CRHIP: Mental Health in the U.S. especially among African American Men

Abstract

This Cultural Relevant Health Intervention Project (CRHIP) addresses the critical issue of mental health among African American men in the United States, a demographic significantly impacted by mental health disparities. The project focuses on the role of culture in shaping perceptions, attitudes, and responses to mental health challenges within this community. African American men often face unique cultural barriers, including stigma, mistrust of healthcare systems, social norms around masculinity, and historical trauma, which deter them from seeking mental health services. The proposed intervention is rooted in cultural understanding and aims to bridge this gap by integrating traditional cultural practices with contemporary mental health approaches. This involves using community-based resources such as faith leaders and peer networks to foster a supportive environment that encourages mental health discussions and reduces stigma. This approach is deemed appropriate due to its direct engagement with the cultural roots of the problem and its alignment with evidence suggesting the effectiveness of culturally sensitive healthcare practices. The intervention's success is anticipated based on similar initiatives that have shown positive outcomes in enhancing mental health service utilization among ethnic minorities. This study shows that the cultural nuances and barriers specific to African American men can be addressed, and this CRHIP aims to do just that.

Introduction

Mental illnesses are among the most prevalent health problems in the United States (CDC, 2023). Statistics show that 20% of adults live with mental health disorders and more than 20% of 13-18-year-olds are living with or have lived with a devastating mental illness at some stage in their lives (CDC, 2023). At the same time, 4% of U.S. adults have severe mental health disorders, such as major depression, bipolar disorder, or schizophrenia (CDC, 2023). The prevalence of mental illness in African Americans is comparable to other ethnic groups. For example, 21.4% of African Americans, 20.7% of Hispanics/Latinos, and 23.9% of Whites live with mental health problems (CDC, 2023).

Yet, even though African Americans have equal rates of mental illness as other ethnicities, contextual differences exist (DeAngelis, 2021). For example, African Americans who live below the poverty line are two-fold more likely to have severe psychological distress than those with financial stability (DeAngelis, 2021). Plus, among Blacks, men are not getting the assistance they need for mental health conditions (DeAngelis, 2021). Notably, only 26.4% of 18-44-year-old African-American and Hispanic men living with anxiety and depression used mental health services, compared to 45.4% of White men with similar illnesses (DeAngelis, 2021).

Various cultural factors affect Black men's likelihood of seeking mental health services from healthcare professionals. Contributing factors include seemingly intractable systemic racism, diminished socioeconomic status, increased social isolation, economic stressors, lack of access to care, and the lingering impacts of the pandemic (Bauer et al., 2020). Without adequate treatment and resources, mental health issues can severely reduce quality of life and lead to unemployment, disability, substance abuse, homelessness, and even suicide among the African-American male population. Bauer et al. (2020) revealed that African-American men chose to handle their issues alone rather than talk to professional mental health providers because others would see them as not man enough and unable to attain their success. This suggests that autonomously maintaining resilience is a cultural barrier against seeking mental health services among African American men. The preferred coping strategies in this community include friends and music (Bauer et al., 2020). When stressed, some play games with their friends, while others listen to music as therapy (Bauer et al., 2020).

Statement of the Problem

The problem of interest to this study concerns the increasing number of African-American men suffering from various mental health disorders (Adkison, 2023). The widespread prevalence of mental illness in general and among African American men in particular represents a severe public health crisis (Morton, 2022).

The proposed culturally relevant health intervention project (CRHIP) addresses mental health among African American men in the United States. The CRHIP is also essential because a past study revealed that the help-seeking behaviors of Black men are hampered by difficulty and inability to disclose personal stressors (Holden et al., 2012). In most cases, Black men fail to seek help because of traditional masculinity that considers obtaining treatment a weakness. The CRHIP seeks to address other culturally relevant matters, including mistrust and social or familial support (Holden et al., 2012).

The main problem is that traditional notions of masculinity, prevalent in many African American communities, often portray mental health struggles as a sign of weakness, discouraging men from seeking help. This cultural stigma is compounded by a general mistrust of the healthcare system, a vestige of historical injustices and ongoing disparities in healthcare delivery.

Political and socioeconomic factors also play a crucial role. Policies and funding priorities often fail to address or even acknowledge the specific mental health needs of African American men. Socioeconomic disparities, including access to healthcare, education, and employment opportunities, exacerbate mental health issues. These factors contribute to a cycle of mental health challenges that are inadequately addressed and often worsen over time.

There is a clear need for more targeted, culturally informed approaches that directly address the unique challenges faced by African American men in the realm of mental health. Thus, this paper proposes a CRHIP that is not only culturally sensitive but also deeply rooted in the specific cultural, political, and socioeconomic context of African American men.

Literature ReviewTop of Form

Today, African American males are among the populations at highest risk of mental health disorders in the United States, with about 21% likely to experience severe mental health conditions compared to the general population (BHC, 2023). While nearly one-quarter (23.9%) of white Americans report suffering from a mental disorder at some in their life, only about 39% of African Americans receive any mental health treatment compared to more than half (52%) of white Americans (BHC, 2023).

Cultural Factors Related to the Problem

Although multiple healthcare and socioeconomic disparities are likely responsible for this disproportionate representation, at least to some extent, racial discrimination and the cultural stigma that is associated with mental illness and those seeking assistance contribute to higher risks among the African-American male population (Shannon et al., 2022). Several cultural and social factors can discourage African-American males from seeking help for mental health disorders (Airhihenbuwa & Webster, 2004). Indeed, powerful stigmas surrounding mental health issues frequently translate into notions of individual weakness or failure, which can discourage African-American males from reaching out for assistance (Foster, 2018).

Cultural Factors that Prevent Black Men from Seeking Help

In the African-American community, various cultural factors prevent men from seeking help for mental illness. Bauer et al. (2020) reported that Black men prefer handling their issues alone rather than going for professional mental health providers because others would disgrace them as not man enough and unable to attain success. This suggests the need to develop health interventions embedded in Black men's social and cultural settings. Airhihenbuwa and Webster...

Evaluation

The evaluation of the proposed intervention, adapted from the Sisters Informing Sisters about Topics on AIDS (SISTA) program to address mental health issues among African American men, involves assessing its potential effectiveness based on research of similar existing projects. This evaluation considers various factors, including cultural relevance, community engagement, and the success of peer-led models in similar contexts.

Cultural Relevance and Community Engagement

The original SISTA program's success can be attributed significantly to its cultural relevance and community-based approach, which are critical factors in the proposed intervention. Research indicates that culturally tailored health interventions are more effective in engaging and retaining minority populations in health programs. Incorporating culturally relevant materials and activities, and involving community leaders and members in the intervention, can help the program to resonate more deeply with African American men, thereby increasing its effectiveness.

Peer-Led Model

The peer-led aspect of the SISTA program, which is retained in the adapted intervention, has been shown to be effective in various health interventions. Studies have demonstrated that peer-led interventions can lead to significant improvements in health knowledge, attitudes, and behaviors. The peer-led approach fosters trust and relatability, which are crucial in addressing sensitive issues like mental health, especially in communities where stigma may be prevalent.

Impact on Stigma and Mental Health Outcomes

The intervention's focus on reducing stigma and encouraging open discussions about mental health is supported by research indicating that stigma reduction is key to improving mental health outcomes in African American communities. Creating a safe and supportive environment for discussing mental health, will help the intervention to encourage more men to seek help and adhere to treatment.

Training in Cultural Competence

Incorporating cultural competence training for mental health workers, as part of the intervention, aligns with findings that such training improves provider-patient communication and increases patient satisfaction and adherence to treatment in culturally diverse populations.

Community Collaboration

The strategy of involving community leaders and groups in the intervention is supported by evidence suggesting that community engagement is crucial for the success and sustainability of health interventions. This collaboration ensures that the intervention is not only culturally appropriate but also enjoys community support, enhancing its potential for long-term success.

Conclusion

The proposed intervention, adapted from the Sisters Informing Sisters about Topics on AIDS (SISTA) program, is designed to address mental health issues among African American men. This intervention is a culturally tailored, community-engaged, and peer-led initiative that aims to reduce stigma, enhance mental health awareness, and improve access to culturally competent mental health care. The role of culture is central to this intervention, as it seeks to resonate with the specific cultural, social, and historical experiences of African American men. The intervention's design incorporates several key elements: culturally relevant materials and narratives that reflect the lived experiences of African American men, the involvement of male mentors or peer leaders who can relate to and effectively engage with the target population, and the creation of safe spaces for open discussions about mental health. Additionally, the intervention includes training for mental health professionals in cultural competence, ensuring that they are better equipped to understand and meet the unique needs of African American men. The inclusion of cultural competence training for mental health workers is expected to enhance the quality of care provided and improve patient-provider relationships, leading to better health outcomes. Finally, the collaboration with community leaders and groups ensures that the intervention…