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Researchers have documented health disparities for African American and other youth of color in the area of mental health. In accordance with calls for the development of innovative methods for use in reducing these disparities, the purpose of this article is to describe the development of an evidence-based intervention targeting the use of psychiatric clinical care by African American families. The authors summarize current research in the areas of perceived and demonstrated bias in the provision of mental health services, the significance of the problem of low African American participation in psychiatric clinical research and care, and evidence-based approaches to conducting family-oriented research to address adolescent mental illness in this population. This discussion is followed by a description of the development of an intervention to improve familial treatment engagement and plans to test the intervention. The article is provided as a foundation for carefully defined plans to address the unmet mental health needs of depressed African American adolescents within a culturally relevant familial context. Recent research suggests that African American and other adolescents of color face grave disparities compared with their White counterparts in the burden experienced by mental illness and in the appropriateness of indicated behavioral and pharmacological treatments for psychiatric illnesses (Breland-Noble, 2004; U.S. Department of Health and Human Services, 2001). Specifically, recent research indicates that African American youth with mental health and behavioral problems in the foster care system, and therapeutic foster care specifically, have a greater likelihood of involvement with the juvenile justice sector and in-home counseling and crisis services. Further, recent research suggests that African American youth are Keywords

The authors describe and illustrate means of engaging depressed African American adolescents in treatment. Twenty-eight youth participated in focus groups or individual interviews. Using grounded theory and transcript based analysis, they derived 5 themes describing African American adolescents’ experience of depression and suggested mechanisms for improving African American youth treatment engagement. Practitioners can educate African American youth about depression as a medical disorder, build trust, and apply innovative approaches to recognizing differential manifestations of depression in African American youth.

This article examines the use of psychotropic medications among youths in residential community-based placements. Data are from a study funded by the National Institute of Mental Health of therapeutic foster care (June 1999 through May 2001) and group homes (January through June 2001). Data were collected from staff by means of in-person interviews. Many youths in both settings received psychotropic medications, and approximately one-half were taking multiple psychotropic medications. After the authors controlled for demographic and clinical factors, the youths in group homes were nearly twice as likely as the youths in therapeutic foster care to receive medication. However, residential setting was not related to polypharmacology. Additional work is needed to study the appropriateness of use and implications of such patterns for research on intervention outcomes.