Family Influences on the Use of Mental Health Services among African Americans

Abstract

We examine how families influence mental health service (MHS) utilization among African Americans by drawing on the concept of family ambivalence, which encompasses both family support and stress, and by placing utilization within the context of family histories of psychiatric disorder and treatment. Data are from the 2001–2003 National Survey of American Life, a nationally representative sample of African American adults (n = 3,149), including a clinical need subsample (n = 605) of respondents with a disorder. Negative family interactions have indirect positive effects on use of any MHS through need for care, whereas family social support lacks any effect. Although poor self-rated mental health (SRMH) is associated with greater utilization of any and specialty MHS given family histories of no disorder or treated disorder, utilization is low given a family history of untreated disorder, irrespective of SRMH. Screening for family histories of psychiatric disorder in primary care is recommended.

African American Muslims: Intersectionality and Cultural Competence

“…Mental health utilization and treatment disparities exist for African Americans (Villatoro & Aneshensel, ). African Americans are 10% more likely to express serious psychological distress than their non‐Hispanic White counterparts (Office of Minority Health, ).…”

“…African Americans are 10% more likely to express serious psychological distress than their non‐Hispanic White counterparts (Office of Minority Health, ). Although African Americans experience serious mental health issues, they receive fewer mental health services than do White Americans (Villatoro & Aneshensel, ). In 2014, only 9.4% of African American adults had received mental health treatment or counseling in the past year, which is less than half the percentage of their White counterparts (Office of Minority Health, ).…”

Mental health, coercion and family caregiving: issues from the international literature

“…Caregivers’ support of their unwell relative has the potential to influence or coerce, or to be perceived as such, regardless of their intention. For example, caregivers may try hard to get reluctant patients to engage in social interactions or activities that the caregiver believes will improve their general wellbeing (Villatoro & Aneshensel, 2014 ). Caregivers may sometimes consider it necessary to take control over matters often considered to be private, such as finances and medication.…”

“…As protection, some families may conceal the illness or hide away the unwell relative (Shefer et al , 2013 ). This may delay presentation to services (Villatoro & Aneshensel, 2014 ).…”

“…Those with a strong belief in pharmaceutical solutions may encourage patients to seek psychiatric help. Often, people alternate between traditional and biomedical services, and family pressure can lead a relative with mental illness either towards or away from particular treatment approaches (Villatoro & Aneshensel, 2014 ).…”