients must ask the necessary questions to providers to assess cultural competency fit. Those questions include the following:

    A. How do you see our cultural backgrounds influencing our communication and my treatment?

    B. How do you plan to integrate my beliefs and practices in my treatment?

2. Diversify the pool of mental health providers in urban and rural areas. Fund programs that address mental health in Black communities based on empirical research findings.

3. Create a list of resources and pamphlets readily available electronically and on paper in clinics, community health centers, faith-based organizations and hospitals to Black men.

4. Make healthcare affordable so that people can afford behavioral health services. If some cannot afford them, provide other viable options that will not exclude them from the process.

There is in this world no such force as the force of a person determined to rise. The human soul cannot be permanently chained. ~W.E.B. Dubois

References

1. African American Mental Health. 2018. The National Alliance on Mental Illness. https://www.nami.org/Find-Support/Diverse-Communities/African-Americans.

2. Substance Abuse and Mental Health Services Administration.2019.https://www.samhsa.gov/about-  us/who-we-are/offices-centers/cmhs

3. “Down in the Sewer’s: Perceptions of Depression and Depression Care among African American Men. 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734547/