CCCK Stigma Characterized with Mental Illness in American Healthcare Systems Literature Review Below is directly from the school’s portal:
It may help to refer back to your Research Methods course when completing this section, since much of what we will discuss here was covered in that course.
Take a moment and choose two studies in your literature review. These should be studies that are easy for you to read, but also include a description about how the study was conducted. So far, we have largely ignored that section, since we have mainly been focusing on the result and conclusions of the studies we have been reading. However, since one of the outcomes associated with this process includes your ability to discuss methodology, we will now focus on that section.
In your literature review, where you discuss these studies, we would like you to know expand your discussion of the study to include a detailed description of the methodology used to conduct the study. To do this, you will need to provide as much detail as possible describing the process, means, people, and tools that were used to conduct the study.
To aid you in that process, you can use the following points to guide your description. Keep in mind that these are only general talking points. Since we do not know the specifics of the study you’re describing some elements may not be applicable.
– How was the study organized and completed? In other words, what was done?
– Participants: Who participated? How were they chosen (sampling)? Does the sample truly represent the broader population it is intended to inform?
– What are the dependent and independent variables? Were there other variables consider? If so, what was their level of measurement (Ordinal, Nominal, Scale).
– Surveys/Questionnaires: What tool/instrument was used? Was it validated?
– Experiments: Were ethical issues addressed? What controls were in place?
– Was deception used? If so, explain why it was necessary? Did the research conduct a debriefing?
– Did the method allow for bias?
– What statistical methods were used to measure the data?
– Using statistical language, what were the findings?
– Was this the best method to derive this information? Would a different experimental method been more effective? Were their limitations?
Complete this process with at least two studies. Once you are done, you will need to submit a revised draft of your Literature Review to your Facilitator. Your draft should include:
1. Corrections and modifications that were identified by your Facilitator and you are now resubmitting to your Facilitator
2. Modifications and additions you have personally made and additional studies or sources that you did not yet address or may have found this week
3. Expanded methodology descriptions of at least two studies.
You may want to be sure to save this draft with a different name or a label, so that you have a historical record of each draft. This is extremely helpful in case you lose the copy you are currently working on or need to refer back to a comment.
Below is what I need for this week:
For this week I will need a methodology to be done to the existing research paper project. The video below is my professor with more detailed information regarding this week’s assignment. I will also include the paper with the references that you did last week. She basically wants the paper to be revised. Possibly take away some things and/or add some things.
Video from my professor https://youtu.be/OgN7otEsF5s
Below is also from my professor
As you are working on revising your literature review and the References page, here are some APA helps for you.
1.) Remember that using “retrieved from” and a long web address for your references is not APA style. Refer to “Cite Journal Article” in References. Also, please watch this video on how to find the correct citation for your articles.
2.) If you do not have a DOI, here is a website to lookup DOI’s. https://www.crossref.org/
Select “search metadata”
Then enter the title of the article and author(s). If there is a DOI, it will appear. Often, this will give you the complete reference as well!
I’d like you to keep working on getting the full references, but not in lieu of working on lit review this week. But keep at it!
3.) I have three additional resources for you.
1. See the attached Table 6.1 Basic Citation Styles for in-text citations by the number of authors.
2. https://www.apastyle.org/learn/faqs/cite-another-source will give you information on how to list a secondary source (a source the author of your article cites).
3. https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_author_authors.html for how to list multiple authors.
As always, let me know what questions you have. Happy revising!
This is due on Sunday before midnight EST because I’m in Florida. The document you created in located below in the blue box. Open it and follow the directions above. Just so that we are clear, you are NOT writing anything else this week. Just basically building on, taking away and revising what we already have. I’m saying this because as customers, we have to enter how many pages we need but I don’t need pages to be written, I just need revising. I honestly don’t know why this needs to be revised at all because I read it and it was remarkable!!! Let me know if you have any questions ok. LITERATURE REVIEW
Central Christian College
Senior Research Project
Professor Rebecca Sidorvich
April 16, 2020
Generally, this section entails research work and previous studies carried by different
scholars that are related to my topic studies. BY thoroughly and examines these past researches,
a gap is identified
The stigma characterized with Mental illness in American healthcare Systems
According to previous studies, Black Americans with current or past mental disorders are
reported to exhibit feelings of being dehumanized, traumatized, and devalued by health
caregivers in North America for the last decade. It, therefore, signifies that those with psychiatric
disorders, and especially African Americans, are stigmatized and handled in a different way.
Ultimately, when confronted with such mental condition, they shy away from reporting or
seeking medical attention as well as counseling procedure from a psychiatric. In most cases,
those who suffer from mental disorders are disowned by American healthcare practitioners.
Several African Americans, especially those from marginalized groups and who suffer from
mental health problems, do not receive any forms of patient care. Those who seek medication
from the outpatient hospital are usually at the risk of dropping out. Some are forced to use other
hypothesized alternatives to specialty care as well as voluntary support. Such tendencies of
seeking help reflect stigma, styles of coping, lack of resources, and inadequate treatment
opportunities (knack et al., 2017).
Additionally, the authors ascertain that there is unequal access to mental healthcare
facilities as black Americans with psychiatric disorders are ignored. Therefore, medical
practitioners in the healthcare setting do not adhere to biomedical ethics of beneficence by
discriminating against other mental patients based on race. This stigmatization has significantly
led to under-reporting of mental illness, particularly among the African American communities.
Professionals in the healthcare system portray a pessimistic attitude towards patients with
psychiatric problems. They exhibit very little hope that their efforts can bring any form of
recovery for such patients. The negative perceptions have significantly led to pervasiveness and
negative interactions between patients and caregivers in the mental healthcare sector. There is a
need for the enactment of appropriate federal laws that would ensure all patients with psychiatric
disorders have equal access to medical care. By so doing, cases of stigmatization based on
social-cultural inclinations such as race would be eliminated. According to (Ward et al., 2013),
black Americans exhibit low endorsement for mental openness. Eventually, this has affected
their behaviors as far as seeking treatment is concerned. It is reported that African Americans
hardly use healthcare services. They associate barriers to seeking mental healthcare services to
receipt of poor quality care, as well as the stigma that is characterized by mental illness. The
association between psychological openness and the decision to look for help on mental
healthcare issues is critical in analyzing why most Black Americans refrain from seeking such
services. Much of their concerns as far as psychological openness is concerned are stigma. It is
worth noting that stigma not only occurs as a result of racial discrimination, but also due to
general perception of the regarding mental disorders. Stigma is more prevalent in the African
American community than the white American society. African American women’s reluctance to
use informal support and seeking professional help is significantly associated with their concern
(Conner, et al., 2010) suggest that the stigma that is characterized by the psychiatric
disorder has negative impact on the attitude towards seeking mental healthcare facilities by
depressed older adults, especially African American older adults. They note that interventions
are needed to engage this particular population in psychiatric health treatments. Based on this
study, depressed older Black American adults portrayed a high of trauma and not willing to seek
treatment. They endorsed high stigma as well as little attitude towards seeking psychological
health treatment. It is also evident from these studies that black Americans had more negative
attitudes toward seeking mental health treatment than their white counterparts. This was
heightened with the relationships between attitudes towards treatment and race. The medical
practitioners have severally failed to consider the preferences of African Americans as well as
their methods of receiving assistance. Thus, it retains stigma and a lack of willingness to seek
treatment. Studies show that the percentage of Black Americans who feared seeking mental
health treatment was 2.5% times greater than the proportion of white Americans.
There are little interventions adopted to eliminate stigma towards those who have mental illness
in healthcare institutions.
Even though there are interventions that have been adopted in some institutions, the
results are not drastic enough to see a significant increase in health care outcomes of those
having mental disorders among the African American Communities in the US. Mentally ill
patients are still suffering from inaccessibility, discrimination, and segregation in health care
institutions. Stigma in health facilities undermines diagnosis, treatment, and successful health
outcomes. Therefore, it is essential to address the issue of stigma to enhance the delivery of
quality mental healthcare among all social groups in the United States. (Nyblade, et al., 2019). It
is also worth noting that the stigma associated with mental illness goes along with medical
professionals, not understanding the living conditions that the patients is going through. More
social awareness of the leading causes of mental illnesses and their effects can significantly
reduce the stigma within the health care setting. Interventions such as these can improve health
care delivery and quality for those who have a mental illness. Also, there need for knowledge on
how to reduce the stigma, which calls for training on importance ethics in healthcare as well as
approaches needed to appropriately work with stigmatized groups (Brondani et al., 2017).
Further, black American men have a negative perception of seeking psychological
counseling as they believe that it is a sign of weaknesses. This is due to the negative stigma that
surrounds mental health. These blacks chose to solve their problems on their own instead of
seeking professional help when faced with psychiatric conditions such as depression and anxiety.
Their desire to handle mental issues on one’s own was the most common reason of having the
perceived mentality of not seeking treatment, making it challenging to estimate exact figures of
individual with psychiatric disorders. Therefore, it necessary for healthcare professionals to
know the socio-demographic characteristics (Mojtabai et al., 2011).
Elimination of stigma among people with mental illness requires the black community to
comprehend that mental health is a crucial component of well-being. Negative stereotypes
regarding mental illness have made individuals believe that psychological disorders are a
personal weakness. Due to the lack of appropriate information on mental illness, they hardly seek
help. Therefore, there is a need to enhance cultural awareness and corresponding responsiveness
in healthcare setups.
Impact of economic constraints, healthcare inequalities and Ethical barriers to seeking
There is a considerable burden of psychiatric health disorders among the African
American Communities due to economic constraints. They are also subjected to inadequate
quality mental health infrastructure. The inequalities between black Americans and white
Americans should be addressed to implement the bioethics principles of healthcare practice.
(Kessler, et al., 2017). Such principles include justice, respect for individuals, non-maleficence,
and beneficence at large.
Moreover, to address untreated psychiatric health needs, there is a need for the
establishment of appropriate mental health infrastructure in all states as well as the integration of
mental health services, particularly in African American communities (Ngui et al., 2010). It is
proved that only one in three African Americans in need of mental healthcare services were able
to receive it. The proportion of black Americans receiving treatment from any facility is
significantly lower than that of the White Americans. Disparities in access to healthcare services
are not only contributed to by financial capacities but also by the fewer psychiatric health
specialists for these black people, especially for those who prefer African American specialists.
Most of them do not have trust with the white American specialist since the feeling of mistrust,
stigma, and racism keeps them away.
Additionally, according to (Sareen et al., 2011), the economic recession has led to
reduction in individual income, which has led to increased cases of mental illnesses among
African Americans. The declining social, economic status is more prevalent in the Black
American Community than the white American Community. It is valid from this study that
severe mental illnesses are much characterized by poverty. Individuals with low income are at a
higher risk of developing psychiatric disorders such as anxiety and depression. Additionally, the
research findings indicate that funding for mental illness in the United States has doubled in the
last ten years. Treating patients with severe mental disorders are associated with exceedingly
high costs. Most of the black American cannot afford medical health insurance that provides
medical coverage against severe mental disorders. Lack of health insurance coverage is a barrier
to seeking services of mental healthcare. Nearly 50% of African Americans are not insured. As a
result, they seek treatment from primary care specialists. However, these healthcare providers
lack diagnosis skills and skill in the treatment of mental and psychological health problems.
Further, owing to the historical oppression of their past subjugation, African Americans are over
presented, particularly in the most vulnerable sections of the population. Several Black
Americans are homeless and incarcerated, which has led to increased mental illness among this
group. Also, they are exposed to violence associated with trauma, which leads to increased
susceptibility to psychiatric disorders (Ward, et al., 2019).
Current proceeding regarding mental health illness goes against health ethics. Physicians
and health practitioners do not address mental health illness in a way that meets healthcare
standards. Therefore, current practices may be deemed unethical, as patients are stigmatized,
neglected, discouraged from seeking medical help, and undermined by practitioners based on
their race. African Americans with mental health needs are likely to be undertreated in the
community. Sometimes if they have to be treated, they are forced to seek help from primary care
providers, who lack resources of healthcare (Bipeta, 2019)
Community mental healthcare services in the United States
Several studies recommend that extensive professional intervention is necessary among
African Americans to ensure that they seek mental healthcare services.
The professional intervention can be offered at the inpatient or the community level. At the
community level, psychiatric healthcare services can be provided by a case manager through
community support programs. These professionals can assist in supporting the individual with
psychological health problems by helping them access the services they may need. Communitybased assessment services aim to provide immediate services in their particular homes so that
those who fear seeking mental healthcare services can be reached (Choudhry, et al., 2016).
Clinical Ethical Issues in psychiatric Health Care
The healthcare system in the US has less regard for ethics when dealing with African
American Patients. Wait time for outpatient psychiatry is, on average, 25 days in large urban
areas. Challenges also arise with patient’s attitude towards treatment, as a society often
undermines and discriminates against those with mental illness, therefore, leading more people to
hide their illnesses to avoid associated stigma. Moreover, Black Americans are more likely to be
inappropriately diagnosed as compared to white Americans. In most cases, they are diagnosed to
be suffering from Schizophrenia while they could have another active psychological disorder.
These are some of the ethical issues in mental healthcare in the United States (Schneider, 2016).
Impact of Racial discrimination and psychological distress on African American communities
African Americans communities in the United States face racial discrimination such that
they are ignored during the provision of mental health care. They encounter diagnosis bias as a
well inappropriate selection of screening equipment. Studies report a diagnosis of Schizophrenia,
and African Americans are underdiagnosed of affective disorders. In black American
communities, mental health issues are often encompassed by the psychological effects of racism.
Racial discrimination cause stigma among black American society, which makes them struggle
with mental health matters without seeking appropriate treatment.
Black communities have been exploited for an extended period by whites based on race. Chronic
racism has seen African Americans to lack trust in the established medical and healthcare
systems. They are criminalized in the American justice system. Although the blacks make up to
12 percent of the American population, they account for more than 30 percent of the people of
those who have been sentenced in prisons. As a result, mental health problems among the blacks
are met with harsh legal consequences, instead of the required treatment. In other words, if a
black American with mental disorders acts out in violence, there a higher probability of being
criminalized instead of being offered an opportunity to get mental healthcare (Yip et al., 2008).
Racism has adversely affected the mental healthcare status of African Americans. Racial
discrimination leads to differentiated access to mental healthcare facilities and services. It also
leads to psychological problems that cause adverse mental health problems. Negative stereotypes
based on race also have far-reaching effects on the psychological well-being of blacks (Hwang et
al., 2008). Racial discrimination is argued to be a predator of the poor mental health status of
black Americans and Latinos.
Studies report that foreigners born in American record lower rates of mental illness than
the Africans who are born in the US. For instance, Mexican immigrants have lower Psychiatric
disorders than those in the entire African American community (Gee et al., 2006).
(Bor et al .,2018) explores more on how racial discrimination has taken its roots in America and
its impact on mental disorders among the African American groups. Black Americans with
psychological problems are exposed to massive killing by police in the US (Parrott, & Parrott,
2015). The attack by police officers has also rendered many black Americans with mental
disorders. On the other hand, this does not happen to the white Americans. Generally, police
killing of black Americans adversely affects their mental health. Also, Grob (2019) provides a
transparent overview on how American society handled problems of mental illness in the past.
According to his studies, mental healthcare hospitals provided minimal care to African American
patients with psychiatric disorders. The development of these hospitals was based on social and
racial groupings. Interaction between patients and Psychiatrists was influenced by racial
inclinations—this disadvantaged Black Americans who were stigmatized and dehumanized; thus,
leading to underreported cases of medical disorders among African Americans (Holley, et al.,
2016).The black community has continually been disadvantaged by being subjected to trauma
through racism and segregation. Researchers suggest that the black community lacks access to
appropriate mental healthcare facilities as well as an adequate response from mental health
professionals. Their psychological needs are not fulfilled due to racial inclination. Further,
economic insecurity cause black America to fail to report their mental conditions.
Need for improved mental healthcare and a more collaborative model of care
Lake (2017) argues that mental illness accounts for approximately 30 percent of the
disability among black Americans in North America. However, the healthcare system does not
provide any treatment and care for these victims. These conditions are radical in North America,
and therefore, it is crucial to improve the practices of mental healthcare and the integration of a
more collaborative model. By so doing, the health care systems will have a clear report on the
individual with mental disorders to be able to provide adequate care. Research by the European
Nations found that approximately 150 million have psychiatric disorders, and the mental
healthcare systems do not have their data. Therefore, 70 percent of this population does not get
the necessary treatment. Also, Mental illness accounts for 1/3 of disabilities suffered by adults
globally and accounts for the most significant cause of preventable deaths in adolescents and
young adults. Two-thirds of those who suffer from depression do not receive any form of
treatment. Lake notes that more funding is needed in psychiatry as current methods of
rehabilitation are not providing significant results. It implies that there is a growing gap between
the healthcare of the blacks’ population and the resources available to them. The gap is much
more significant in rural settings (Gonzales et al., 2015).
Conner, K. O., Copeland, V. C., Grote, N. K., Koeske, G., Rosen, D., Reynolds III, C. F., &
Brown, C. (2010). Mental health treatment seeking among older adults with depression:
the impact of stigma and race. The American Journal of Geriatric Psychiatry, 18(6), 531543.
Nyblade, L., Stockton, M. A., Giger, K., Bond, V., Ekstrand, M. L., Lean, R. M., … Wouters, E.
(2019). Stigma in health facilities: why it matters and how we can change it. BMC
Medicine, 17(1). doi: 10.1186/s12916-019-1256-2
Sareen, J., Afifi, T. O., McMillan, K. A., & Asmundson, G. J. (2011). Relationship between
household income and mental disorders: findings from a population-based longitudinal
study. Archives of general psychiatry, 68(4), 419-427.
Ngui, E. M., Khasakhala, L., Ndetei, D., & Roberts, L. W. (2010). Mental disorders, health
inequalities, and ethics: A global perspective. International Review of Psychiatry, 22(3),
235–244. doi: 10.3109/09540261.2010.48527
Bipeta, R. (2019). Legal and ethical aspects of mental health care. Indian Journal of
Psychological Medicine, 41(2), 108. doi: 10.4103/ijpsym.ijpsym_59_19
Brondani, M. A., Alan, R., & Donnelly, L. (2017). The stigma of addiction and mental illness in
healthcare: The case of patients’ experiences in dental settings. Plos One, 12(5). doi:
Schneider, M. R. (2016). Clinical and Social Contexts of Ethical Issues in Mental Health Care.
AMA Journal of Ethics, 18(6), 567–571. doi: 10.1001/journalofethics.2016.18.6.fred11606
Yip, T., Gee, G. C., & Takeuchi, D. T. (2008)….
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