title: Barriers to treatment among African Americans with obsessive-compulsive disorder.
abstract: African Americans are underrepresented in OCD treatment centers and less likely to experience a remission of symptoms. This study examines the barriers that prevent African Americans with OCD from receiving treatment. Seventy-one adult African Americans with OCD were recruited and administered the modified Barriers to Treatment Participation Scale (BTPS) and the Barriers to Treatment Questionnaire (BTQ). Comparing the BTQ between a European American Internet sample (N=108) and the African American OCD sample (N=71) revealed barriers unique to African Americans, including not knowing where to find help and concerns about discrimination. A Mokken Scale Analysis of the BTPS in the African American participants identified seven major barriers, including the cost of treatment, stigma, fears of therapy, believing that the clinician will be unable to help, feeling no need for treatment, and treatment logistics (being too busy or treatment being too inconvenient). Pearson and point-biserial correlations of the scales and demographic and psychological variables were conducted. Significant relationships emerged between age, gender, income, education, insurance status, and ethnic affirmation/belonging among several of the Mokken scales. A one-way ANOVA demonstrated that concerns about cost were significantly greater for those without insurance, versus those with public or private plans. Suggestions for overcoming barriers are presented, including community education, affordable treatment options, and increasing cultural competence among mental health providers.
authors.affiliation: University of Louisville, Department of Psychological & Brain Sciences, Louisville, KY 40292, United States. m.williams@louisville.edu
authors.forename: Monnica T
authors.initials: MT
authors.lastname: Williams
authors.forename: Julian
authors.initials: J
authors.lastname: Domanico
authors.forename: Luana
authors.initials: L
authors.lastname: Marques
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Leblanc
authors.forename: Eric
authors.initials: E
authors.lastname: Turkheimer
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000208:ethnology / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology; D055815:Young Adult