African American communities across the United
States are more culturally diverse now than in any
other time in history, with increasing numbers of
immigrants from African nations, the Caribbean,
Central America and other countries. To ensure
African American communities have access to
adequate and affordable care, a better understanding
of the complex role that cultural backgrounds and
diverse experiences play in mental disorders in these
communities is vital.
Access to Care
According to the National Institute of Mental Health,
African Americans and other diverse communities are
undeserved by the nation’s mental health system.
For example, one out of three African Americans who
need mental health care receives it. Compared to the
general population, African Americans are more likely
to stop treatment early and are less likely to receive
Despite recent efforts to improve mental health
services for African Americans and other culturally
diverse groups, barriers remain in access to and quality
of care from, insurance coverage to culturally
competent services. For those with insurance,
coverage for mental health services and substance use
disorders is substantially lower than coverage for other
medical illnesses such as hypertension and diabetes.
Historically, mental health research has been based
on Caucasian and European based populations, and
has not incorporated understanding of racial and ethnic
groups and their beliefs, traditions and value systems.
Culturally competent care is crucial to improving
utilization of services and effectiveness of treatment for
Culture—a combination of common heritage beliefs,
values, and rituals—is an important aspect of racial
and ethnic communities.
African Americans are a resilient people who have
withstood enslavement and discrimination to lead
productive lives and build vibrant communities.
Throughout U.S. history, the African American
community has faced inequities in accessing
education, employment, and health care. However,
strong social, religious, and family connections have
helped many African Americans overcome adversity
and maintain optimal mental health.
Many Americans, including African Americans,
underestimate the impact of mental disorders. Many
believe symptoms of mental illnesses, such as
depression, are “just the blues.” Issues of distrust in
the health care system and mental illness stigma
frequently lead African Americans to initially seek
mental health support from non-medical sources.
Often, African Americans turn to family, church and
community to cope.The level of religious commitment
among African Americans is high. In one study,
approximately 85 percent of African Americans
respondents described themselves as “fairly religious”
or “religious” and prayer was among the most
common way of coping with stress.
Because African Americans often turn to
community—family, friends, neighbors, community
groups and religious leaders—for help, the opportunity
exists for community health services to collaborate
with local churches and community groups to provide
mental health care and education to families and
Studies have shown that family participation in a
support group or a church group can improve the
family’s ability to care for family members with mental
disorders and cope with the emotional distress of
being a caregiver.
Rates of Mental Disorders
Rates of mental illnesses in African American
communities are similar to those of the general
population. Most individuals are able to maintain
good mental health. However, many are in desperate
need of mental health treatment. Culturally diverse
groups often bear a disproportionately high burden
of disability resulting from mental disorders.This
disparity does not stem from a greater prevalence
rate or severity of illness in African Americans, but
from a lack of culturally competent care, and
receiving less or poor quality care.
For some disorders, such as schizophrenia and
mood disorders, there is a high probability of
misdiagnosis because of differences in how African
Americans express symptoms of emotional distress.
And while the rate of substance use among African
American is lower than other ethnicities, alcohol and
drugs are responsible for more deaths in the African
American community than any other chronic disease
in the U.S.
Cultural identity encompasses distinct patterns of
belief and practices that have implications for one’s
willingness to seek treatment from and to be
adequately served by mental health care providers.
More research must be done to better understand
mental health disparities and to develop culturally
competent interventions for African Americans.With
proper diagnosis and treatment, African Americans—
like other populations—can increasingly better manage
their mental health and lead healthy, productive lives.