Abstract
According to the US Department of Health and Human Services Office of Minority Health and Mental Health America, African Americans are 20% more likely to experience serious mental health problems than the general population. In the United States, the historical manifestation of racism has had a significant impact on psychological and mental health services. Three aspects of racism, the belief of inferiority directed toward persons of color, cultural bias, and racial trauma, permeate assessment, diagnostic, and treatment processes. Failure to acknowledge these historical events has resulted in racial-ethnic disparities in diagnosis and the long-standing skepticism, mistrust, and misuse of mental health services by African Americans. Institutional racism, along with the prevalence of the small percentage of African American mental health providers, speaks to the need for cultural competence training among white mental healthcare providers and the eradication of ethnocentric monoculturalism to reduce misdiagnosis, inadequate treatment, and the disparity of mental health care in the African American community.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
American Psychiatric Association. (2017). Mental health disparities: Diverse populations. https://www.psychiatry.org/psychiatrists/cultural-competency/education/mental-health-facts
Bell, C. C., Jackson, W. M., & Bell, B. H. (2015). Misdiagnosis of African Americans with psychiatric issues – part II. Journal of the National Medical Association, 107(3), 35–41.
Cartwright, A. S. (1851). Report on the diseases and physical peculiarities of the Negro race. New Orleans Medical and Surgical Journal, 691–715.
Capodiupo, C. M. (2019). Microaggressions in. counseling and psychotherapy. In D. W. Sue, D. Sue, H. A. Neville, & L. Smith (Eds.), Counseling the culturally diverse: Theory and practice (8th ed., pp. 120–141). John Wiley & Sons.
Combs-Orme, T. (2013). Epigenetics and the social work imperative. Social Work, 58(1), 23–30.
Cordilia, J., & Petersen, A. (2020). Health & wellness: Racism's mental health impact. Wall Street Journal. http://eres.regent.edu:2048/login?url=https://www.proquest.com/docview/2425496098?accountid=13479. Accessed 30 Sep 2020.
Eack, S. M., Bahorik, A. L., Newhill, C. E., Neighbors, H. W., & Davis, L. E. (2012). Interviewer-perceived honesty as a mediator of racial disparities in the diagnosis of schizophrenia. Psychiatric Services, 63(9), 875–880.
Fitzgerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: A systematic review. BMC Medical Ethics, 18(19).
Guillory, J. D. (1968). The pro-slavery arguments of Dr. Samuel A. Cartwright. Louisiana History: The Journal of the Louisiana Historical Association, 9(3), 209–227.
Johnson, F. M. (2012). The protest psychosis: How schizophrenia became a black disease by Jonathan M. Metzl. The Journal of African American History, 97(4), 499–501.
Lehrner, A., & Yehuda, R. (2018). Cultural trauma and epigenetic inheritance. Development and Psychopathology, 30(5), 1763–1777.
Mental Health America. (2013). Black and African American communities and mental health. https://www.mhanational.org/issues/black-and-african-american-communities-and-mental-health. Accessed 30 Sep 2020.
Noonan, A. S., Velasco-Mondragon, H. E., & Wagner, F. A. (2016). Improving the health of African Americans in the USA: An overdue opportunity for social justice. Public Health Reviews, 37(12). https://doi.org/10.1186/s40985-016-0025-4.
Paradies, Y., Ben, J., Denson, N., Elias, A., Priest, N., Pieterse, A., Gupta, A., Kelaher, M., & Gee, G. (2015). Racism as a determinant of health: A systematic review and meta-analysis. PLoS One, 10(9): e0138511. https://doi.org/10.1371/journal.pone.0138511.
Perzichilli, T. (2020). The historical roots of racial disparities in the mental health system. Counseling Today. https://ct.counseling.org/tag/topic-ct-social-justice/. Accessed 30 Sep 2020.
Richardson, N. M. (2012). The protest psychosis: How schizophrenia became a black disease. Disability Studies Quarterly, 32(1), 10.
Schwartz, R. C., & Feisthamel, K. P. (2009). Disproportionate diagnosis of mental disorders among African American versus European American clients: Implications for counseling theory, research, and practice. Journal of Counseling & Development, 87(3), 295–301.
Smith, K. M. (2019). How bigotry created a black mental health crisis. The Washington Post. https://www.washingtonpost.com/outlook/2019/07/29/how-bigotry-created-black-mental-health-crisis/. Accessed 30 Sep 2020.
Snowden, L. R. (2003). Bias in mental health assessment and intervention: Theory and evidence. American Journal of Public Health, 93(2), 239–243.
Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19–5068, NSDUH Series H-54). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
Sue, D. W., Sue, D., Neville, H. A., & Smith, L. (2019). Counseling the culturally diverse: Theory and practice. Hoboken, NJ: John Wiley & Sons.
Suite, D. H., La Bril, R., Primm, A., & Harrison-Ross, P. (2007). Beyond misdiagnosis, misunderstanding and mistrust: Relevance of the historical perspective in the medical and mental health treatment of people of color. Journal of the National Medical Association, 99(8), 879–885.
Tegnerowicz, J. (2018). “Maybe it was something wrong with me”: On the psychiatric pathologization of black men. Research in Race and Ethnic Relations Inequality, Crime, and Health Among African American Males, 73–94.
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.
Whaley, A. L. (2004). A two-stage method for the study of cultural bias in the diagnosis of schizophrenia in African Americans. Journal of Black Psychology, 30(2), 167–186.
Williams, D. R., & Williams-Morris, R. (2000). Racism and mental health: The African American experience. Ethnicity and Health, 5(3), 243.
Williams-Washington, K. N., & Mills, C. P. (2018). African American historical trauma: Creating an inclusive measure. Journal of Multicultural Counseling and Development, 46(4), 246–263.
Willoughby, C. D. E. (2018). Running away from drapetomania: Samuel A. Cartwright, medicine, and race in the antebellum south. Journal of Southern History, 84(3), 579–614.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Smith, J.R. (2021). Diagnosis Issues with African Americans. In: Adekson, M.O. (eds) African Americans and Mental Health. Springer, Cham. https://doi.org/10.1007/978-3-030-77131-7_6
Download citation
DOI: https://doi.org/10.1007/978-3-030-77131-7_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-77130-0
Online ISBN: 978-3-030-77131-7
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)