title: Lives in isolation: stories and struggles of low-income African American women with panic disorder.
abstract: Research evidence points to the existence of racial-ethnic disparities in both access to and quality of mental health services for African Americans with panic disorder. Current panic disorder evaluation and treatment paradigms are not responsive to the needs of many African Americans. The primary individual, social, and health-care system factors that limit African Americans' access to care and response to treatment are not well understood. Low-income African American women with panic disorder participated in a series of focus-group sessions designed to elicit (1) their perspectives regarding access and treatment barriers and (2) their recommendations for designing a culturally consistent panic treatment program. Fear of confiding to others about panic symptoms, fear of social stigma, and lack of information about panic disorder were major individual barriers. Within their social networks, stigmatizing attitudes toward mental illness and the mentally ill, discouragement about the use of psychiatric medication, and perceptions that symptoms were the result of personal or spiritual weakness had all interfered with the participants' treatment seeking efforts and contributed to a common experience of severe social isolation. None of the focus-group members had developed fully effective therapeutic relationships with either medical or mental health providers. They described an unmet need for more interactive and culturally authentic relationships with treatment providers. Although the focus-group sessions were not intended to be therapeutic, the women reported that participation in the meetings had been an emotionally powerful and beneficial experience. They expressed a strong preference for the utilization of female-only, panic disorder peer-support groups as an initial step in the treatment/recovery process. Peer-support groups for low-income African American women with panic disorder could address many of the identified access and treatment barriers.
authors.affiliation: Adjunct Associate Professor of Psychiatry, Medical University of South Carolina, Charleston, SC, USA. dokterj@gmail.com
authors.forename: Michael
authors.initials: M
authors.lastname: Johnson
authors.forename: Terry L
authors.initials: TL
authors.lastname: Mills
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Deleon
authors.forename: Abraham G
authors.initials: AG
authors.lastname: Hartzema
authors.forename: Judella
authors.initials: J
authors.lastname: Haddad
mesh_terms: D001741:Black or African American / Q000208:ethnology* / Q000523:psychology; D005260:Female; D017144:Focus Groups / Q000379:methods; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D054624:Health Status Disparities; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D016584:Panic Disorder / Q000191:economics* / Q000208:ethnology* / Q000523:psychology; D011203:Poverty / Q000191:economics / Q000208:ethnology* / Q000523:psychology; D012657:Self-Help Groups / Q000191:economics; D012934:Social Isolation / Q000523:psychology; D012959:Socioeconomic Factors
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