2. Triple Whammy—HIV, Mental Disorders, African Americans
Mental Health–Seeking Habits of African Americans
Clear, current data are not readily available regarding the types and sources of assistance that African Americans seek when experiencing mental or emotional problems. An earlier review of studies of “psychiatric morbidity” by Neighbors found that when experiencing symptoms of emotional distress, many African Americans either do not seek help or delay seeking it. [Neighbors 1984] An analysis of data from the National Survey of Black Americans, also by Neighbors, found that “47 percent of the respondents who were willing to talk about their problems had experienced feelings
of a ‘nervous breakdown’” and that “45 percent of those at the point of a nervous breakdown did not consult a professional for help with their problem.” [Neighbors 1988]
Although more recent data indicate that the percentages of African Americans who seek some type of assistance when experiencing mental health concerns, the percentage who turn to mental health professionals remains low.
Use of Mental Health Services Among African Americans (N = 1011)
[Surgeon Culture, Race]
12-Month Disorder |
Mental Health Specialist1 (SE) |
Any Provider2 (SE) |
Mood disorder (eg, depression, bipolar disorder) |
15.6 % (3.5) |
28.7% (4.5) |
Anixety disorder (eg, general anxiety disorder, post-traumatic stress disorder, panic disorder) |
12.6% (2.4) |
25.6% (5.3) |
SE, standard error
1. Psychologist, psychiatrist, or social worker
2. Mental health specialist, primary care practitioner, other professional (nurse, occupational therapist, other health professional, clergy member, counselor), spiritualist, herbalist, natural therapist, faith healer
Barriers to Care
In many African American communities, religious institutions—whether Protestant, Roman Catholic, Muslim, or other—play a critical role not only in spiritual life but also as a source of assistance during mental and emotional difficulties. By sponsoring events such as health fairs and educational efforts to reduce risky sexual and drug-use behaviors, religious institutions serve as one important resource for individuals’ healthcare needs. However, they can also act as barriers to enhancing mental and emotional well-being by, for example:
- Stigmatizing men who have sex with men (MSM)
- Portraying mental disorders as character flaws or weakness of faith
- Condemning behaviors or lifestyles that may be perceived as associated with HIV infection
Other factors that may contribute to underuse of professional mental health services in some African American communities can include using some of the following resources to the exclusion of needed mental health specialists: [Primm 2010]
- Reliance on personal connections, such as family members, friends, and other community members
- Reliance on primary care providers or other nonspecialists
- Dependence on emergency departments for diagnosis and treatment of mental health concerns
- Use of folk remedies, faith healers, herbalists, and other nonstandard modes of care
