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Here are some alarming science-based facts about African-Americans and the availability, accessibility, and their utilization of psychologists, and how the lack of Black psychologist in the profession has a negative impact on the mental health treatment of people of African descent. • African Americans are less likely to receive treatment than the undertreated White mainstream population. (Department of Health & Human Services, 2001) • African Americans ministers both inadvertently and intentionally act as gatekeepers and impediments to their congregation seeking professional mental health services outside of the church. (Veroff, Douvan, & Kulka, 1981; Neighbors, Musick, and Williams, 1998) • African Americans are more likely to be incorrectly diagnosed than White clients. (Klonoff, E. A., Landrine, H., & Ullman, J. B., 1999). • African Americans are more likely to receive treatment via emergency rooms and inpatient care. (Hu, Snowdwn, Jerrell, Nguyen, 1991) • African Americans are more likely to be coerced by family members or mandated by court-order into counseling. (Takeuchi & Chueng, 1998) • African Americans are more likely to receive adverse treatment because of possible racial bias. (Department of Health & Human Services, 2001). • African Americans are more likely to prematurely terminate counseling. (Sue, Fujino, Hu, Takeuchi, & Zane, 1991; Sue, Zane, & Young, 1994; Terrell & Terrell, 1981). • African Americans have lower expectations of White psychologists and counselors (Watkins and Terrell, 1988). • African Americans view White psychologists as less credible and less capable. (Watkins, Terrell, Miller, & Terrell, 1989) . • African Americans are less disclosing to White psychologists (Thompson, Worthington and Atkinson, 1994). • Mental health practices can be used as a form of cultural oppression against people of color (Sue & Sue, 2003). • African Americans are less likely to receive a Black psychologist for those who prefer one because only 1.8% of all psychologists are Black. Of that 1.8%, a smaller percentage, 0.5% (one-half of 1%) are Black male psychologists. (Townes, 2004; American Psychological Association, 2007). "When
seeking to explain differences between African Americans and whites, it
is important that researchers first consider the impact of black-white
demographic and socioeconomic differences. This is because disparities
found in research sometimes are attributable to differences in poverty
and marriage rates, regional distribution, and other population
characteristics. However, investigators often continue to observe
black-white differences after controlling for differences in social
status and demographics and must look elsewhere to explain their
findings. One of many possible explanations is racial bias:
African Americans might, under the circumstances being investigated,
be victims of adverse treatment because they are black."
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When four decades of research and psychology
literature suggest that Black clients generally prefer Black counselors (Wintersteen,
Mensinger, & Diamond, 2005;
Campbell & Alexander, 2002; Thompson, Bazile, & Akbar, 2004;
Speight & Vera, 1997; Okonji, Ososkie, & Pulos, 1996; Coleman,
Wampold, & Casali, 1995; Atkinson, 1985, 1983; Casas, 1984; Sue
& Sue, 1977; Harrison, 1975; Burell & Rayder, 1971; White, 1970;
Grier & Cobbs, 1968; Vontress, 1967), it creates a public
health dilemma when Black people are underrepresented in the mental
health profession and overrepresented in populations that have a high
need for mental health services. When
Black people need psychological help in a White-dominated society, the
race of their counselor can be a critical factor as to whether or not
they seek and receive help.
Black clients are more likely to receive mental health treatment
under emergency conditions, and under coerced and mandated conditions
rather than the preferred conditions that Whites receive treatment, like
voluntarily and self-referred (Hu, Snowdwn, Jerrell, Nguyen, 1991;
Takeuchi & Chueng, 1998).
Black people often have no choice but to be seen by providers
that they might not have chosen or preferred if given the chance to
select a mental health provider (Thompson Sanders, Brazile & Akbar,
2004).
Research also suggests that racism, racial biases, and
stereotyping done by therapists may account for mental healthcare
disparities found between Black and White clients.
Black clients were less likely to receive appropriate care for
anxiety and depression or newer antidepressant medications, and more
likely to be diagnosed with schizophrenia vs. affective disorders than
White clients (DHHS, 2001).
This mistrust of White people and white psychologists has deep
historical roots and is well documented throughout the psychology
literature.
Racism and discrimination exist against Black people across individual, institutional, and cultural levels, and place Black people at higher risk of mental disorders such as depression and anxiety (Clark, R., Anderson, Clark V. R., & Williams, 1999; Giscombé, & Lobel, 2005); Jones, 1997). The institutional disparities in mental healthcare for Black clients reflect the disparities present of the culture at large and may provide insight to the persistence of racial preferences. Over a half-century after legalized segregation ended, many Black Americans still live in geographical hypersegregation from Whites, and are exposed to high levels of family stress, concentrated effects of poverty, and violence (Bureau of Justice Statistics, 2005; Charles, 2003; Charles, Dinwiddie, & Massey, 2004; Denton, 1994; Emerson, Yancy, & Chai, 2001; Farley, 1991; Massey, 2001; Massey, Gross, & Shibuya, 1994; Wilkes & Iceland, 2004; Wilkes & Iceland, 2006; Wilson, 1987; U.S. Census Bureau, 2005). Racism and discrimination, in itself, may be perceived as more stressful for Black people and a unique source of stress for African Americans when compared to White Americans (Thompson Sanders, 2002). |
The
Black Client