Abstract
Over the years, depression has topped the list of the most common disorders in the United States, affecting close to 17 million Americans every year. The trend and the projection of the pattern of this mental disorder have raised eyebrows both at the domestic and global levels considering its effects on health and the quality of life. Notably, depression is more prevalent among black communities as compared to black ones. (Zawn, 2020) holds the view that black African Americans face various social problems contributing to depression. Therefore, this research paper seeks to establish depression among African American men to identify the effects of depression, the risks associated with it, and the treatment-seeking barriers. This research process made use of a systematic review and included all the studies around African Americans or black men living in the United States. Each study was reviewed critically to establish whether the published information is relevant to the topic of depression among black American men stating its effects and risk factors. The results demonstrated that societal factors such as racism, slavery, discrimination, and unequal distribution of resources and opportunities are the major sources of increased numbers of mental health-related issues among African Americans. Therefore, the increased mental-related issues among back American men will be reduced when the playing field is leveled.
Background of the study
Depression has topped the list of the most common disorders in the United States, affecting close to 17 million Americans every year. According to the World Health Organization (WHO), depression is likely to be the leading cause of disability and the second leading cause of diseases. This is even made worse by the increase in the aging population. WHO projects that by 2025, depression will be a leading cause of disease among the elderly. The report released by WHO has generated a heated debate both at the domestic and global levels. This has fueled research and publications on depression. However, the information research on depression in African Americans is still missing. There is less information on how depression is affecting African Americans. This is a research gap that needs to be filled. Following an extensive literature review, few were focused on African American depression.
Close to 37 million people identify themselves as black African Americans in the United States. Since the time of George Washington Carver, African Americans have contributed a lot to the transformation of Society through the fight for social justice and racial and even economic justice. Despite the huge progress made thus far, this will remain incomplete if the issue of mental disparities among these communities has not been completed. Mental health is key in determining the general physical health of an individual (Vance, 2019). In adulthood, Black men face increased mental health concerns, including anxiety and depression. The increase in the number of depression among this group of individuals is informed by racism which they experience in their daily working environment, insufficient access to mental health care facilities, and the historical trauma that the black community is still facing being subjected to them by the medical fraternity. Since black communities mostly exist at an intersection of racism and health inequality, they end up depressed.
Research has shown that the black adult community is 20% more likely to be faced with mentally related diseases such as depression or generalized anxiety disorders. Similarly, younger black men aged between 18 and 25 years are more prone to depression as compared to their white counterparts. These groups of individuals are also experiencing reduced utilization of mental health facilities as compared to whites. With these statistics, it is evident that even as the efforts to reduce disparities in race and class continue, it is clear that inequality is intensifying. However, there is a need to have more research to verify such statistics and to establish why there is underutilization of mental health facilities among black adults. However, some researchers have cited less access to adequate insurance, financial burden, and fear of discrimination in the health facility based on historical experience as some of the contributors to this discrimination.
According to Vance (2019), systemic barriers are also some of the contributing factors to increase cases of discrimination among black American adults. Even though black communities constitute only 12% of the total population in the United States, they are still the majority in the high-risk population which is normally affected by negative occurrences. For Instance, the black community makes up 40% of the homeless people in the US and more than 50% of the prison population. Additionally, exposure to violence and incarceration contributes to mental illness. Moreover, African Americans are also at risk of developing increased mental health because of their historical experiences, economic position, and social influence, which further expose them to other challenges that affect their psychological and physical health.
However, it is important to note that these challenges affecting African Americans did not start recently. African Americans have been treated as second-class citizens in the US for generations. These individuals are going through a difficult period. Surprisingly, these individuals are facing continued discrimination through racism, continued enslavement, colonialism, and other human sufferings. The back community is treated as less human, unlike their white’s counterparts. The developing research has established that violence and abuse affect how one behaves, and this is encoded. The same can be passed down to the younger generation when the DNA has been altered. The passage of these altered genes affects future generations and puts them at greater risk of being mentally depressed. American Society has made it difficult for African Americans to survive the
Despite the progress that has been made so far, there is a stigma surrounding mental health concerns. Most Black Africans find it difficult to disclose their physiological difficulties. Most of these individuals prefer to seek help from religious guidance, prayer, or even guidance from their religious leaders. War on mental health, including depression, will only be won when everybody understands that mental health is basic to realizing general well-being the same way healthy eating and getting enough sleep are. Most individuals believe that seeking support for human health is a sign of weakness. This has kept people struggling to cope with such conditions because they fear seeking help while others do not even know where to find help. Therefore, this calls for cultural awareness were members of the community, especially African Americans. Research has established that the lack of responsiveness, lack of awareness, and increased stigmatization have altered the quality delivery of mental health treatment. The good news is that the increased use of social media, which has seen public education about mental health and increased funding to mental health care facilities, is on the rise. This trend has since the improvement in the delivery of mental healthcare services.
Literature review
Tori (2021), through his publications ‘Black men’s mental health matters,’ presented his satisfaction and what black men go through as subjected to American Society. He recalls the year 2020 when the white police officer brutally murdered George Floyd in public. Tori argues that American Society has made it difficult for black Americans to seek support from mental health facilities. Racism is a barrier to ensuring that black Americans get good healthcare and mental support. Howard Stevenson, Ph.D., director of the Racial Empowerment Collaborative at the University of Pennsylvania, said, ” We should place less emphasis on whether Black men are resistant to therapy,” said Stevenson, “and more on understanding the contexts in which they already feel comfortable talking about their feelings and traumas. If a Black man is able to find a treatment that is culturally responsive, that he understands, and that embraces the uniqueness of his difference, he is more likely to use that service”. Through this, Stevenson was simply saying black African Americans are trying to seek support in areas they know that they will not be harassed or discriminated against on the basis of their colors.
In an effort to ensure that African Americans get mental support amid discrimination in Society, Tori (2021) points out that psychologists have resorted to taking these services close to where they are. For Instance, psychologists have now adopted mental care services at barber shops, shopping malls, local TV stations, churches, social media, and other places where African Americans can easily access. While addressing this new modification, Wizdom Powell, Ph.D., an associate professor of psychiatry at the University of Connecticut, pointed out that the African American society will benefit more if psychologists redesign the structure of mental health services and have it rendered in the way that suits these individuals. For Instance, a culturally relevant approach with messages speaking against racism and equal treatment of African Americans will see these marginalized communities interact freely with this psychologist and thus be able to get help.
Wizdom went further to state that intervention should not be the only option that psychologists should pursue, even if that is the main focus (Tori, 2021). She calls for programs that will support African Americans and thus ensure that their talents are harnessed and not left to waste. Wizdom holds the view that neglect of African Americans is one of the major contributors to their increased level of mental health.
Bailey et al. (2019) presented yet very disturbing statistics on ethnic and racial differences that contribute to depression among people of color. The authors pointed out that even though African Americans are faced with mental related problems like the rest of the Americans, there are differences. For Instance, black adults living below the poverty line are faced with more risks of experiencing mental-related problems as compared to their white counterparts who enjoy financial security. Similarly, Bailey et al. (2019) also pointed out that the symptoms of depression are more persistent and aggressive in African Americans compared to their white counterparts. Sadly, black men are not receiving support for the same problems as compared to their white counterparts (Blumberg et al., 2015). According to the report by National Center for Health Statistics dated 2021, only 24.8% of black American men used mental health services in seeking support for their mental problems. In contrast, their white counterparts were at 48.7%. This demonstrates the reactance of African Americans in using mental health services. Every time black men seek mental health services, they prefer to be attended to by psychologists of their same. However, this preference disadvantages them since African Americans psychologists are very few. According to APA Center for Workforce Studies Data, only 4% of the psychologists in the US are African Americans. This is far below the population of African Americans. Therefore, even though African Americans prefer seeking support from the psychologists of their race, this is not sustainable since their number outdo that of the psychologists.
According to American Psychiatric Association. (2017), black men’s mental health in the US is more complex than it appears in statistics and clinic records. Racism and black men’s historical injustices in the US have become a major contributors to depression among blacks. This situation is further fueled by the discrimination they go through while trying to seek mental health services, poverty, and marginalization that has made it difficult for them to access quality mental health services. Unlike their white counterparts, African Americans are less likely to get the attention of mental health professionals and are less likely to be included in mental health research (Tori, 2021). Powell et al. (2016), through their study reported in Behavioral medicine, indicated that black men have a feeling of mistrust towards white psychologists because of racism that they face along the internalized masculinity norms. American history covers the dark days of African Americans. Even though the situation has improved, there are still gaps that need more interventions to ensure that black African Americans get the support they need. Powell (2016) holds the view that even though most adult black Americans do not face the dark days of racism and slavery, these feelings are still in their spirit. American history is not good for them. Every time they recall such historical records, their trust in the system fades. They always believe that the system is rigged against them.
In addressing the solutions to Africa’s state of mental wellbeing, Tori (2021) pointed out that address to racism should be prioritized. He cites that the decline in the number of black African Americans seeking mental support is because of racism and discrimination that they witness in these mental health facilities. Therefore, Tori is calling on all psychologists to familiarize themselves with the racism statistics and how the same has affected black American adults. He is also asking these psychologists to read the latest research work in order to understand the nature of Society. Psychologists need to learn about the bias and racism they display in their facilities for them to work effectively with African Americans. Additionally, clinicians need to be aware of and adopt that knowledge into their therapeutic work. Psychologists need to understand that about 8% of the US population are immigrants from the Caribbean and Africa, among others. Tori is asking that psychologists learn how to handle these varying categories of people. Most of the immigrant citizens from Africa do not feel as inferior because they grew up in a non-discriminatory environment.
According to the report presented by the Health and Human Services Office of minority health, black adults in the United States represent the highest percentage in terms of persistence in the case of mental health as compared to their white counterparts. According to this report, the majority of black Americans demonstrate sadness, hopelessness, and emotional distress. Worst of all, black Americans living below the poverty line are twice as likely to report a case of mental-related problems as compared to the rest of the blacks. Additionally, the report by the Mental Health Facts for African American guide dated 2020 stated that black Americans who need help and support sometimes do not get it. The report showed that despite the need, only a third of them get the support. Additionally, they are less involved in research.
In his interview with OurHealth Media Network, Doctor Harold Woody, the CS Mott and Dao professor of public health at Michigan State University College, believe that black American men are going through a lot in silence. He maintained that the current mental health service is working against them because they are not getting the support they need. Therefore, Dr. Harold has resorted to coming up with community-based programs that seek to boost the support of black Americans. He further states that among black men aged 15 and 24 years, suicide is the third leading cause of death. He believes that majority of the people walk around thinking about suicide as a sign of giving up on the fight against mental health.
Additionally, in explaining the reason behind the increased mental health among black men, Dr. Harold maintained that racism and slavery had placed the black men’s community in a disadvantaged position. Most of these individuals do not have equal access to opportunities like the rest of the population. They do not have equal opportunities to leverage like their white counterparts.
Applying findings to practice
The majority of the available literature holds the view that, indeed, majority of the black Americans are suffering in silence. Most of these individuals do not know what to do when faced with challenges. Society is working against them. Available literature and research work clearly show that the main cause of the increased numbers among Black Americans includes the following.
Racism
Discrimination on the basis of color has pushed African Americans to the wall. Society is rejecting them because of their skin color. The racism card work against them in all areas, including employment, access to quality healthcare, shelter, and job opportunities. Racism is making things difficult for them because they are required to make more effort than their white counterparts to land the same opportunities. When these men realize that they are losing opportunities and access to services due to racism, most of them suffer even more. Tori (2021) stated that American Society is punishing people according to their skin color. In comparison, whites are accorded all the rights, whereas the black African ones are killed by even the police who are supposed to protect them, as it was in the case of George Floyd.
Bias mental health facilities
Almost all the sources perused highlighted the issue of bias and irresponsible mental health professionals. American psychologists are adding salt to the wounds of African Americans. Instead of helping, they overcome mental problems. It is for this reason that the majority of African American men prefer seeking help from psychologists of their color. To them, they feel more comfortable sharing their problems.
Poverty
Poverty is a contributor to mental discomfort among African Americans as compared to their white counterparts, black Americans. This is informed by the unequal distribution of resources and job opportunities among the population. Most employers and even financial institutions prefer working with white than they would have African Americans. This has denied African Americans an opportunity to explore their potential and better their standards of living.
Discussion
As demonstrated in the research findings above, the issues around increased cases of mental health can easily be managed and have a free society. The majority of the causes are within human control. Even though American Society has made progress over the years, there are still gaps that need to relooked into. Even though African Americans have moved from being slaves to enjoying their freedom, Society is still treating them as second-class citizens. The distribution of resources in the US does not favor black Americans. Most of them are forced to work harder to access the kind of services their white counterparts find easy. The playing ground needs to be leveled in order to ensure everything is based on merit. Both whites and blacks should compete equally for the available opportunities.
Additionally, as Tori (2021) and Dr. Harold (2017) described, psychologists need to act professionally. It is so unfortunate that the very people that Society relies on to give direction on what is good for mental health are the same people that subject others to discrimination and mental-related problems. Such an irony. The research findings indicate that psychologists need to draw the line and demonstrate professionalism in their roles. These individuals need to restore the confidence of black Americans and make them believe that Society means well to them. Black Americans prefer seeking support from black American psychologists because they know that they will not be subjected to discrimination like the rest of the psychologists.
Moreover, mental health programs should be made readily available in the community so that they become accessible to the people in the community. Just as Dr. Harold advised, community-based programs will see mental health services taken close to the people. This will ensure that people get the support they need before the situation gets out of hand.
Addressing poverty is another approach through which depression among African Americans. As demonstrated in the research, Black Americans living below the poverty line are likely to experience mental stress twice as higher compared to African Americans living above the poverty line. This is a confirmation that poverty is a major contributor to mental health among these African Americans. Therefore, resources should be made available and distributed equally so that people in the community can better their lives.
Recommendation and Conclusion
The current research work focused solely on the already published information, both primary and secondary sources. A peer review is done to ensure that the right sources are selected and that the topic and content of the discussion are almost there. However, the next research work should be based on field study. Sampling the target and conducting research on them on the topic. This will ensure that the researcher interacts with actual truth on the ground. The researcher will be placed right at the center of these challenges, and that will provide a deep understanding.
Additionally, more time should be dedicated to the research work to ensure quality and reliable information is available to the audience. Similarly, more time will also see the adoption of more sources and even live interviews with the stakeholders of the whole field. It is important to listen directly from the source.
The findings of the research indicate that the nature of American Society has made life difficult for African Americans. Society is treating this group of individuals as second-class citizens. It is surprising to note that even the psychologists who are supposed to be the pillars of moral support have converted and become part of the problem. The research indicates that white psychologists discriminate against blacks. In response to this, the blacks have either resorted to seeking support from their fellow black psychologists or even lived silently with the same problems.
Because of the increasing number of mental health among black Americans. Since this research work has established that biased psychologists are the major contributors to black Americans’ reactance to seeking services there. Therefore, the government should lay down measures to see psychologists undergo training programs on racism and managing a diverse society. This will reduce discrimination among Americans.
References
American Psychiatric Association. (2017). Mental health disparities: Diverse populations. Retrieved from:https://www.psychiatry.org/psychiatrists/cultural-competency/education/mental-health-facts
Bailey, R. K., Mokonogho, J., & Kumar, A. (2019). Racial and ethnic differences in depression: current perspectives. Neuropsychiatric disease and treatment, 15, 603.
Blumberg, S. J., Clarke, T. C., & Blackwell, D. L. (2015). Racial and ethnic disparities in men’s use of mental health treatments (pp. 1–8). Hyattsville, MD: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
Lin, L., Stamm, K., & Christidis, P. (2018). Demographics of the US psychology workforce. Washington, DC: Author.
OurHealth Media Network (2017). Depression in Black men. [Video].https://youtu.be/1gqEMC1Dxg0
Powell, W., Adams, L. B., Cole-Lewis, Y., Agyemang, A., & Upton, R. D. (2016). Masculinity and race-related factors as barriers to health help-seeking among African American men. Behavioral Medicine, 42(3), 150–163.
Shattell, M., & Brown, P. J. (2017). Black mental health matters: What nurses need to know about chronic stressors of persons of color. Journal of psychosocial nursing and mental health services, 55(9), 3–5.
Thomas, S. P. (2021). Black mental health matters: Addressing post-COVID mental health needs of Black Americans. Issues in Mental Health Nursing, 42(8), 707-708.
Tori, D. (2021). Black men’s mental health matters: Psychologists are working to develop more effective ways of promoting Black men’s mental health. Retrieved from:https://www.apa.org/monitor/2021/09/ce-black-mental-health
Vance, T. A. (2019). Addressing mental health in the Black community. Columbia Department of Psychiatry.
Zawn, V. (2020). What to know about depression in Black communities. Retrieved from:https://www.medicalnewstoday.com/articles/black-depression#causes
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