Literature suggests that African Americans experience greater difficulty in accessing mental health services than Caucasians (Davis & Ford, 2002). Furthermore, African Americans who do gain access often face barriers to accurate mental health assessment and diagnosis, leading to a lack of effective mental health treatment. Many African American adolescents who are in need of mental health treatment fail to receive these services or discontinue between the first and third appointment.
The gap between the need for and utilization of services is especially serious for African American adolescents, who are already at an increased risk for poor health outcomes as a result of poverty, unemployment, poor education, and the consequences of living in troubled communities (Copeland, 2006). Given the long-term risk of failing to provide mental health services to this population, it is crucial to examine barriers to access and utilization in order to eliminate these barriers. A lack of attention to the current disparities will have far reaching negative effects for African American adolescents, their families, and our society resulting in increased stress and disability, homelessness, incarceration, substance abuse, community violence, child abuse and neglect, increased foster care placement, and juvenile delinquency, etc.
There is a significant divide between the African American community and the traditional mental health system. The first step is to identify what those barriers are - it is about culture, language, misperceptions about the nature of mental health and mental illness, systemic discrimination, racism and fear of stigma. The information provided serves to better understand the relationship between barriers to mental health care among African Americans and how going forward we can help to facilitate positive and beneficial outcomes.
During the 19th century, the prevailing diagnostic system centered on four main syndromes, -- melancholy, mania, dementia, and idiocy; however, geography and race of clients often combined to create a different typology (Lowe, 2006.) By this time there was a new movement put into place concerning the delivery and organization of health care that dramatically changed mental health care by propelling national efforts to develop state-funded asylums for the care of the mentally ill. Although many states began establishing institutional facilities, the accessibility and quality of mental health care left considerable room for improvement. By 1849 thirteen states had initiated state-funded asylums for the care of the mentally ill (Lowe, 2006).
With most African Americans living in the south, care for the insane was generally thought to be tremendously scarce. Ironically enough the quality of care in the North was questionably no better. With most African Americans living in bondage, this new form of care was rarely accessible therefore; the surge of institutional reform did little to change the status of mental health. The delivery of mental health services became increasingly more segregated during the mid 1800’s, which affected the funding and public attitude toward those receiving care (Lowe, 2006). In March 1875, the North Carolina General Assembly appropriated $10, 000 to build a colored insane asylum. The Eastern Asylum for the Colored Insane was opened in1880 with accommodations for four hundred and twenty patients (Jackson, 2001). The availability of specialized care for the mentally ill was often limited to white citizens, which forced alternate paths of service for most African Americans. This meant that almshouses and jails remained their primary providers of institutional care.
Most of the knowledge of mental health for the African American population in the first half of the twentieth century came from several large studies that focused only on the...