Race and Culture in Mental Health
Our cultural context (race, ethnic group, gender, religion, language, social class and so forth) is influencing the way how we understand mental fitness and health. The culture we live in additionally determines the concepts of normal and/or abnormal. Just take a look at the following video where Dr. Joy Angela DeGruy talks about her theory of Post Traumatic Slave Syndrome or PTSS.
The circumstances in society, such as access to work, shelter, and health care, also influence our understanding of our experience and how we function in our communities and in society. Anthropological and cross-cultural studies show that cultural beliefs and ideas about what actually mental illness signifies are affecting treatment and its course.
Researchers agree that cultural bias operates in diagnoses since a lot of clinicians (irrespective of group membership or racial/cultural background) are socialized and taught during professional development to see people of Color as more disturbed then Whites. Symptoms of disturbance may be experienced and expressed differently by members of distinct cultural groups.
Traumatic Stress-Health professionals have found in many studies that people who are exposed to various types of life-events may find such events as stressful or traumatic.
Definitions of Trauma-There are 2 main ways to identify and understand extreme reactions to stress. One is to use DSM diagnostic criteria of post-traumatic stress disorder (PTSD) or Acute Stress Reactions (ASR) or other diagnoses. The other way to understand traumatic stress would be to use broader criteria and to consider the person’s evaluation of the event to determine whether it was traumatic. See also: PTSS-Post Traumatic Slave Syndrome
PTSD – Post-Traumatic Stress Disorder-An event is life-threatening and results in a reaction of intense fear or helplessness or horror, and is leading to functioning impairment. The criterion uses an exposure or dose-response model. Relying on external factors and less on subjective evaluation.
Need for a broader model of trauma
The criterion for PTSD focuses on the reactions to threatening life events. Some life events may not be seen as life-threatening but may produce a traumatic stress reaction. Because the DSM framework for understanding stress reactions is based upon the pretty narrow criteria that apply to diagnose Acute Stress Reactions or PTSD.
Research on Traumatic Stress in summary
Some people who are exposed to life events experience the event as traumatic and have stress that leads to psychological symptoms. The general rates of developing PTSD after exposure to life events are about 5-10%.
People of Color experienced higher rates of PTSD after exposure to traumatic events (rates above 10% between 15% & 40%) and their symptoms were actually more severe. The veterans of Color were having higher PTSD rates and other psychological symptoms of distress not explained by the specific exposure to war-related trauma.
Some of the higher rates of symptoms by People of color are explained by exposure to race-related stress in the form of discrimination and racism. It is suggested that a lot of People of Color have been confronted with racism and hostility neglect that may heighten the effect of life event crises.
Features of Traumatic Stress – Summary
Traumatic stress involves a reaction to an event that is perceived as negative, sudden and uncontrollable. It may be a form of on-going physical and/or psychological threat that produces fear, anxiety, depression, helplessness and/or PTSD related symptoms.
The threat and stress associated with recent disasters is a source of constant worry for people in communities of Color. The concern may lower self-worth and increase the feeling of being in danger. Thus, institutional policies and procedures can communicate danger as well as a lack of attention to a group’s current circumstances.
Traumatic stress is real and may be affecting people without their awareness. Many people of Color are at high risk for symptoms of traumatic stress given prior histories of trauma in their community.
What is needed are procedures to help organizations deal with traumatic stress, broader diagnostic criteria to assess stress reactions, and treatment strategies that are racially-culturally effective for reducing the symptoms of traumatic stress.
Treatment and Training
The training associated with responding to traumatic stress in communities of Color must be grounded in the worldview and cultural patterns of that community.
Crisis Response Operations
In training people to respond to communities of Color after a disaster the training must
consider and address how people in the respective communities were treated prior to the
What is their receptiveness to the people and agencies involved in the first response? Has the community reported feelings of distrust and fear as have many community members and organizations have indicated? Action should be underway to reduce such feelings so as to enhance disaster response to communities of Color.