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Cultural competency training is aimed at helping health care providers understand patients’ values, beliefs, and behaviors so they can customize treatment to meet patients’ social, cultural, and linguistic needs. For black Americans, this means becoming more aware of the impact of community stressors and how these factors are contributing to their mental health problems, said panelists at the first-ever CBCF panel devoted to mental health in the black community. These factors include violence and trauma, racism, implicit bias, poverty, and limited access to educational, recreational, and employment opportunities, said Stewart, who is also the director of the Center for Health in Justice Involved Youth at the University of Tennessee Health Science Center. “Just being a black person in America can keep you in a constant state of rage,” she said, quoting James Baldwin.
There are only about 2,000 black psychiatrists nationwide, Stewart pointed out. “There are not enough black psychiatrists in America to serve all the black people who need mental health care.” She called for all psychiatrists to become more culturally competent, and for all to encourage young blacks with an interest in STEM (Science, Technology, Engineering, and Mathematics) to enter the mental health field. “Medicine needs their voice. We need their presence.”
Patricia Newton, M.D., M.P.H., CEO and medical director of the Black Psychiatrists of America, told attendees that less than half of blacks with mental disorders get the care they need; that number drops to one-quarter when blacks of Caribbean descent are taken into account.
Blacks are also more likely to be subjected to implicit—or unconscious—bias by clinicians, Newton added. “Very often, our people are misdiagnosed.” For example, blacks with depression are often misdiagnosed with schizophrenia and blacks grieving the loss of a loved one, who say they’ve experienced a “visitation,” have been diagnosed as psychotic, due to cultural and religious misunderstandings, she said. Making matters worse, blacks are more likely to be hospitalized for psychosis than to receive community treatment, she said.
Mental illness, suicide, and sexual abuse are seriously underreported among blacks, Stewart said, because these topics are taboo in churches, throughout the community, and even within families. “You can’t get an accurate reporting of what you’re not talking about.”
She encouraged black people to educate themselves about mental illness using reputable sources, openly discuss issues of mental health, and identify people in the community who need help. “We have to dispel the myth that mental illness doesn’t happen to us in the black community, that it’s a ‘white folks’ disease.’ We are suffering in silence and in pain.”
(Image: David Hathcox)
