Black Californians are concerned that their mental health assessments and diagnoses are inadequate, according to a report from the African American Health Institute of San Bernardino County, California Watch reports.
The report was based on 635 surveys, 45 individual interviews, 35 focus groups and 10 public forums and meetings with residents and mental health professionals in California.
It is one of five state-commissioned demographic-specific studies that were conducted as part of the California Reducing Disparities Project. The reports will be used to develop a statewide strategic plan to address mental health disparities.
Key Findings
According to the report, black residents said a lack of culturally proficient health care providers is a barrier to adequate mental health care.
V. Diane Woods -- founding president of the African American Health Institute of San Bernardino County and primary author of the study -- said that black residents "felt like they did not have a good assessment (from their provider) to understand what their particular issues are."
She added, "And if you are not getting a good assessment, you are not getting a good plan or care, and it increases the probability that you will be placed on the wrong medication."
The report also found that only four counties in the state -- Butte, Monterey, Riverside and San Bernardino -- have plans to use Mental Health Services Act funds for prevention and early intervention mental health care programs tailored to black residents.
However, some county officials said they have developed such plans since the study was conducted.
Recommendations
The report authors recommended that the state:
- Analyze the use of mental health screening tools among black residents;
- Direct more funds to community-based mental health organizations; and
- Support efforts to gather additional data on minority mental health service use and outcomes.
Experts Weigh In
Annelle Primm -- the American Psychiatric Association's deputy medical director and director of its Office of Minority and National Affairs -- wrote in an email, "Because of a lack of cultural understanding, some clinicians may misdiagnose African American patients." She added, "[I]t is well documented in literature that African Americans have been overdiagnosed with schizophrenia and underdiagnosed with illnesses like major depression and bipolar disorder."
Thomas Parham -- a past president of the National Association of Black Psychologists -- said, "Historically, what has happened is African Americans are given more institutionalization and drugs as the treatment of choice as opposed to therapy."
He added, "You tend to have misdiagnosis because clinicians are not culturally competent."
Karen Lincoln -- an associate professor of social work at the University of Southern California -- said in an email, "There is a white norm around symptom presentation," adding, "If you aren’t looking for the right symptoms or if the language being used to describe the symptoms is unfamiliar to you, you can have disparities in diagnosis" (Yeung, California Watch, 7/17).