Abstract
This study explores the factors that contribute to particular misconceptions and stigmas related to mental illnesses and their treatment that are common in communities of people of color. People of color who have mental illness may conceal it and avoid proper treatment due to fear of others’ negative attitudes. Therefore, the study’s main objective is to identify possible ways to address the prevalence of these misconceptions and stigmas. The research focuses on specific erroneous ideas and beliefs about mental illnesses and analyzes the behavior patterns caused by them. It also examines the origins and causes of mistrust and underutilization of medical services in this regard, including healthcare disparities regarding the treatment approach and its conditions. Based on the presented analysis, the paper proposes specific recommendations aimed at solving the problem.
Statement of the Problem
Mental illnesses are one of the most significant challenges to the healthcare system in modern times. According to Wilson et al. (2018), depression alone “affects more than 19 million American adults each year” (p. 263). It should be emphasized that contemporary treatment methods make it possible to effectively cope with mental illnesses and in some cases, fully cure them. However, certain individuals, for some reason, fail to seek appropriate treatment. One of the most significant causes is the existence of misconceptions and stigmas concerning this issue. These may relate to underestimating the problem, wrong ideas about the treatment means and psychotherapeutic or psychiatric care, false stereotypes about patients, and others. These misconceptions and stigmas are particularly prevalent in communities of people of color and affect their behavior. At the same time, researchers note that the prevalence rates of mental illnesses among racial and ethnic minorities are about the same level as those among whites (Wahowiak, 2015). Thus, misconceptions and stigmas that cause mistrust and underutilization of healthcare services should be investigated to prevent adverse consequences for people’s health.
Purpose and Significance of the Study
I work in the healthcare area, and I frequently encounter people of color who have been affected by the problem of mental illness but who mistrust and underutilize medical services in this regard. For this reason, the subject of this study is significant to me. I expect the result of this research will be a greater scientific understanding of the emergence and impact of mentioned misconceptions and stigmas, and the identification of methods to reduce their influence on people of color.
This study will identify specific false ideas and beliefs that subsequently adversely affect people’s trust in mental illness treatment. According to Holley et al. (2016), “people with mental illnesses who are of color, compared to whites, experience more serious diagnoses, less effective and convenient treatments, and fewer providers from the same identity groups” (p. 311). Consequently, this situation requires special attention and in-depth study. An expanded understanding of the origins and causes of mentioned misconceptions and stigmas will help address the social problem of reduced access to mental health care for people of color. This study will be beneficial to both the representatives of these communities and the healthcare professionals who work with them.
Research Questions
This study poses several research objectives, which are reflected in the following main question of the research:
- What are the misconceptions and stigmas about mental illnesses and their treatment among communities of people of color?
The study also addresses relevant specific questions associated with the problem:
- What are their origins and causes, and how do they affect the behavior of people of color?
- Are there any healthcare disparities concerning people of color that contribute to their misconceptions and stigmas?
Definitions
A clear distinction should be made between the concepts of “stigma” and “misconceptions.” Within the framework of this research, (1) “stigma” is defined as “negative attitudes and beliefs about mental illness that allow for individuals to fear, reject, avoid and discriminate against individuals who suffer from mental illnesses” (Wilson et al., 2018, p. 264). (2) “Misconception” is defined as a set of erroneous beliefs regarding the characteristics of mental illness and its treatment.
It should be pointed out that the scope of the study depends on the definition of “mental illness,” as it determines the health conditions that are subject to certain misconceptions and stigma. This notion is interpreted differently by researchers and physicians and therefore requires a formal approach. Thus, in this study, (3) “mental illness” is defined as the dysfunctional behavioral and mental states constituting the disorders listed in the DSM-5 (American Psychiatric Association, 2013). The term (4) “people of color” refers to all individuals who are not considered white, including African-Americans, Native Americans, Asian-Americans, Hispanic Americans, and Middle Eastern Americans.
(5) “Treatment underutilization” refers to all behaviors associated with ignoring or refusing to receive treatment for mental illness, as well as discouraging others. The (6) “mental illness treatment,” in turn, is defined as medical and psychotherapeutic interventions by healthcare professionals concerning a specific mental disorder. (7) “Health disparities” are referred to as inequalities in the treatment approach and conditions that contribute to mistrust and underutilization of healthcare services by many people of color.
Review of Literature
Overview
This literature review examines various issues related to misconceptions and stigma about mental illness among communities of people of color. These include the actual rates of mental illness among ethnic and racial minorities, health disparities and their specific types, prejudices, and stigma of people of color in this regard, and related sociocultural factors. This review describes the most significant research findings and the most promising methodological approaches regarding this topic. It summarizes the major themes and contributions, evaluates the current state of scientific understanding of the problem and associated gaps, and presents prospective areas for future research, including this one.
The sources are comprised of articles from peer-reviewed, credible journals collected through Google Scholar using keywords such as “mental illness,” “people of color,” “discrimination,” and “disparities.” It should be noted that the authors of these articles are unanimous that the problem is urgent and acute. All studies confirm that ethnic and racial minorities face health inequalities, underutilize medical treatment, and have misconceptions and stigma about mental illness.
Findings
It is observed that the prevalence of mental illness among people of color is at about the same level as that of whites. According to Bignall et al. (2015), this prevalence is “similar across ethnic groups” (540). Moreover, there is evidence that ethnic and racial minorities experience more significant psychological stress and are more vulnerable to mental illness (Wahowiak, 2015; Wilson et al., 2018). Researchers emphasize that people of color face such types of healthcare discrimination as condescension, neglect, rudeness, devaluation of their problems, and violation of their privacy and other rights (Holley et al., 2016). There is evidence demonstrating that ethnic and racial minorities tend to view mental illness symptoms as part of normal life or attribute them to some supernatural causes (Bignall et al., 2015). People of color are less aware of the etiology and course of mental illness, have less confidence in health professionals, and underutilize modern methods of treatment (Maura & de Mamani, 2017; Wilson et al., 2018). This situation is due to a variety of sociocultural factors, including lower socioeconomic status and access to treatment for ethnic and racial minorities, as well as culturally conditioned stigma.
Generally, studies confirm the existence of misconceptions and stigma about mental illness among people of color and partially explain their origins and causes. The studies of Bignall et al. (2015) and Wilson et al. (2018) are particularly significant, as they describe in more detail the cognitive representations and attitudes and the dysfunctional behavioral patterns associated with treatment underutilization. Given the research questions raised, a qualitative research methodology appears to be the most promising and effective in identifying specific misconceptions and stigmas affecting behavior. Most of the findings mentioned were obtained using qualitative methods, including in-depth interviews.
Conclusions
It may be concluded that the studies have unequivocally confirmed the existence of this problem, have studied in great detail the causes and conditions in which it exists, and have described specific health disparities. Despite this, research into specific misconceptions and stigma and description of their cognitive structure still represents a research gap and can provide significant explanatory potential. Initial steps had already been taken in that direction, but more thorough research is required to propose improved recommendations. Further studies should be based on a qualitative methodology aimed at identifying specific characteristics of misconceptions and stigma that lead to mistrust in the medical services and treatment underutilization. This research project is a continuation of the mentioned investigation efforts aimed at filling the specified knowledge gap.
Methods
Design of the Study
This study’s primary research focus is the specific misconceptions and stigmas of people of color that contribute to mistrust and underutilization of healthcare services for mental illness. Therefore, the main research question is: “What are the misconceptions and stigmas about mental illnesses and their treatment among communities of people of color?” Further research questions concern their origins and causes, the impact on behavior, and the healthcare disparities that exacerbate the situation. Researchers state that the lack of awareness, cultural mistrust and negative attitudes lead to various adverse behaviors, including discrimination against people with mental illness, underutilization of medical care, and neglect of mental health problems (Wilson et al., 2018). Consequently, the necessity of an in-depth study of specific views and beliefs determines the research design features.
The research methodology should be structured in such a way as to obtain comprehensive information from people of color on the subject concerned. It is assumed that a qualitative approach to data collection and analysis is most appropriate in this case. The study’s main objective is to apply the proper methods, gather detailed information on relevant misconceptions and stigmas, and analyze them to identify the most prominent ones. The primary assumption regarding this design is that the research process will mostly consist of face-to-face communication with the research participants. The data collected will be subjected to content analysis that decodes the “text in terms of certain subjects and themes” (Bryman, 2016, p. 297). This will enable identifying specific misconceptions and stigmas and the prevalence of their particular types among people of color. This approach is applied in similar studies of the mental illness discrimination of specific population groups (Holley et al., 2016). This design will provide comprehensive insights into relevant attitudes and beliefs and will enable an analysis of their impact on mistrust and underutilization of healthcare services.
Role of the Researcher
The researcher has experience working in healthcare institutions and is familiar with patients with mental illness who are members of ethnic minority groups. These patients or their family members frequently dismiss treatment, discourage others from it, and do not admit the presence of mental illness. The most relevant data in this regard can be obtained in a natural healthcare setting. Generally, healthcare institutions cooperate with researchers and grant permission to conduct research involving patients. At the same time, obtaining the informed consent of potential research participants and complying with data privacy rules are mandatory. Each study participant will be guaranteed anonymity and confidentiality, and the data will be used only for research purposes. These principles will be reflected in the informed consent, and the design of the study will be approved by an authorized ethics committee.
Data Collect Procedures
Collecting detailed information on the misconceptions and stigmas of people of color requires appropriate methods. In this case, it is reasonable to use the “in-depth, qualitative interviewing” that “relies almost exclusively on open-ended questions” (Babbie, 2017, p. 263). The researcher himself will conduct semi-structured face-to-face interviews, which will be recorded on tape with the study participants’ consent. Despite being semi-structured, interviews will have a guide plan that is consistent with research questions. It will include questions about the objective characteristics of mental illness, possible treatment methods, the participant’s attitude towards these issues, and the healthcare disparities (see Appendix A). Interviews will be carried out in healthcare facilities, where participants will also be selected, as this will ensure the highest level of research validity. Participants will be randomly selected from members of ethnic minority groups who have been directly or indirectly affected by mental illness. These data collection parameters will allow gathering information in the most natural environment and ensure its highest relevance.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Association Publishing.
Babbie, E. (2017). The basics of social research. (7th ed.). Cengage.
Bignall, W. J. R., Jacquez, F., & Vaughn, L. M. (2015). Attributions of mental illness: an ethnically diverse community perspective. Community Mental Health Journal, 51(5), 540-545.
Bryman, A. (2016). Social research methods. Oxford University Press.
Holley, L. C., Tavassoli, K. Y., & Stromwall, L. K. (2016). Mental illness discrimination in mental health treatment programs: Intersections of race, ethnicity, and sexual orientation. Community Mental Health Journal, 52(3), 311-322.
Maura, J., & de Mamani, A. W. (2017). Mental health disparities, treatment engagement, and attrition among racial/ethnic minorities with severe mental illness: a review. Journal of Clinical Psychology in Medical Settings, 24(3-4), 187-210.
Wahowiak, L. (2015). Addressing stigma, disparities in minority mental health: Access to care among barriers. The Nation’s Health, 45(1), 1-20.
Wilson, S. L., Gaunt, C. J., Jones, K. N., & Solomon, C. (2018). Correlation between perception and the underutilization of mental health services in the treatment of depression amongst African Americans. EC Psychology and Psychiatry, 7, 263-269.
Appendix A
Interview Questions
In-depth interviews will be conducted in a semi-structured format, but will follow a general plan guiding the conversation with research participants:
- Did you have any direct or indirect experience with mental disorders problems?
- Which mental disorders do you know? Please describe their causes and symptoms briefly.
- What do you think the mechanisms for the emergence of mental disorders are? Are they a real problem or not?
- Do you think there are high-risk factors for the development of mental disorders? And if so, which ones?
- Do you think it is necessary to treat mental disorders? If so, what are the most effective methods of treatment?
- What kind of healthcare services can traditional medicine provide to people with mental disorders?
- What would you advise your relative or friend if he or she was diagnosed with a mental disorder?
- Could mental disorders affect the patient’s life, and how significantly?
- How do you feel about patients with mental disorders? How do they differ from ordinary people?
- How do people in your family and community feel about mental disorders and patients with them?
- Do you or your relatives and friends have any particular views on mental disorders and related symptoms, such as persistent low moods, exhaustion, fatigue, anxiety, and others?
- If so, did your parents and senior community members have similar views? What do you think about how and when they appeared?
- What would you do if you were diagnosed with a mental disorder? What would you think about it?
- Have you experienced any disparities concerning ethnicity or race in obtaining medical services in healthcare facilities?
- Do you think that these disparities exist in our society, and how much do they affect the quality of healthcare services provided to people of color?
- How do these disparities, if they exist, affect your attitude towards healthcare in general and the treatment of mental disorders?
- Would you seek medical help if you encountered problems with mental disorders? Please explain why.