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Monday, July 14, 2014

July is Minority Mental Health Month; experts discuss mental-health complications among African Americans

By Melissa Landon
Kentucky Health News

July is Minority Mental Health Month. KET's Renee Shaw interviewed Sycarah Fisher, associate professor in the College of Education at the University of Kentucky, and Shambra Mulder, an assistant professor in the School of Education at Kentucky State University, about challenges and differences professionals face in providing care for African Americans with mental health conditions. The show is available online and airing on KET's secondary channels.

"Getting the right diagnosis and treatment for mental health issues are difficult tasks, and can be even more challenging for ethnic and racial minority groups," Shaw said at the beginning of the interview on her weekly show, "Connections."

Fisher said mental illness is particularly stigmatized in African American communities and other ethnic or racial groups, perhaps because some "feel like getting help, especially from medical professionals, makes [them] weak, and [they're] expected to be strong and be able to take care of [themselves]."

Mulder agreed, adding that "The church and spirituality play a big role in the African American community," so those who seek medical help might be seen as lacking the faith to be healed. It may also have to do with the lack of minorities working in the field, she said. Research shows that African-Americans are more inclined to seek or stay in therapy if they have a minority therapist.

Fisher discussed ways more minorities might be recruited to the field. She called that "a very, very big task," noting that it can be uncomfortable to be the only African American in a program. Even the students who do make it into Ph.D. programs have more difficulty graduating, she said. Many programs are seeking grants to bring in minority psychologists.

Mulder added that if people haven't seen or heard of many black psychologists, they might think it's really difficult or might not think they couldn't do it. Shaw clarified that they weren't saying a doctor must be black to understand a black patient, it's just that mental health is a sensitive issue that people are sometimes uncomfortable discussing.

Fisher said it's important for people, especially African Americans, to talk about their disorders and treatments and how it is helping so that others will feel comfortable seeking medical attention that they need. Mulder said that even taking medication can be stigmatized.

Adding to the problem is that racial and ethnic minorities are more often misdiagnosed. Fisher "A lot of measures that are used to identify different types of behavior disorders aren't normed on African American samples," Fisher said. "We're taking and giving measures to African-American individuals, but yet when we're comparing them to different cultural groups."

Mulder agreed, adding that some people may not want to be forthcoming about their symptoms. If they will not accurately explain what they're dealing with, it's difficult to make the correct diagnosis. Shaw pointed out that this and other factors can lead to delayed treatment, which can have serious consequences. Fisher said, "The earlier you intervene, the better your outcomes are going to be. . . . The longer you wait, the more severe the problem behaviors are going to get."

The experts also discussed diagnosis of children. Shaw asked how professionals perceive the difference between a child who has a mental health issues and a child who is being abused or something similar. Fisher said environmental factors must be addressed, and Mulder said, "The behavior might be age appropriate, but the environment might not be age-appropriate," such as asking kindergartners to sit for a long time.

Shaw said people may wonder what schools can do to help. Fisher said a school psychologist's job is to make sure the student can function in the school environment. They may not have enough time to talk with the students and provide all the help they need, so they can "rally the troops" and "connect our services with the services they're receiving in the community."

Mulder noted that although it's important for school psychologists to make sure students are diagnosed so they can get the help they need, doctors are supposed to notice the early symptoms in young children. Later on, teachers may notice something is amiss but usually only if it is externalized behavior. Parental input is also important although they often don't have sufficient knowledge of what symptoms would be. Schools are moving to a more preventative approach, Fisher said. Teachers will report things that disrupt the classroom and miss the internalized behaviors.

Click here to watch the show.

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