The “No-Show” Phenomenon and the Issue of Resistance Among African American Female Patients at an Urban Health Care Center

Abstract

Using data from 90 African American female medical and mental health patients, this exploratory study examined the reasons patients missed scheduled appointments at a low-income, urban healthcare center. Results indicated a clear difference between the two groups in their appointment-keeping behavior. Mental health no-show patients were more likely than medical no-show patients to cite external factors such as a broken-down car or a scheduling conflict to explain missed appointments. The article also presents a discussion of resistance and its possible role in the no-show phenomenon. Implications and recommendations for future research are also presented.

African American women's beliefs about mental illness, stigma, and preferred coping behaviors

“…African American women's use of mental health services also may be influenced by barriers, including access (inaccessible location, transportation problems, lack of health insurance, and poverty), availability of services (few opportunities for group counseling and in-home services), social issues (lack of childcare), poor quality of care (limited access to culturally competent clinicians and case management), and cultural matching (few opportunities to work with racial and ethnic minority clinicians; Cristancho, Garces, Peters, & Mueller, 2008; Miranda et al, 2003; Tidwell, 2004). In addition, a sociopolitical history involving trauma and victimization of African Americans served to foster cultural mistrust toward the U.S. health care system (Whaley, 2001).…”

Engaging African Americans in Therapy: Integrating a Public Policy and Family Therapy Perspective

“…For many African Americans there is a prevalent belief that mental health providers will not be culturally or racially sensitive (Tidwell 2004;Whaley 2001). Researchers have Contemp Fam Ther (2008) 30:31-47 39 suggested that ethnic minority groups, like African Americans, who have historically been subjected to chronic and serious forms of racism will exhibit higher prevalence rates for mental disorders and a mistrust of mental health professionals (e.g., Sue and Chu 2003).…”

“…The church community is an important source of social support for many African Americans (Billingsley 1999;Dana 2002;Tidwell 2004). However, some churches may perpetuate stigma unintentionally.…”

“…Again, at any point an individual may drop out of treatment for a variety of reasons. According to Tidwell (2004), after a referral has been made for mental health treatment there could be structural issues for some ethnic minority patients in terms of making that first appointment. Such issues may include transportation problems, babysitting problems, conflicts with school, lack of or inadequate health insurance, scarcity of providers, and long waiting lists (Carr Copeland 2005;Richardson et al 2003;Tidwell 2004).…”

Patient and Practitioner Perspectives on Culturally Centered Integrated Care to Address Health Disparities in Primary Care

“…32 Patients may have to overcome many barriers to access mental health treatment across service settings including limited access to care because of location, lack of transportation or mental health insurance, and issues related to low socioeconomic status. [33][34][35][36] For example, education level, a basic component of socioeconomic status, is strongly associated with health care. Education increases access to health information and occupational resources such as health insurance and promotes health literacy.…”