Racial disparities in healthcare while breaking the stigma on cultural practices.
In recent years, the country has witnessed an attempt to bridge the racial disparity involving those covered by health care. Medicaid covers some medical procedures and services for low income Americans however it fails to address mental health issues.
Cultural practices plays a role in African Americans seeking help as well as their residential location. Mental Illness, especially in the African American community, is prevalent but it is rarely discussed. Mental Illness is stigmatized in the African American community and even if someone is of low income wants help, they are not always able to afford it through Medicaid.
The Agency for Healthcare Research and Quality reported in 2014, the implementation of the Affordable Care Act has helped to close the gap in insured individuals, 15.9 percent of African Americans versus 11.1 percent of white Americans were still uninsured. The number of medicaid enrollees increase in South Carolina. Between 2011 and 2013 the state saw an 13.8 percent increase in enrollment for Medicaid. Which means that one in four South Carolinians have been enrolled, according to South Carolina Health Data. Although the Affordable Care Act is put in place to help people, there are still some communities that are not willing to open up about their mental illness.
Where did the Stigma come from?
In some communities mental illness is not often seen as a medical condition that is treatable but, as a sign of weakness not to be discussed.
Courtney Leak, is an black clinical psychiatrist at Winthrop University, who studies mental illness within the black community. She believes a stigma is placed on black mental health because it is not common for African Americans to ask for help. “ Throughout history African Americans had to be incredibly strong so asking for help in general is not a thing they do,” Leak said. “We don’t go to the doctor as much as our majority counterparts. We don’t do a lot of outside things. For example, we ask grandma or our neighborhood what to do for this cold.”
Cultural practices have influenced the way mental illness is addressed within a community ,which is passed down to the next generation. The Department of Human Health and Services found that older African American adults believed depression was a sign of weakness and lack of inner strength.
“I think there is a huge gap between grandparents raising grandchildren and the old school struggles with understanding the concept of therapy,” Leak said. “That generation is not going to go to therapy on their own usually. Unless the child introduces them to family therapy because they are so used to a handling things on their own because it wasn’t an option for them in the 50s, 60s, and 70s. That wasn’t something they could do.”
Sometimes families do not like to address the issue of their loved ones being mentally ill because they would often tell others to pray for them. According to the National Library of Medicine, religious coping to deal with mental health issues is most prevalent in the African American community than in the non-white Hispanic communities. The church plays a significant role in older African Americans lives because some believe in seeking assistance to treat their mental illness is stigmatized. This often hinders African Americans from seeking additional help.
Amara Sturkey is an 23 year old, black female, mental health advocate who lives with bipolar disorder involving depression and anxiety. She remembers others telling her that she does not need additional help because she should solemnly depend on her faith. Sturkey said there is nothing wrong with consulting with your pastor but they can only provide limited information.
“ You don’t have to have a degree to be a preacher all you have to say is that you have gotten the call from God,” Sturkey said. “In order to be a therapist you have to have a degree but, pastors will tell you what they think and not what they know because they don’t have the proper education behind it. “
Mental health treatment was never an option for African Americans because they did not have the opportunity to get help. Leak said African Americans never went to therapy because mental health was often viewed as an white man’s illness.
“I think also there was a time these things weren’t always available to us so we had to make do. People do what they are used to doing,” said Leak. “If you look at past studies from the 1900s on mental health only rich white males were privileged to receive services.” “The earlier you receive something the less stigma there is to it. For us there are a lot of layers of it wasn’t available, as well as we have to be strong to move through the world.”
Why is it not available?
Some African Americans do not have access to quality healthcare treatment due to the location of their homes which puts them at risk for poor healthcare outcomes. South Carolina Health Data, found that African Americans comprised 51 percent of residents who live in high need areas along the I-95 corridor which includes the Pee Dee, Orangeburg, Clarendon, Dillon and Jasper counties.
Most small towns may only have one clinic and the nearest hospital may be 30 minutes away. For example, Dillon, SC, is an impoverished, rural and low income area. This area has a family medicine clinic affiliated with McLeod Hospital. McLeod Hospital’s main campus is 30 minutes away in Florence, S.C. The U.S. Department of Health and Human Services of Minority Health, records in 2015, 34 percent of black Americans have serious psychological distress among adults 18 years and older.
Leak said South Carolina has community mental health centers in each county but it may be in one centralized place. She also said people living in a rural area may not have transportation to get access to mental health treatment. Leak continued to say in York County the mental health center is in Rock Hill and the country consists of York, Fort Mill and other different places. Leak said if a person does not feel connected to their therapist they are not willing to go back.
“Most places have tendencies to take what they can give and may not have a therapists who can relate to what you have experienced,” Leak said. “I’m not saying you should not see a therapist of a different religion, socioeconomic level or race but sometimes you need that person to connect with to know how you feel and if you don’t feel connected to your therapist or doctor and then you are more susceptible to more struggle, hurt and illness.
What can the government do?
South Carolina has increased Medicaid for adults with serious mental illness. The National Alliance on Mental Illness found in 2013, South Carolina had a 43,155 expansion of uninsured adults with a serious mental illness. The state is obligated to give coverage to those on Medicaid access to treatment for a mental illness and also administering funds under the National Mental Health Act.
The South Carolina Code of Laws Section 44-9-70, the state department of Mental Health is designated as the state agency authorized to administer minimum standards and requirements for mental health clinic under the National Mental Health Act, and is authorized to promote and develop community mental health outpatient clinics. This mean that the state must only cover the basics in helping someone treat their mental illness but is not required to direct them into the right direction.
Since some African Americans are not taking the initiative to seek help outside of their cultural practices and residential location one can see how they are uneducated about other alternatives. Some may argue that it is the responsibility of those being diagnosis to seek help but it is the government responsibility to provide quality healthcare as well as educate everyone about mental illness.
The Mental Health First Aid Act of 2016 was introduced by republican representative, Lynn Jenkins and democratic representative Doris Matsui in April. This act focuses on funding for Substance Abuse and Mental Health Services Administration which offers training grants for mental health awareness.
Under the Mental Health First Aid Act, the use of funds will train teachers and other school personnel the appropriate way to identify symptoms in childhood and adolescent mental disorders, emergency services personnel to identify and appropriately respond to an individual with a mental illness and educate teachers and personnel on resources that are available in the community.
Some government officials are working towards making mental health services available to everyone by implementing programs and distributing funds to the issue.
How to break the stigma?
In order to break the stigma on mental health, African American families must address there is a problem with their loved one. Black families should not be afraid to speak on the issue.
Leak said black families should stop letting things be okay by ignoring the signs of an mental illness. She also said families should ask how they could help their family member.
“We never acknowledge it we may talk about it behind their backs or get on your phones but no one ever says this is not okay,” said Leak. I think sometimes you need one person that is going to do something different by going to counseling and then rest of the family sees that changes it will at least sparks the interest to say this isn’t all bad.”
According to the Epidemiologia e psichiatria sociale, black people with a mental illness are more likely to seek help if their families are supportive, and if a family member has had a positive personal experience of mental health care.
Sturkey family supported her in wanting to get additional help because she had family members who had positive experiences with counseling. She has also witnessed how refusing to get help has taken a toll on family members. Sturkey said family members should offer support and not outcast the person living with a mental illness.
African Americans should understand that having a mental illness is something normal and going to therapy is just not something for white Americans.
While waiting for her session Sturkey said she see all different types of people such as lawyers and doctors.
“I think making African Americans feel that this is okay and you are not an outcast,” said Sturkey.
Leak said clinicians should work to break the stigma in the black community by being visible in the community and educating them about their options.
“Clinicians needs to do a better job in attending things black people go to. To say we are here,this is an option for you, and this is a safe place for you to land if you feel like you are falling,” said Leak. “There is responsibility on both sides as well as the health care situation needs to make it more available for all different types of people.”
Everybody else drowned. Then God made the sun shine and dry up the rain. Everyone in the ark came out. Noah said: “Look! God has sent us a sign in the sky. It means that He will never flood the world again.” The sign in the sky was the very first rainbow.
When You're Inspired to Write.. 