More Than a Pound of Cure, an Ounce of Prevention: Core Constructs for Reducing Mental Health Disparities… But let’s face it. When it comes to disparities within our healthcare system, how are people of Color affected and what do we know about people of Color?
In the following video, Dr. Joy DeGruy is talking about her invaluable work at the Association for Baha’i Studies. Her book about Post Traumatic Slave Syndrome (PTSS) is addressing the issue of healing the wounds inflicted on so many in our country.
So what do we know about People of Color?
- They have shorter life spans.
- They have higher rates of heart disease, cancer, and hypertension.
- They have higher rates of negative effects of substance abuse and sexually transmitted diseases (NIH, 2000).
- Chronic physical illness creates a higher risk of psychological distress (e.g., anxiety and depression).
What Do We Know About Race?
- That misdiagnosis of physical and mental health can be due to clinician bias or racial discrimination.
- Institutional racism is evident in health diagnosis, treatment, and use of medications with people of Color.
- The SGR (2001) report observed that in regard to mental health “racial and ethnic disparities .. are likely the result of racism and discrimination” ( p.32). (DHHS, 2001)
- Studies link racism to poor mental and physical health.
- Racism and discrimination are stressful events that compromise the mental health of people of Color
What do we Know about Culture?
- There is a call for behavioral health care to be culturally competent (DHHS, 2001).
- Cultural competence means as the SGR report noted that; (1) clinicians and service providers need to consider the cultural identity of the patient; (2) service providers need to be able to explore cultural aspects of illness; and (3) service providers need to consider environmental factors that contribute to illness and distress.
- Service providers need to examine cultural factors in the clinician-patient relationship.
- And use a cultural assessment for diagnosis and care.
What do we Know about Culture and Mental Health Treatment?
- Mental disorders are determined by use of the DSM and treated according to its guidelines.
- The focus of cultural knowledge for competence is on members of historically disenfranchised racial groups usually in terms of their socio-demographic factors.
- There is a historical legacy in the sciences that views people of Color not as culturally different but as deprived or inferior. Fact is that there is A HUGE lot of Traumatic Stress in communities of Color.
- The dominant theories of personality and human development do not consider race or culture as factors in mental health.
- Racism and discrimination and its effects are not incorporated into mental health assessment, diagnosis, or treatment.
What do we Need to Know to Understand Race and Culture?
In my research, I have questioned how we understand the experiences of people of Color and the models we use to explain health disparities. I think we need to understand.
(A) The role of dominant cultural patterns and how dynamic cultural conflicts are barriers to cultural competence training and skill development.
(B) Race as a psychological aspect of culture. See also: the Unidentified Trauma, Racial Harassment.
(C )How to create and use broader assessment and diagnostic criteria for understanding psychological distress, and
(D) How to unpack racism so its effects can be better understood.
Dominant White American Cultural Patterns
- Individualism social relations and separation of professional and personal lives.
- Self-expression as external accomplishments.
- Systems of hierarchical power and verbal communication.
- A future time orientation.
- Judeo-Christian religious system.
- Nuclear family structures.
- European cultural traditions.
American Cultural Patterns and Mental Health
The noted patterns of culture are embedded in our theories of human development and personality, thus models of mental health treatment operate on the same cultural assumptions. Dr. Joy DeGruy has published a highly relevant book after decades of research and consultancy in this field. Read all about it here.
We believe strongly in individual responsibility, intrapsychic processes, talking things out with a stranger or professional. Working with the individual and not a community or family system.
We seldom include system level influences in the assessment of mental distress due to our cultural beliefs and historical notions about people of Color.