A critical review of research on the mental health status of older African-Americans

Abstract

This paper summarises current research on the mental health status of older African-Americans with a specific focus on late-life depression, one of the most common forms of mental disorder among older persons. Social gerontologists have brought to the forefront the need to consider the impact of historical eras, cohort location, and lifecourse development when studying various dimensions of the ageing process. Unfortunately, this type of theorising is still in its infancy, and has not been widely applied to the general population and all dimensions of health, let alone investigations into the mental health status of older African-Americans. Virtually none of the empirical studies we reviewed adequately address the historical, biographical, or structural factors related to the mental health status of older African-Americans. We suggest that to understand contemporary manifestations of racial presumptions, there must be an appreciation of the historical antecedents. African-Americans live with the corrosive effects of a legacy of slavery that presumed black inferiority. The identification of salient factors of risk and resilience among this population is critical to developing effective intervention and mental health maintenance programmes. By emphasising the socio-historical influences on the mental health of older African-Americans, we can develop a greater understanding of this population's mental health needs ; thus paving the way for improved mental health services and a reduction in mental health disparities.

Elder Abuse and Neglect in African American Families: Informing Practice Based on Ecological and Cultural Frameworks

“…African Americans also may fear being judged due to cultural values and traditions that divert from the majority culture (e.g., multigenerational parenting) (Hall, 1999;Howard et al, 2002;Griffin, 1999). In fact, it has been documented that African Americans are at increased risk of being misdiagnosed when receiving mental health services due to cultural differences with the majority culture (Mills & Edwards, 2002).…”

The Influence of Cultural Health Beliefs on Self-Reported Mental Health Status and Mental Health Service Utilization in an Ethnically Diverse Sample of Older Adults

“…Because little consideration has been given to ethnic differences in mental health (Mills & Edwards, 2002), along with health beliefs as client-centered services are becoming progressively more common, it has become necessary to explore the health beliefs of the ethnically diverse in the area of mental health. Some research has begun exploring this area.…”

Context and culture: African-American elders’ experiences of depression

“…For many African-American elders, depression is communicated through having the ''blues,'' which originally were the melancholy hymns and songs of the poor and oppressed representing a persistent mourning for opportunities lost due to racism (Cheng, 2001). A popular means of coping with depression in this group is through prayer, which is a private dialogue with God and a communal conversation that reflects the long history of suffering for all African Americans (Mills & Edwards, 2002).…”

“…Another reason may be the differences in how various populations understand depression, such as medical professionals, social scientists, and a group of elderly African-American men and women (Mattis & Jagers, 2001) One research study showed that African-American elders attributed depression to a ''crisis of the spirit'' (Mills & Edwards, 2002). Described this way, it seems important for clinicians to acknowledge the spirit in treating psychic pain, perhaps through awareness that prayer, worship, or spiritual counseling can attend to this crisis.…”