Special People/Special Needs
Mental illness is a special need within itself; couple that with being a minority, specifically an African American, and the problem increases. The following paper will display examples and data portraying the difficulty that African Americans face when seeking mental health services, particularly for schizophrenia. Also included will be assessment techniques, intervention strategies and treatment planning. According to the NAMI Multicultural Action Center (Medline Plus, 2004), “African Americans in the United States are less likely to receive diagnoses and treatment for their mental illnesses than Caucasian Americans.” This can be due to many factors, including strong family and religious bonds that do not persuade outside resources, even when called for. Also barring treatment is the bias that many African Americans hold towards mental health professionals. This is due to a history of misdiagnoses, inadequate treatment, and a general lack of cultural understanding on behalf of the mental health professional. In fact, data shows that as of 2004 only “2% of psychiatrists, 2% of psychologists, and 4% of social workers in the United States are African American.”(Medline Plus) To complicate this, many African Americans are stigmatized in their own community and mental illness remains vastly misunderstood. Those with insurance, often do not seek treatment for fear of being ostracized. Those that do seek treatment often struggle with misdiagnoses. Unlike specific diseases like cancer or diabetes which can be diagnosed from specific blood or other laboratory testing, mental illness or disorders are defined by signs, symptoms, and/or functional impairments that are much more difficult to diagnose. Mental health practitioners and counselors are governed by the American Psychological Association (APA): “Diagnostic and Statistical Manual of Disorder DSSM-IV-TR,” the American Counseling Association (ACA) and the International Statistical Classification of Diseases and Related Health Problems (ICD). In 1987 the APA established the Society of Psychological Study of Ethnic Minority Issues (Division 45), which later went on to publish the “Guidelines for Provider of Psychological Service to Ethnic, Linguistic, and Culturally Diverse Populations.” This publication led to the acceptance to policy the “Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists” (Atkinson, 2004, p.57) These guidelines list different mental disorders and the criteria and diagnostic codes for diagnosis, which are used worldwide by clinicians and researchers. Unfortunately, these guiding principles are just that, guiding principles. In the end it still depends on the accessibility, delivery, and level of competency of the professional(s) whom diagnose and treat the patient(s). This leads us to schizophrenia. Schizophrenia is on of the most challenging disorders to diagnose, because many of the symptoms can be found in other mental disorders which can lead to misdiagnosis. As stated by the National Women’s Health Resource Center (National Women's Health Resource Center [NWHRC], 2002) “Some individuals with schizophrenia have prolonged periods of elation or depression, which can be confused with bipolar disorder (also called manic depression) or major depressive disorder. People with bipolar disorder and major depression can also experience psychotic symptoms” Unfortunately, minority groups have taken an even bigger toll on misdiagnoses, due to clinicians systematic testing use of standard assessment tools such as the; Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS), Calgary Depression Scale for Schizophrenia (CDSS), Global Assessment Functioning (GAF), Hamilton Depression Rating (HAM-D) Scale, Montgomery-Asberg Depression Rating Scale (MADRS). These scales and rating work for...