Why is there a sigma of mental health in the African American community

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Everyone is susceptible to the development of mental health regardless of race, color, gender, or identity. More than half of the citizens in the United States are recognized with a mental illness in their lifetime, and African Americans are at higher risk of developing a mental illness due to limited resources and other barriers. The challenge is further enhanced in the community due to a stigma prevailing in the group that prevents most members from seeking medical help. The lack of knowledge about mental illness calls for increased awareness of the challenge, especially when the condition is viewed differently from other physical diseases. The significant impacts of mental illness in the African American demography makes it a healthcare issue and calls for further consideration of the condition as more social workers are needed to work with the community to address the issue. The barriers to knowledge and access to medical assistance among African Americans take center-stage in this paper.

Introduction

Mental health conditions have effects regardless of race, color, gender, or identity. Anyone can experience the challenges of mental illness regardless of their background. Although we are similar, your experiences and how you understand and deal with these conditions may be different. Anyone can develop a mental health problem, but African Americans sometimes experience more severe forms of mental health conditions because of limited resources and other barriers. African Americans are twenty percent more likely to have severe psychological distress than Whites are. Also, African Americans and other minority communities are more likely to have similar experiences, such as barriers from health, educational, social, and economic resources because of cultural and societal factors. These may contribute to worse mental health outcomes. More than half of the people in the United States are being recognized with a mental illness in their lifetime; however, now not everybody will acquire the assistance they need. Even though mental illness is common and might affect everyone, there is still a stigma attached. This stigma creates shame in seeking help, especially in the African American community. The understanding of mental illnesses has come a far way from where it used to be, but improvements have to make. Mental illnesses should not be viewed any differently from physical diseases. I believe the two are very similar. When the mind is ill, it is not just the brain, but it has effects on the whole body and health overall. Substance abuse, self-damage, and suicide are widespread and dangerous in people with mental illness. The stigma connected to mental illness stops people from getting the assistance they need and causes them to cover their pain. Clinically trained social workers are the nation’s largest group of mental health service providers. (Staff, 2016). This is important to social work because social workers push the conversation of mental health forward. Many social workers in the field are first responders to most mental health claims. Also, the stigma of mental illness in the African American community has to change, and social workers can be the driving force of a new outlook of mental health. This navigates towards a better view of mental health. It is important to understand how we got to this point. Though this text will discuss the following, what is mental illness, historical information of mental health in the African American community, barriers to mental health in the African American community, also the perspective African Americas have on mental health.

Literature Review

WHAT IS MENTAL ILLNESS

Mental illness is a general term referring to all mental health conditions that involve changes in emotions, thinking, interaction with other people, and behavior in a person. The changes can be caused by different factors, such as genetics, daily habits, environment, biology, and life experiences (McNally, (2011).). Mental illness is diagnosed and treated like any other physical disease. They often lead to significant distress and can alter the ability of a person to function. For a person to be considered as mentally ill, their social, educational, or occupational functioning must have been affected. Daily experiences where one encounters some stressing moments should not be considered like mental illness. When the effects or symptoms are prolonged, though, it has to is treated as a mental illness case. Mental illness includes many types of mental health problems. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the following classes of mental illnesses are found; bipolar and related disorders, neurodevelopmental disorder, depression, schizophrenia spectrum, psychotic disorders, trauma-related disorders, eating disorders, sexual dysfunction, personality disorders, elimination disorders, somatic symptom and related disorders, sleeping and waking disorders, gender dysphoria, paraphilic disorders, substance-related and addictive disorders, neurocognitive disorders, and disruptive, impulse-control and conduct disorders. Some definitions are found below:

Depression: has been one of the most common mental disorders. It is estimated that about 300 million people in the world are affected by depression. As compared to men, more women are more prone to depression. A chronic type of depression is a persistent depressive disorder, also known as dysthymia. A person with this disorder might experience symptoms for up to two years. In America, about 1.5 percent of adults are said to experience dysthymia each year. Clinical depression, also called major depressive disorder, is experienced through extreme sadness, feelings, and hopelessness. People experiencing clinical depression might think about or attempt to commit suicide. Seven percent of Americans are said to experience at least one major clinical depression episode per year. Depression may be characterized by displeasure, sadness, guilty feelings, and low self-worth, poor concentration, tiredness, disturbed appetite, and disturbed sleep. Depression is treatable through therapy and the use of antidepressants for severe cases.

Schizophrenia: is a psychosis mental disorder that affects how a person perceives reality. It is characterized by distorted thoughts, language, behavior, and sense of self. Everyday experiences may include hallucinations whereby they hear, see, and feel things that do not exist, and delusional with false beliefs and suspicions firmly held on to when there is really nothing. In the world, it affects 23 million people, while in America, about 1 percent of the population is estimated to have schizophrenic experiences. Persons experiencing schizophrenia may experience stigma and discrimination hence resulting in a lack of access to health or social services. They’re also at high risk of being exposed to human rights violations leading to being confined in institutions for a longer time. It can begin from as early as adolescence or in young adults. Schizophrenia is treatable with appropriate medicines as well as psychosocial support.

Bipolar affective disorder: is a mental illness that is characterized by manic and depressive episodes with an in-between of regular mood periods; a person with bipolar disorder experiences episodes of manic highs, energetic, and depressive lows. The person’s energy levels are affected, elevated moods, the pressure of speech, decreased need for sleep, inflated self-esteem, and they cannot reason. Bipolar disorder causes extremely severe mood swings, which are not comparable to the small ups and downs experienced daily. Bipolar disorder affects 60 million people in the world, while in America, about 2.6 percent of the people are affected yearly. Medicines to stabilize the moods are used for treatment during the acute phase and to prevent relapse.

Development disorders: these include pervasive developmental disorders such as autism and intellectual disability. They usually begin during childhood but can continue into adulthood, resulting in delayed functions in relation to the maturation of the central nervous system. As compared to other mental health illnesses, developmental disorders are characterized by following a steady course as opposed to occurring in periods. The primary characteristic is the impairment of skills in developmental areas such as adaptive behavior and cognitive functioning. In autism, there is impaired communication and language, social behavior, and carrying out activities repetitively. Persons affected by these disorders need the support of family in setting up environments that they are comfortable and setting daily routines that are not disrupted as well as identifying where they can learn better.

Dementia: is the result of deterioration in cognitive function, the processing of thoughts, which is more than what is expected as one age normally. It usually affects one’s ability to comprehend, remember, calculate, learning, language, and judging. These impairments lead to a lack of emotional control, deteriorated social behavior, and motivation. Stroke can contribute to dementia.

Anxiety disorder: is the type of disease that is more than usual anxiety experienced on a daily basis. A person with this condition tend to worry about many things, sometimes with no reason to worry at all. People with this condition are often afraid that things will never work out in their favor.

Post-traumatic stress disorder (PTSD): is a mental illness that results from one experiencing traumatic events in their lives. These experiences can range from war or national disasters to physical or verbal abuse.

Common signs of other mental illnesses may include: having insomnia or too much sleep, depriving oneself of food or overeating, feelings of fatigue without doing much, numbness, experiences of unexplainable pains in the body, feelings of hopelessness, indulging in drinking, smoking, or drug abuse, feelings of confusion, irritability, anxiety, anger, and forgetfulness. These symptoms help the physicians to come up with a diagnosis so as to give the right treatment.

Mental illnesses treatments are aimed to reduce the symptoms while making the condition to be manageable. It may include medications such as antidepressants, anti-anxiety, mood-stabilizing, and antipsychotic drugs. Psychotherapy, hospitalized care, and lifestyle treatment is other forms of treatment.

HISTORICAL INFORMATION OF MENTAL HEALTH THE AFRICAN AMERICAN COMMUNITY

According to the 2014 U.S. Census, 13.2 percent of the U.S. population is African Americans, which is roughly 45.7 million people. However, these figures might not be accurate due to the overrepresentation of people who are hard to find during the census. Those who are homeless are many African Americans, whereas some just decline is participating in the poll.

African Americans trace back their ancestry to the slave trade from Africa. For a period of more than 200 years, millions of them were purchased and brought to the west. When slavery ended in the early 1800s, their economy activities relied heavily on agriculture, with most of them being sick. They were exploited and remained at the bottom of the economic ladder as most African Americans were sharecropping. They continued to live in poverty with meager incomes and little or no opportunity for betterment. The African American community has tried to make changes to the fights for social and economic justice, but however, there still exist disparities in mental health issues. African Americans suffer more increased rates of mental illnesses. Historical adversities including slavery, sharecropping, racial based exclusion from health services, exclusion from education, and differences in social and economic resources, which translates into disparities in the socioeconomic status (Jones, (1998)). These differences automatically turn into the causes of mental illnesses among African Americans. Homeless people and those in prisons have a higher chance of suffering from mental illnesses too. Racism continues to impact mental health conditions and has done so for generations, and it is yet to be addressed. Psychiatrists and medical professionals have been engaging in misdiagnosis through exploiting African Americans by specific mental illnesses hence prolonging the problems. Some mental diseases could be used to suggest that African Americans were inferior compared to other races.

John Galt, a physician of the Eastern Lunatic Asylum in Virginia in 1848, referred to African Americans as being immune to mental illness because they do not own property, engage in business, vote, or hold office. He assumed that in the time when wealthy white men were being exposed to the emotional stress of profit-making. Mental illness has been in existence in a long time, but for African Americans, little about the condition has been available. According to Dr. Benjamin Rush, many of the people in slavery experienced abnormal behaviors, one of which was “negritude,” a desire by the African Americans to become white. Drapetomania is another mental health condition that caused slaves to run away from their plantations. Dysesthesia, which is now depression was a disease that caused dullness in the slaves. Severe beatings and abuse were often used to treat both conditions, according to Dr. Samuel Cartwright. He also believed that the slaves had to be treated like children by their owners in order for them to remain submissive. However, both physicians failed to recognize that it was the emotional stress causing the conditions and therefore offer the appropriate medication. Mental health facilities during the pre-civil war barred slaves from receiving treatment. The mental health experts believed that if the African Americans were put together with the whites, they would affect the white’s healing process. The African Americans were therefore housed outside near the institutions. Some child slaves were, however, cared for in the yards of those asylums. They were, however, misdiagnosed and often falsely accused of crimes, which led to prolonged stays in the institutions. The distrust of the healthcare system might have started here since the children were regularly being subjected to child labor, which was being praised by the authorities of the asylum. There is no way they could carry out manual work if they were mentally ill. After the Civil War led to the freedom of almost four million slaves, there were increased cases of insanity and consumption, which Dr. Powell of the Georgia Lunatic Asylum argued that it was due to the freedom accorded to them that is why they could not control their appetites or passions thus leading to increased vices. Like other medical experts, he also failed to acknowledge that socioeconomic factors such as poverty and racial discrimination could be leading to those improved conditions. Individuals with mental illnesses, and the inadequate faced sterilization in the 1920s as they were seen as unfit for reproduction. Eugenics movement is what resulted in this. They only wanted people who had good genetic stock to give birth. Sterilization focused on African Americans in the U.S., with their populations decreasing due to the practice. States passed laws for sterilization, even for the misdiagnosed individuals. In the 1960s in North Carolina, sterilized African American women were more than 85 percent of the legal sterilizations. During the 1930s to 1960s, African Americans were victimized through psychosurgery, which is a surgical process of removing a part of the brain (lobotomy) in order to treat mental illnesses. The reasons for performing this procedure were, however, ruled to be socio-political rather than medical. Brain dysfunction was believed to be the cause of widespread violence in urban places and the inner city, hence psychosurgery was viewed as the treatment. Social scientists, however, saw the urban violence as reactions due to poverty, oppression, discrimination, and police brutality against African Americans (Fink, & Tasman, (1991)). The doctors argued that the brain disorder could be treated surgically hence promoting their agenda in trying to end the political unrest in that period. The procedures were performed on children who were even five years when they show aggressive behaviors. Two New York psychiatrists identified a condition known as protest psychosis in 1968. The situation was said to drive “Negro men” to insanity. They believed that African American liberation caused delusions and hallucinations in African American men. Later, they identified protest psychosis like schizophrenia, and today African American men are the ones diagnosed with schizophrenia mostly. Psychology and science show that African Americans were exploited through medical experiments. In the 1800s, a physician by the name Marion Sims carried out surgical experiments on female African slaves and infants without using anesthesia on them. They were used to carry out medical research and mostly died from the tests. From 1932 to 1972, African American men were used in the Tuskegee Experiment by the U.S. Public Health Service. They were made to believe that they were being treated for free, but they were being experimented on to study how untreated syphilis progresses. It resulted in most of them dying from the disease and passing it on to their unborn children. These historical traumas have impacted the mental health in the African American community.

BARRIERS TO MENTAL ILLNESS IN THE AFRICAN AMERICAN COMMUNITY

Several barriers contribute to mental illnesses in the African American community. Racial bias plays a significant role since they are always perceived as violent, and therefore, when they get involved in criminal activities, no one really cares to help them. When a white person is involved in illegal activities such as mass shootings, there is speculation that he is mentally ill. Mental illness doesn’t discriminate; it affects all people despite their color. Mental illnesses can affect African Americans more severely because of unmet needs and the other barriers they face. They face cultural barriers, religious barriers, and language barriers. When they deal with these barriers, they are denied their right to treatment since mental illnesses are diseases like any other physical disease. Some of the issues they are facing in dealing with mental illnesses are.

Misunderstanding of mental illness

African American community does not understand what mental health is and does not talk about the topic. Coping with mental illnesses like depression is considered a spiritual or moral weakness due to negative stereotypes and attitudes of rejection. The lack of knowledge might lead some to believe that mental illness is a punishment from God. Therefore, the shame and stigma associated with mental illnesses might make some of them not to seek treatment. The signs and symptoms associated with mental illnesses might not be clear to all of them. Hence it can go unrecognized. Some of them refer to depression as “the blues,” and they think that it is something they can control. The lack of information makes them not aware of when to seek help. Studies show that 63 percent of African Americans believe that depression is a personal weakness, with only 32 percent finding that it is a health problem. Six percent believe that it is normal in aging for one to be depressed. Forty percent believe it is normal for a partner to get depressed for more than a year after losing their spouse to death, while 45 percent believe that it is normal for a mother to get depressed after giving birth for at least two weeks.

Reluctance for treatment

Only a quarter of African Americans, which accounts for about 30 percent of adults, willingly seek treatment for mental illnesses as compared to about 40 percent of whites who receive treatment in America per year. The barrier to treatment is due to factors such as denial when one does not accept that they might be dealing with a mental health condition. Another factor is some don’t want help. Some people might feel embarrassed or ashamed, and since they fear to be labeled as weak in the community, they decide not to seek advice concerning the conditions. Lack of money or insurance is another factor why some cannot receive treatment. Hopelessness also can contribute to one being reluctant to seek help. African Americans distrust the health system due to past misdiagnoses. They are negatively affected by discrimination in the system hence receiving the inadequate treatment most times. The lack of cultural competency prevents many of them from staying without treatment. Studies also show that medications are metabolized slowly in African Americans, and since they receive high doses, the adverse side effects are more, therefore, discouraging them from continuing with medication.

Inability to access mental health services

Many African Americans are not able to access mental health care due to a lack of health insurance or money. Eleven percent of African Americans lack any form of health insurance as of 2017. The percentage of people who are unable to get treatment or prescribed medicine is high for people with no health insurance. In the poor working category, the most significant representation is African Americans, and they do not qualify for public coverage, and the jobs they work in do not offer private coverage. Poverty is also a contributor since it increases the chances of being mentally ill. The people experiencing hunger, homelessness, and lacking basic needs are more prone to mental health disorders such as depression and even engaging in the use of drugs. According to the U.S. Census Bureau of 2014, the poverty rate for African Americans was 26.2 percent. Poverty contributes highly to mental health issues.

Faith, spirituality, and community

In the African American community, religion, family, and community are the most significant sources of support. At least 85 percent of African Americans consider themselves religious. Research shows that they rely on faith, social communities, and families for emotional support, with most commonly turning to prayer to deal with stressful moments instead of seeking health care, which most times is necessary (Taylor, Chatters, & Levin, (2003)). As much as these spiritual beliefs are excellent sources of support, it can be a hindrance to receiving professional treatment or therapy. Faith, family, and community can help in the process of recovery, but it should be accompanied by other treatment forms. Since spirituality is an integral part of their lives, they can actively help in the treatment plan. If they lack information about mental illnesses, though, they can be a source of stigma instead of support.

Racism

Racism continues to impact the mental health of African Americans. There have been several historical instances of adverse treatments leading to mistrust. In the slavery era, if one displayed mental illness signs, they would receive more beatings, which led them to hide or disguise any psychological issue they might have. Myths have, therefore, been created about mental health conditions. African Americans also believe that if their people made it through slavery, they can make it through anything, hence no need to take their problems to some stranger/psychiatrist.

Provider bias and lack of cultural competency

Lack of cultural competence in providers leads to misdiagnosis and poor quality of treatment for African Americans. In African American women, physical symptoms such as body aches and pains are mentioned as part of the depression, but since the provider is not competent with the culture might not recognize it as a mental illness symptom hence leading to misdiagnosis (Metzl, (2010)). African Americans only make up 3.7 percent of members in the American Psychiatric Association, with only 1.5 percent of members in the American Psychological Association.

Violence

African Americans witness or are victims of abuse and crimes. The exposure to violence increases their chances of being prone to suffering from PTSD, anxiety, and depression. Children who are exposed to violence experience long term effects of mental illnesses.

THE PERSPECTIVE AFRICAN AMERICANS HAVE ON MENTAL ILLNESS

Mental illnesses can affect anyone, regardless of color, race, or gender. The experiences and concerns, though, might differ. African Americans sometimes experience mental illnesses more severely because of the barriers they experience and are 20 percent more likely to develop severe problems of mental illnesses than other populations, as stated by Health and Human Services Office of Minority healthy. African American adults are three times more likely to get severe psychological distress as compared to those living above poverty (Breland-Noble, Al-Mateen, & Singh, (2016)). They are also more likely to experience sadness, feelings, worthlessness, and hopelessness as compared to white adults. African American teenagers commit suicides at a higher rate than white teenagers. Since African Americans are more prone to exposure to violence and crimes, they are more likely to be diagnosed with post-traumatic stress disorder (PTSD) throughout their lives. These statistics show that mental illnesses are more amongst the African American community, and it is essential for them to acknowledge the same in order to get treatment. Ward, Wiltshire, Detry, and Brown in 2013 conducted a study that shows that African American communities have several attitudes towards mental illnesses. African Americans believe that mental health is a stigma that leads to non-openness about the same. For example, they do not seek help, which leads to their behavior is affected. In the study, those who participated were reluctant to acknowledge mental health problems and not sure about seeking treatment for the same. The African American community relies on religious teachings, including pastoral guidance and prayer to cope with mental illnesses, and cultural lessons on the origins of mental health and the nature in which mental illnesses appear. Beliefs in a person about psychological diseases can influence their willingness to seek treatment or not. Therefore, cultural opinions on mental disorders are essential. Mental illnesses are viewed as:

Taboos

The stigma around mental illness in the African American community is a major taboo. Depression and anxiety, which can lead to suicide, are still treated as a taboo hence leading to no health treatment sought by those affected by the conditions.

Stigma

Stigma results when a person who has a mental illness is negatively evaluated by those surrounding them. In most cases, this is what happens in African American communities. The whole society suffers from perceived stigma where they view people with mental illnesses in a certain way. A common belief is that mental illness is one’s fault. Mental illness stigma generally develops from a lack of knowledge about mental health. The son believes of causes of mental illnesses being biological leads to passing down of misinformation from one generation to the other hence the continued lack of information concerning psychological disorders in the African American communities. Due to this misinformation, it might not be evident when one needs to find the required help.

Weakness and instability

The National Mental Health Association conducted a national survey in 1998, which indicated that 63 percent of African Americans believe that mental illnesses such as depression are an indication of personal weakness. Another study showed that some men believe that it is a lack of being motivated. African American adults who are older think that depression is a sign of weakness and one’s lack of inner strength. Clinical depression is not a personal weakness; however, but a medical illness that needs to be treated. Knowledge of mental illnesses needs to be increased so that the exposure can open up the African Americans’ minds on the issues of mental health.

Myths

Depression in African American communities is perceived as the “blues,” which means referring to life’s ups and downs. However, that is not the case because there are several moments of happiness and sadness in a person’s life (Neighbors, (1996)). It is normal to feel sadness during bad times, such as mourning, or when one is getting through a divorce, financial problems, or when sick. However, if the “blues” are prolonged, that is a sign of clinical depression that might go untreated if the myth is not changed. Another myth about depression is that some groups of African Americans are expected to undergo depression, for example, new mothers, teenagers, older people, women experiencing menopause, or the ones having chronic illnesses.

The mindset that they can survive anything.

African Americans, especially women, are expected to be active as identified in the idea of “strong black woman” and persevere anything they are going through. The concept of African American women being strong suggests that African American women are expected to go through all kinds of hardship without them breaking down, whether physically or mentally. The people believe that if their ancestors made it through slavery, they could also make it through anything, and they should take it to God in prayer instead of telling strangers/psychiatrists their problems. The mindset makes one seem as spiritually weak if they say that they are feeling sadness or anxiety. African Americans also believe that it doesn’t exist amongst them, or those are not their type of concerns. A study conducted for 18 months showed that African Americans emphasized on non-biomedical interpretations of signs and symptoms of mental illnesses. The psychiatric medication was viewed as frustrating due to the professionals’ medication focus. These cultural stereotypes lead to African Americans to denying emotional problems.

Methodology

Mental health stigma is a negative evaluation for people with mental health illness and/or mental health treatment. It can be received in specific categories, such as perceived stigma and personal stigma. Perceived stigma is a mental health stigma where one believes that society has a particular perception of mental health patients. Its stigma is an individual’s belief in people with mental illness. Stigma mental health in the African American community is built on the grounds of personal stigma where an individual focuses on their own beliefs on mental health. These categories of individuals with mental health are never willing to undergo any procedural treatment. In most cases, personal stigma denounces the thought of getting treated until the disorder nearly incapacitates. Within the African American regions, the problem is pronounced by the fact that members of a particular ethnic minority group are less likely to seek health treatment. (Corrigan, 2015). Getting to the task to understand the effect of prevalent stigma helps determine the dangers of the illness. Some individuals never recover due to their own fault. Most of the African American beliefs can result in an assortment of negative results for those with health illness. Such effects include; inadequate and unsafe housing, low employment, and even a reduction in the utilization of mental health care. People with personal stigma play a more significant role in the development of mental health stigma in the African American communities. One of the most researched health topics associates some factors to health stigma in relation to ethnic minorities is lack of knowledge. Different misinformation on the illness has led to varying levels of stigmatization. Few African Americans believe in the genetic sources as a psychiatric source of the problem. The biological causes are related to beliefs whose probability will not add up for an individual with any kind of mental health illness and is an African American. It is, however, researched that culture among the Latino population has lessened the effect of stigma. There is more will and power to attend any institution of health in order to check for the issue of mental health as for the acculturated individuals. Stigma reduction may be due to information and acquisition of knowledge on disorders related to mental health. Creating familiarity with different causes of mental health treatment reduces mental health stigma among African Americans by a high percentage. The ECA (Epidemiologic Catchment Area) of the 1980s sampled citizens of Baltimore, St. Louis, Durham-Piedmont, Los Angeles, and New Haven and assessed both the community at large and institutions which includes mental health hospitals, jails, residential drug or alcohol treatment facilities, and nursing homes (Robins & Regier, 1991). Overall, it included 4,638 African Americans, 12,944 whites, and 1,600 Hispanics. A current look at the NCS (National Comorbidity Survey), covered a representative sample of people residing inside the network that protected 666 African Americans, 4,498 whites, and 713 additional U.S. Citizens (Kessler et al., 1994). Participants of both studies discussed whether or not they had signs of frequently diagnosed mental disorders within the past month, year, or at any time in the course of their lives. Results for certain disorders are provided in Figure 1. After analyzing demographic differences among African Americans and whites, the ECA discovered that African Americans have been much less probable to be depressed and more likely to be affected by phobia than have been whites (Zhang & Snowden, 1999). The NCS findings additionally suggest that African Americans were less likely than whites to be affected by the main despair.

Figure 1: Results of the ECA and NCS Studies of Mental Health Care for African Americans.

Source: Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General. Office of the Surgeon General (US); Center for Mental Health Services (US); National Institute of Mental Health (US). Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2001 Aug.

The studies displayed gender differences in rates of mental illness. Anxiety disorder, prevalence rates of depression, and phobia were found to higher in African American women than in African American men. These differences paralleled those found for white women and men. Lack of knowledge creates anxiety and further frustrates the situation, thus worsening. Individuals in such a case usually experience interpersonal stress, and this means that individuals who are suffering from this medical condition experience a lot of fear of anxiety on mental illness. (Thompson, 2004). Ethnic bias manifests and maintains the alarms by putting up a belief that one group is superior to another or otherwise and, therefore, should not meet or instead collaborate. Racial biases have increased anxiety and thereby increasing the mental health problem occurrences amongst African Americans. African Americans are usually less willing to treat medical conditions. People with anxiety often have less affinity to relationships due to established myths and concerns, thereby leading to mistrust. Within the American states, the fears are much developed by the fact that mental health is associated with the term crazy or somewhat illegal drug use. Research shows that the minority ethnic groups were reported to be visiting a psychotherapist but with fewer results due to the already formed opinions: discrimination, unwillingness, and the inability to comprehend life circumstances and not based on color. Many in the African American community, the story is one of resilience and perseverance. Since we survived slavery, of course, we can handle “sadness” or “anxiety.” With this outlook, anything less would be considered moral or spiritual weakness. Part of the issue is that we often fail to recognize that mental illness is much more than feeling anxious or melancholy. We fail to realize mental disease as an “illness,” as we would cancer, diabetes, or high blood pressure.

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