Fear, black people and mental illness: A vicious circle?

Abstract

The relationships between black communities and the mental health (MH) services are fraught. Paradoxically, black communities receive the MH services they don't want, but not the ones they do or might want. Black people mistrust and often fear services, and staff are often wary of the black community, fearing criticism, and not knowing how to respond, are fearful of black people, in particular, young black men. The situation is fueled by prejudice, misunderstanding, misconceptions and sometimes racism. The present paper describes the findings of a study to explore the issues in greater depth. The study was premised on a belief that there are 'circles of fear' which lead to poorer treatment of black communities. A purposive sampling approach was used to seek out groups and individuals in whom the 'circles of fear' were likely to be evident. The findings suggest that there are fears which impact negatively on the interaction between black communities and MH services. Two major themes emerged in this study, i.e. the sources of fear and the consequences of fear. Sources of fear included perceptions of MH services, attitudes to mental illness and diagnosis, and experiences of hospital care. The impact of fear included limited trust, limited engagement and delayed help-seeking behaviour. The study concludes that these fears mar the interactions between these communities and MH services, affect help-seeking behaviour adversely, and lead to restrictive and punitive interventions. Progress will only be made in breaking the 'circles of fear' if there is a systematic change in the experience of black services users at each point in the care pathway.

What is the Lived Experience of Being Discharged From a Psychiatric Inpatient Stay?

“…Evidence suggests patients will avoid seeking treatment for mental illness due to fear of stigma from health professionals and employers, resulting in them not always receiving the help they need (Keating & Robertson, 2004;Stuart, 2004;Wrigley, Jackson, Judd, & Komiti, 2005). In the extreme, people may opt to avoid stigma altogether by avoiding any institution that might mark them including mental health care and treatment programmes .…”

Stigma and discrimination limit access to mental health care

“…The interplay of these factors produces the contradictory situation in which black groups may have higher rates of many mental illnesses, lower rates of general referral and treatment, but higher rates of compulsory treatment and forensic service contact (Keating & Robertson, 2004; National Institute for Mental Health in England, 2003). In the USA patterns of contact with mental health services are in some ways different for black and white people.…”

Psychoeducation to Address Stigma in Black Adults Referred for Mental Health Treatment: A Randomized Pilot Study

“…In the general population, Blacks tend to hold more stigmatizing perceptions of mentally ill individuals than Whites do (Anglin et al 2006;Pescosolido et al 1999;Whaley 1997;Corrigan and Watson 2007). With respect to service use, Blacks report that stigma is a significant treatment barrier in qualitative studies (Alvidrez et al 2005;Cooper-Patrick et al 1997;Keating and Robertson 2004;Thompson et al 2004), and some quantitative studies have found that stigma-related beliefs account, at least in part, for ethnic disparities in mental health services use (Alvidrez 1999;Ojeda and McGuire 2006).…”