Lives in isolation: stories and struggles of low-income African American women with panic disorder.
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.
Johnson
Michael
M
Adjunct Associate Professor of Psychiatry, Medical University of South Carolina, Charleston, SC, USA. dokterj@gmail.com
Mills
Terry L
TL
Deleon
Jessica M
JM
Hartzema
Abraham G
AG
Haddad
Judella
J
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
Ment Health Serv Res. 2002 Sep;4(3):123-30
12385565
Int J Qual Health Care. 1996 Oct;8(5):499-504
9117204
Am J Public Health. 2003 Feb;93(2):239-43
12554576
Health Soc Work. 1998 May;23(2):146-52
9598397
Arch Gen Psychiatry. 2005 Mar;62(3):290-8
15753242
Psychiatr Serv. 2007 Dec;58(12):1547-54
18048555
Arch Gen Psychiatry. 2001 Jan;58(1):55-61
11146758
Ethn Dis. 1996 Winter-Spring;6(1-2):167-75
8882845
Community Ment Health J. 1999 Dec;35(6):515-30
10863988
J Health Care Poor Underserved. 2008 Aug;19(3):874-93
18677076
Am J Psychiatry. 1993 Mar;150(3):465-9
8434663
Cult Med Psychiatry. 1997 Sep;21(3):337-63
9352168
Soc Sci Med. 1988;26(12):1245-59
3206246
J Gen Intern Med. 1997 Jul;12(7):431-8
9229282
Hosp Community Psychiatry. 1992 Jan;43(1):61-4
1544652
J Gen Intern Med. 2000 May;15(5):284-92
10840263
BMJ. 2000 Jan 8;320(7227):114-6
10625273
J Am Acad Nurse Pract. 1996 Feb;8(2):53-9
8788738
Psychiatr Serv. 1999 Mar;50(3):362-8
10096640
Psychol Med. 2005 Mar;35(3):317-27
15841868
Cult Med Psychiatry. 2001 Sep;25(3):297-316
11680477
J Natl Med Assoc. 2007 Apr;99(4):428-38
17444433
Hosp Community Psychiatry. 1994 Aug;45(8):798-803
7982696
Cult Med Psychiatry. 1998 Jun;22(2):231-44
9693876
Am J Public Health. 1994 Feb;84(2):222-6
8296944