The experience of Black consumers in the mental health system--identifying barriers to and facilitators of mental health treatment using the consumers' perspective.
Research has shown that relative to Whites, Blacks are less likely to seek outpatient mental health treatment and more likely to seek emergency services. Furthermore, Blacks often terminate treatment prematurely. The goal of the present study was to identify barriers to and facilitators of mental heath treatment among Blacks who have a documented need for mental health services. Thirty-four Black mental health consumers were interviewed for this purpose. Comments were categorized into four main categories: (a) barriers to treatment, (b) treatment facilitators, (c) recommendations for improvement of services, and (d) advice to potential consumers. The most common barriers were the importance of family privacy, lack of knowledge regarding available treatments, denial of mental health problems, and concerns about stigma, medications, and treatment. Participants also reported system barriers, such as not receiving appropriate information about services or receiving inadequate, dehumanizing services. Acknowledging the need for mental health services, having a supportive environment, and positive past treatment experiences were identified as treatment facilitators. Community outreach, adequate follow-up, and coordination of services also were important messages delivered by consumers. The results of this study indicate the importance of educating the general public, not just mental health consumers, about the nature of mental illness and available services.
School of Social Work, Bar Ilan University, Ramat Gan, Israel 52900. ayalon@mail.biu.ac.il
Liat
L
Ayalon
Jennifer
J
Alvidrez
D000328:Adult; D001741:Black or African American / Q000193:education / Q000208:ethnology*; D001294:Attitude to Health / Q000208:ethnology*; D003219:Confidentiality; D003717:Denial, Psychological; D005260:Female; D006272:Health Facility Environment / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006287:Health Planning Guidelines; D006297:Health Services Accessibility / Q000458:organization & administration*; D054625:Healthcare Disparities / Q000458:organization & administration*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D020380:Needs Assessment / Q000458:organization & administration; D015404:Nursing Methodology Research; D011287:Prejudice; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012495:San Francisco; D012944:Social Support; D013240:Stereotyping; D011795:Surveys and Questionnaires; D013597:Systems Analysis