scholarly journals 163 Appreciating Historical Racial and Ethnic Nuance in Developing Novel Approaches to Effective Communication of Mental Illness in the Black Community

CNS Spectrums ◽  
2020 ◽  
Vol 25 (2) ◽  
pp. 304-304
Author(s):  
Napoleon B. Higgins

Abstract:There are many barriers to mental health care in the Black Community. These barriers lead to racial disparities in access to treatment and quality of life, along with inappropriate treatment and misdiagnosis in mental and physical health. These disparities directly lead to increased morbidity, mortality and poor mental health in the our communities. Many would question if Black people are not interested in mental health and don’t see it as a needed concern. This talk will address that all cultures are not the same and that there is a fundamental need to address communities on their terms and not make them conform into a "majority culture" approach and perception of mental health care, but rather focus on the individual patient and community needs for mental health care. Often psychiatrists and other mental health professionals are trained in a very academic scientific approach to identification and treatment of mental illness. Too often this model does not fit the needs of all patients due to it not taking into account ethnic differences in communication of mental health and desired outcomes of the patient. This often leads to a lack of understanding on with both sides, the mental health professional and the patient. Too often a patient may see the physician, be given a diagnosis, starts taking a prescription, but then not be able to explain what is their diagnosis, the name of the medication, what it is for, nor what is the medication supposed to do for them. This could lead to unexpected poor outcomes due to the lack of effective communication. This talk will attempt to explain the barriers of communication to the Black community while appreciating and supporting cultural nuance and effective communication. This is needed to help bring mental health to the community in a digestible way and to meet the communities needs on their level. To do this, psychiatry needs to shift it’s focus to understanding cultural characteristics, such as how Black patients may have different cultural needs and may benefit from a unique, customized approach to their mental health. There is a need for psychiatry to take into consideration the spiritual aspects of patients and how many focus not only on needing to improve themselves, but also on how their mental health and behavior are impacting their family and the community as a whole. The traditional model of interview, diagnosis with medication, and follow up for medication adjustment is not fitting all communities leading to the detriment of their mental health.

2016 ◽  
Vol 26 (4) ◽  
pp. 348-354 ◽  
Author(s):  
C. Hanlon

The explicit inclusion of mental health within the Sustainable Development Goals is a welcome development, borne out of powerful advocacy using public health, economic and human rights arguments. As funding comes on line for scale-up of evidence-based mental health care by task-sharing with primary care, it is time to take stock about care for people affected by severe mental illness (SMI). The existing evidence base for task shared care for SMI provides an imperative to get started, but is skewed towards relatively more affluent and urban populations in middle-income countries where specialist mental health professionals provide most of the care. Randomised, controlled trials and rigorous implementation research on task shared service models are underway which will go some way to improving understanding of the quality, safety, effectiveness and acceptability of more widely generalisable care for people with SMI. A sub-group of people with SMI have more complex and long-term needs for care, with a high risk of homelessness, imprisonment and human rights violations as family and social supports become overwhelmed. Case studies from non-governmental organisations provide examples of holistic approaches to rehabilitation, recovery and empowerment of people with SMI, but rigorous comparative studies are needed to identify the most efficient, effective and scalable approaches to care. Health system constraints are emerging as the over-riding barriers to successful task-sharing, highlighting a need to develop and evaluate chronic care models for people with SMI that succeed in reducing premature mortality, improving wellbeing and achieving better social outcomes. Addressing these evidence gaps is essential if task-sharing mental health care is going to deliver on its promise of promoting recovery for the full range of people affected by SMI.


2021 ◽  
Vol 10 (11) ◽  
pp. 803-808
Author(s):  
Prakasha Amin ◽  
Mohan A.K

BACKGROUND In many rural communities, the cause of mental illness is attributed to black magic, spirit possession of past sin and the coastal region of Karnataka is not exempted from it. The natives of this region ascribe the cause of mental illness to the spirit or demigod, and they seek the help of traditional healers such as spirit dancers for the recovery. This help-seeking behaviour of the people results in delay in seeking psychiatry care and affects the recovery of the person with mental health problems. Therefore, this study explores the opinion of clients undergone traditional healing for mental health problems and the results of the study could contribute to planning an appropriate health promotion activity to promote community mental health. METHODS The present study was explorative, undertaken in the Udupi district of Karnataka state, which explores the views of the respondents about the cause of mental health problem and the outcome of traditional healing for their problems. Altogether 200 clients visiting traditional healers for mental health care were interviewed based on the snowball sampling technique and the interview schedule was used as a tool to gather the data. RESULTS Of the 200 respondents interviewed, 27.5 percent were adults (31 to 40 years), while 43.1 percent were unemployed. Black magic was found to be the major cause for mental health problems among 25.5 percent of the respondents; whereas, 26 percent of the respondents felt recovered completely after undergoing traditional healing for mental health problems. CONCLUSIONS The recognition of mental health problems is very much essential for people with mental health problems to seek professional help. This could help mental health professionals to diagnose illness at the very beginning and provide better mental health care. However, the explanatory model of the patients needs to be taken into consideration while providing modern medical care. KEY WORDS Black Magic, Mental Illness, Serpent Worship, Spirt Dancer, Traditional Healers


Author(s):  
Tine Nesboe Toerseth

Abstract Background In 2015, a decision was made to implement clinical pathways in Norwegian mental health services. The idea was to construct pathways similar to those used in cancer treatment. These pathways are based on diagnosis and evidence-based medicine and have strict timeframes for the different procedures. The purpose of this article is to provide a thorough examination of the formulation of the pathway “mental illness, adults” in Norwegian mental health services. In recent decades, much research has examined the implementations and outcomes of different mental health sector reforms and services in Western societies. However, there has been a lack of research on the process and creation of these reforms and/or services, particularly how they emerge as constructs in the contexts of policy, profession and practice. Methods A qualitative single case study design was employed. A text and document analysis was performed in which 52 articles and opinion pieces, 30 public hearing responses and 8 political documents and texts were analysed to identify the main actors in the discourse of mental health services and to enable a replication of their affiliated institutional logics and their views concerning the clinical pathway. Additionally, ten qualitative interviews were performed with members of the work group responsible for designating the pathway “mental illness, adults”. Results This article shows how the two main actor groups, “Mental health professionals” and “Politicians”, are guided by values associated with a specific logic when understanding the concept of a clinical pathway (CP). The findings show that actors within the political field believe in control and efficiency, in contrast to actors in mental health services, who are guided by values of discretion and autonomy. This leads to a debate on the concept of CPs and mental health services. The discussion becomes polarized between concern for patients and concern for efficiency. The making of the pathway is led by the Directorate of Health, with health professionals operating in the political domain and who have knowledge of the values of both logics, which were taken into consideration when formulating the pathways, and explains how the pathway became a complex negotiation process between the two logics and where actors on both sides were able to retain their core values. Ultimately, the number of pathways was reduced from 22 to 9. The final “Pathway for mental illness, adults” was a general pathway involving several groups of patients. The pathway explains the process from diagnosis through treatment and finalizing treatment. The different steps involve time frames that need to be coded, requiring more rigid administrative work for compliance, but without stating specific diagnostic tools or preferred treatment strategies. Conclusions This article shows that there is also a downside of having sense making guided by strong values associated with a specific institutional logic when constructing new, and hopefully better, mental health care services. This article demonstrates how retaining values sometimes becomes more crucial than engaging in constructive debates about how to solve issues of importance within the field of mental health care.


1996 ◽  
Vol 24 (3) ◽  
pp. 274-275
Author(s):  
O. Lawrence ◽  
J.D. Gostin

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.


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