Facts about African American Mental Health

July is designated as National Minority Mental Heath Awareness Month. On my Psychology Today blog I have discussed potential reasons for health disparities. Below are some facts provided from the National Alliance on Mental Illness.

• Mental illness is frequently stigmatized and misunderstood in the African American community. African Americans are much more likely to seek help though their primary care doctors as opposed to accessing specialty care.

• African Americans are often at a socioeconomic disadvantage in terms of accessing both medical and mental health care: in 2006, one-third of working adult African Americans were uninsured in the preceeding year.

• Experiences of mental illness vary across cultures, and there is a need for improved cultural awareness and competence in the health care and mental health workforce.

• African Americans in the United States are less likely to receive accurate diagnoses than their Caucasian counterparts. Schizophrenia, for instance has been shown to be over diagnosed in the African American population

• Culture biases against mental health professionals and health care professionals in general prevent many African Americans from accessing care due to prior experiences with historical misdiagnoses, inadequate treatment and a lack of cultural under standing; only 2 percent of psychiatrists, 2 percent of psychologists and 4 percent of social workers in the United States are African American.

• African Americans tend to rely on family, religious and social communities for emotional support rather than turning to health care professionals, even though this may at times be necessary. The health care providers they seek may not be aware of this important aspect of person life.

• Some studies suggest that African Americans metabolize some medications more slowly than Caucasian Americans, yet they often receive higher doses of psychiatric medications, which may result in increased side effects and decreased medication compliance.

• Social circumstances often serve as an indicator for the likelihood of developing a mental illness. African Americans are disproportionately more likely to experience social circumstances that increase their chances of developing a mental illness.

• With the implementation of various programs and innovations, African Americans’ patronization rates for mental health services may be improved.

• Programs in African American communities sponsored by respected institutions, such as churches and local community groups can increase awareness of mental health issues and resources and decrease the related stigma.

• Programs that improve enrollment rates in safety net health care providers can result in increased mental health care due to improved mental health coverage in the African American community.

• Encouragement in the community to join mental health related professions can increase the number of African American mental health care providers and increase social sensitivity among the provider community.

It is my hope that poliy efforts can work to improve our ability to provide services to the African American community. One effort is to increase my research to better understad barriers towards treatment. Please visit my research website for more information.


Reference: 
National Alliance on Mental Illness (2014). African American Community Mental Health. Obtained July 2014 from
http://www.nami.org/Content/ContentGroups/Multicultural_Support1/Fact_Sheets1/AfricanAmerican_MentalHealth_FactSheet_2009.pdf

Mental Health Awareness

May is Mental Health Awareness month.  Please view the video below to learn more about psychotherapy. In psychotherapy, psychologists apply scientifically validated procedures to help people develop healthier, more effective habits. 

Get the facts, Therapy works! 








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5 Tips for Helping Children Cope with Early Childhood Trauma

I previously published a blog on trauma in children on Psychology Today.  Common forms of trauma include physical and sexual abuse, witnessing domestic and community violence, being separated from family members, and neglect.  According to the US Dept of Health and Human services (2013), child neglect is the most common trauma experienced by children.  Furthermore, children in the age group of birth to 1 year had the highest rate of victimization at 21.2 per 1,000 children ( DHHS, 2013) In regards to ethnicity, the most confirmed cases by CPS are among Whites (43.9%) followed by African-Americans (21.5 percent) and Hispanic Americans (22.1 percent).

Signs of Trauma in Young Children

Children’s reactions to trauma vary at different ages. Some of the common reactions of children are listed on the next page. If any of the behaviors or symptoms don’t improve or go away over time, it is important to seek professional help. Possible reactions to trauma may include:

• Fear of being separated from parent

• More clinging and dependent behaviors

• More aggressive behaviors

• More withdrawn behaviors showing little emotion

• Aimless motion, disorganized behaviors, and or/freezing

• Unable to comfort self

• Difficulty falling asleep, night waking

• May reenact scene in play

• Problems with toileting (bedwetting, soiling)

• Thumb sucking

• Loss of language skills and acquired language

• Memory problems 

Tips for Helping Children Cope with Trauma

1. Avoid blaming the child or displaying your anger: It is important to remain calm and use a calm voice with talking with children about their traumatic experience. 
2. Reassure the child that they will be safe: Many children fear for safety after experiencing trauma. It is important to let the child know that you will be present to support them. This may involve letting the child be aware of your whereabouts at all times.
3. Don’t minimize the child’s feelings: Avoid telling the child to “Stop being a baby, don’t cry”. Normalize the child’s emotions at let them know that it’s okay to be sad.
4. Follow the child’s lead: It’s okay to not encourage the child to talk about the trauma. However, it the child decided to open up to you be there to listen and support them.
5. Help the child identify their feelings: It is important for children to talk about their hurt or sadness. It may be necessary to seek professional help from a psychologist or licensed mental health professional trained to deal with trauma.

Copyright 2013 Erlanger A. Turner, Ph.D. 

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References:

Child Welfare Information Gateway. (2013). Child Maltreatment 2011: Summary of key findings. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau.

National Child Traumatic Stress Network (2010). Early Childhood Trauma Retrieved September 2013 from http://www.nctsn.org/sites/default/files/assets/pdfs/nctsn_earlychildhoodtrauma_08-2010final.pdf

Osofsky, J. Helping young children and families cope with trauma. Retrieved September 2013 from http://www.nctsnet.org/nctsn_assets/pdfs/Helping_Young_Children_and_Families_Cope_with_Trauma.pdf

Understanding Adolescent Self-Harm Behavior

Self-injury, also called self-harm, is the act of deliberately harming your own body, such as cutting or burning yourself. It's typically not meant as a suicide attempt. Rather, self-injury is an unhealthy way to cope with emotional pain, intense anger and frustration. Self-harm behaviors may also be linked to a variety of mental disorders, such as depression, eating disorders and borderline personality disorder. 

The following video presents on adolescent self-harm behaviors.

Featured presenters:

Reo W. Newring, Ph.D.

Licensed Clinical Psychologist

Paige Lembeck, M.A.

Graduate Student

Children's Hosptial & Medical Center

Omaha, Nebraska

Teen Suicide-Related Behavior: Risk and Protective Factors

May has been designated as Mental Health Awareness Month. Given the prevalence of suicide related behaviors (suicidal thoughts or suicide attempts) among adolescents, I feel it is important for us to become aware of this issue. It is particularly important for parents to be knowledgeable about what signs to look for and when it is appropriate to seek treatment.

According to the National Institute of Mental Health (NIMH), suicide remains the third leading cause of deaths among adolescents. Spirito and Esposito-Smythers (2006) reported that within a twelve-month period, 16.9% of adolescents seriously considered attempting suicide, 16.5% developed a suicide plan, 8.5% attempted suicide (female, 11.5%; male, 5.4%), and 2.9% of adolescents required emergency treatment as a result of a suicide attempt. In my recent Psychology Today blog post, I discussed the rates of suicide among lesbian, gay, and bisexual (LGB) youth. LGB youth also are at high risk of suicidal behavior due to bullying and lack of acceptance by peers and family. While depressive symptoms are a risk factor, even among those who exhibit depression or depressive symptoms, clinician face difficulties predicting self-harm or suicide attempt (Hetrick, et al., 2011). Therefore, it is important for parents to pay attention if they notice differences in their child’s behavior.

Risk Factors of Suicide

Risk factors for suicide are characteristics or conditions that increase the chance that a person may try to take her or his life. Suicide risk tends to be highest when someone has several risk factors at the same time. The most frequently cited risk factors for suicide are: 

• Mental disorders, in particular:
• Depression or bipolar (manic-depressive) disorder
• Alcohol or substance abuse or dependence
• Schizophrenia
• Borderline or antisocial personality disorder
• Conduct disorder (in youth)
• Psychotic disorders; psychotic symptoms in the context of any disorder
• Anxiety disorders
• Impulsivity and aggression, especially in the context of the above mental disorders
• Previous suicide attempt
• Family history of attempted or completed suicide
• Serious medical condition and/or pain

It is important to bear in mind that the large majority of people with mental disorders or other suicide risk factors do not engage in suicidal behavior. 

Warning Signs of Suicide 

• Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself
• Looking for ways to kill oneself by seeking access to firearms, available pills, or other means
• Talking or writing about death, dying, or suicide when these actions are out of the ordinary for the person
• Feeling hopeless
• Feeling rage or uncontrolled anger or seeking revenge
• Acting reckless or engaging in risky activities - seemingly without thinking
• Feeling trapped - like there's no way out
• Increasing alcohol or drug use
• Withdrawing from friends, family, and society
• Feeling anxious, agitated, or unable to sleep or sleeping all the time
• Experiencing dramatic mood changes
• Seeing no reason for living or having no sense of purpose in life  

Protective Factors for Suicide

Protective factors for suicide are characteristics or conditions that may help to decrease a person’s suicide risk. While these factors do not eliminate the possibility of suicide, especially in someone with risk factors, they may help to reduce that risk. Protective factors for suicide have not been studied as thoroughly as risk factors, so less is known about them. Protective factors for suicide include: 

• Receiving effective mental health care
• Positive connections to family, peers, community, and social institutions such as marriage and religion that foster resilience
• The skills and ability to solve problems

Protective factors may reduce suicide risk by helping people cope with negative life events, even when those events continue over a period of time. The ability to cope or solve problems reduces the chance that a person will become overwhelmed, depressed, or anxious. Protective factors do not entirely remove risk, however, especially when there is a personal or family history of depression or other mental disorders. 

What To Do When You Suspect Someone May Be at Risk for Suicide

1. Take it Seriously

• 50% to 75% of all people who attempt suicide tell someone about their intention.
• If someone you know shows the warning signs above, the time to act is now.

2. Ask Questions

• Begin by telling the suicidal person you are concerned about them.
• Tell them specifically what they have said or done that makes you feel concerned about suicide.
• Don't be afraid to ask whether the person is considering suicide, and whether they have a particular plan or method in mind. These questions will not push them toward suicide if they were not considering it.
• Ask if they are seeing a clinician or are taking medication so the treating person can be contacted.

3. Do not try to argue someone out of suicide. Instead, let them know that you care, that they are not alone and that they can get help. Avoid pleading and preaching to them with statements such as, “You have so much to live for,” or “Your suicide will hurt your family.”

4. Encourage Professional Help

• Actively encourage the person to see a physician or mental health professional immediately.
• People considering suicide often believe they cannot be helped. If you can, assist them to identify a professional and schedule an appointment. If they will let you, go to the appointment with them.

5. Take Action

• If the person is threatening, talking about, or making specific plans for suicide, this is a crisis requiring immediate attention. Do not leave the person alone.
• Remove any firearms, drugs, or sharp objects that could be used for suicide from the area.
• Take the person to a walk-in clinic at a psychiatric hospital or a hospital emergency room.
• If these options are not available, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for assistance.

6. Follow-Up on Treatment

• Still skeptical that they can be helped, the suicidal person may need your support to continue with treatment after the first session.
• If medication is prescribed, support the person to take it exactly as prescribed. Be aware of possible side effects, and notify the person who prescribed the medicine if the suicidal person seems to be getting worse, or resists taking the medicine. The doctor can often adjust the medications or dosage to work better for them.
• Help the person understand that it may take time and persistence to find the right medication and the right therapist. Offer your encouragement and support throughout the process, until the suicidal crisis has passed.

References

American Foundation for Suicide Prevention https://www.afsp.org/

National Suicide Prevention http://www.suicidepreventionlifeline.org/

National Institute of Mental Health http://www.nimh.nih.gov/health/topics/suicide-prevention/suicide-prevention-studies/warning-signs-of-suicide.shtml

Copyright 2013 Erlanger A. Turner, Ph.D.