Camille Huggins, Doctoral candidate New York University Silver School of Social Work January 9, 2012 Trauma conference, Hebrew University of

Transcription

1 Camille Huggins, Doctoral candidate New York University Silver School of Social Work January 9, 2012 Trauma conference, Hebrew University of Jerusalem

2 Mental health treatment utilization Dependent variable is defined as seeking formal and informal services for mental health treatment Formal mental health treatment Psychiatrist, psychologist, social worker Primary care provider, emergency room Informal mental health treatment Friends, family Folk healers, director of a senior citizen center (Cohen et al., 2005)

3 Traumatic Events An event is considered traumatic if it involves actual or threatened death or serious injury to the self or loved ones. Examples of a traumatic event: Interpersonal violence, physical or sexual assault, unexpected or sudden death Combat exposure Natural disaster Serious accident (Diagnostic and Statistical Manual of Mental disorders, DSMIV-TR, American Psychiatric Association, 2000)

4 Trauma Statistics among older African Americans 68% of older adults report at least one traumatic event during their lifetime (Norris, 1992). 60% (Norris, 1992) to 66% (Lincoln et al., 2005) of older African Americas have experienced at least one traumatic event in their lifetime. Older African Americans more often report exposure to multiple traumatic events than Whites (Breslau et al., 1995). 41% of African Americans have been threatened or sexually assaulted in their lifetime (Conradi & Wilson. 2010). 27% African Americans tend to experience higher levels of PTSD or related mental disorders from combat exposure compared to Whites 13.7%. African Americans reported higher rates of childhood trauma (e.g., parental death, abuse) than Whites (Sohn & Harad, 2008).

5 The diversity of the African American population Older Adults according to the World Health Organization is a person receiving a pension. Older adults are categorized presently and for the next twenty years can be divided into four birth cohorts: Oldest old (85 and over) Children of the Depression (70-80) The War Baby (62-70) The Baby Boomer-young old (NIH-HHS Health Retirement study, 2002)

6 African Americans Persons of African ancestral origin who were born or live in the United States and both self-identify or are institutionally identified as African American due to skin color. African Americans comprise to about 13.4% of the American population (U.S. Department of Commerce, 2005).

7 Caribbean Blacks Persons of African descent who were either born in the Caribbean, are naturalized US citizens or are first generation US. Citizens born to Caribbean parents. Caribbean Blacks come from a multitude of islands located in the Caribbean Sea. Caribbean Blacks tend to settle in northeastern US (e.g., Boston, New York City, Miami, Ft. Lauderdale) 4.4% of the US African American population of the 2000 census (Logan & Deane, 2000)

8 Data Set The Research on Depression and Anxiety Disorders in Elders Clinical Correlation study (RDADE; Cohen, Maggai, Yaffee, Walcott-Brown, 2005), data was collected between in Brooklyn, New York. African Americans 296 Caribbean Blacks 568 Whites 252

9 Socio-cultural Variables The determination of needs to utilize mental health treatment is based on the significance of an illness and the importance of receiving professional help (Mechanic, 1975). Mental disorders unlike physical disorders often are not immediately apparent and they might impede functioning. The social and cultural aspects take into account an ecological perspective. Country of origin, ethnicity, religion, race, rural, urban setting.

10 Ethnic identity Ethnic identity subject sense of being a member of an ethnic group, belonging to the group and having knowledge and preference for the group, being involved in a ethnic group. Social identity- positive self concept Acculturation-assimilating to the dominant group (Phinney, 1996)

11 Religiosity Belief in religion, religious coping, relying heavily on God or not. (Krause, 2003)

12 Mental health beliefs Knowledge about mental illness depression, anxiety, trauma. Feelings about mental illness. How should it be addressed: religion, stress, heredity, environment, empathy. (Kuppin & Carpiano, 2008; Schnittker et al., 2000)

13 Spirituality African perspective regarding spirituality. West African belief about communing with the spiritual world. Voodoo Knowledge of herbs, diagnostic ritual central to healing. 85% of French speaking Caribbean Blacks believe in Voodoo. (Desrosiers & Florose, 2002)

14 Behavioral health model Incorporates socio-cultural factors Predisposing-propensity to use a service according to demographics, social structure, and health beliefs Enabling-family, personal beliefs, community Need for care perceived or evaluated for formal or informal mental health services. (Andersen 1968,1995)

15 Findings Different factors associated with mental health service utilization between older African Americans and Caribbean Blacks. Older African Americans and Caribbean Blacks had more than one traumatic event in a lifetime (e.g. 2-3). Older African Americans: Higher depression, more mental health service utilization. Older Caribbean Blacks: higher belief in spirituality, less mental health service utilization

16 Implications Further research is needed regarding mental health beliefs about trauma among African Americans No research on trauma related to immigration among African Americans