Patterns and Pathways to Mental Health Care: Experiences of African American Males and Females

2.50
Hdl Handle:
http://hdl.handle.net/10755/151797
Type:
Presentation
Title:
Patterns and Pathways to Mental Health Care: Experiences of African American Males and Females
Abstract:
Patterns and Pathways to Mental Health Care: Experiences of African American Males and Females
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Hines-Martin, Vicki, PhD
P.I. Institution Name:University of Louisville Health Science Center
Title:Assistant Professor
Objectives: The purpose of the study was to describe the help-seeking process, barriers and facilitators experienced as participants identified mental health problems and sought methods to address those problems leading to their initial contact with mental health services. Design: The qualitative study used a grounded theory approach that employed theoretical sampling. A reiterative process of coding and pattern identification was used to identify themes related to study objectives. Population, Sample, Setting, years: The study population was comprised of African American adults who voluntarily accessed public mental health services in a southern border state in the U.S. The sample consisted of 29 African American males and females ages 19 to 45 years who sought mental health services for the first time within a 12-month period. Study participants were low income individuals who accessed services through in-patient and outpatient settings. Three public mental health service organizations were used as recruitment sites. These service organizations functioned as the safety net providers for low-income clients and were located within one of the largest urban counties in a primarily rural state. The qualitative study was conducted July 2000 through September 2001. Concept: Within the United States, increasing attention has been given to mental health issues and disparities in service use by minority groups. The Surgeon General's Report on Mental Health (Department of Health and Human Services [DHHS], 1999) and the supplemental report on Mental Health:Culture, Race, and Ethnicity (DHHS,2001) clearly identify the lack of scientific evidence focused on the reasons underlying these disparities. Understanding this aspect of mental health services use by minority populations is critical to improving the equitability of access and the development of culturally competent care. Methods: Study participants were recruited indirectly through recommendations of counselors, therapists, case workers, psychologists, nurses and physicians functioning in the identified recruitment sites. Clients who expressed interest in being informed about the study were subsequently contacted by the investigators, provided with specifics of the study, and written informed consent was obtained. Participants were interviewed using an 11-item semistructured interview guide developed from pilot study work. Interviews were audiotaped, transcribed, coded and entered into NUD*IST software program for data management. Patterns and themes were identified through transcript analysis, fieldnotes and memos. Scientific adequacy was supported through an audit trail and inter-rater verification of identified codes and themes. Findings: Both similarities and dissimilarities between male and female participants were identified. All participants experienced "A Life of Overload" that was typified by multiple, daily stressors over long duration. A cluster of behaviors was identified that was categorized as "Marginal Living". Marginal living was characterized by a progressive experience of rising emotion and behavioral problems with many of these problems beginning in early adolescence and childhood. Initially, problems were never identified as related to mental health needs and subsequently unaddressed or inappropriately addressed. Just prior to successfully accessing mental health services, an event that was categorized as the "Last Straw" occured in one of two ways and mental health services were accessed. Distinct differences were identified between females and males. These differences were in relation to level of life disruption, avoidance techniques used, family relationships, and choice of inpatient and outpatient service use. Conclusion: The complexity of the lives of this population has been poorly articulated in the literature. The duration of mental health problems was lengthy and unrecognized by the individual as well as their significant others and their communities. Health professionals missed multiple opportunities for early intervention. Participants must be able to not only identify they had a significant problem but must also decide what type of services they needed based on meager information. Access into mental health services was confusing and required multiple attempts before success was achieved. Implications: Findings offer insights into mental health promotion and intervention strategies. Emphasis on early recognition as a problem solving technique is critical to maximize benefit to this population in an environment of financial constraint. Many areas for future research were identified.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePatterns and Pathways to Mental Health Care: Experiences of African American Males and Femalesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151797-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Patterns and Pathways to Mental Health Care: Experiences of African American Males and Females</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hines-Martin, Vicki, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Louisville Health Science Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">vphine01@louisville.edu</td></tr><tr><td colspan="2" class="item-abstract">Objectives: The purpose of the study was to describe the help-seeking process, barriers and facilitators experienced as participants identified mental health problems and sought methods to address those problems leading to their initial contact with mental health services. Design: The qualitative study used a grounded theory approach that employed theoretical sampling. A reiterative process of coding and pattern identification was used to identify themes related to study objectives. Population, Sample, Setting, years: The study population was comprised of African American adults who voluntarily accessed public mental health services in a southern border state in the U.S. The sample consisted of 29 African American males and females ages 19 to 45 years who sought mental health services for the first time within a 12-month period. Study participants were low income individuals who accessed services through in-patient and outpatient settings. Three public mental health service organizations were used as recruitment sites. These service organizations functioned as the safety net providers for low-income clients and were located within one of the largest urban counties in a primarily rural state. The qualitative study was conducted July 2000 through September 2001. Concept: Within the United States, increasing attention has been given to mental health issues and disparities in service use by minority groups. The Surgeon General's Report on Mental Health (Department of Health and Human Services [DHHS], 1999) and the supplemental report on Mental Health:Culture, Race, and Ethnicity (DHHS,2001) clearly identify the lack of scientific evidence focused on the reasons underlying these disparities. Understanding this aspect of mental health services use by minority populations is critical to improving the equitability of access and the development of culturally competent care. Methods: Study participants were recruited indirectly through recommendations of counselors, therapists, case workers, psychologists, nurses and physicians functioning in the identified recruitment sites. Clients who expressed interest in being informed about the study were subsequently contacted by the investigators, provided with specifics of the study, and written informed consent was obtained. Participants were interviewed using an 11-item semistructured interview guide developed from pilot study work. Interviews were audiotaped, transcribed, coded and entered into NUD*IST software program for data management. Patterns and themes were identified through transcript analysis, fieldnotes and memos. Scientific adequacy was supported through an audit trail and inter-rater verification of identified codes and themes. Findings: Both similarities and dissimilarities between male and female participants were identified. All participants experienced &quot;A Life of Overload&quot; that was typified by multiple, daily stressors over long duration. A cluster of behaviors was identified that was categorized as &quot;Marginal Living&quot;. Marginal living was characterized by a progressive experience of rising emotion and behavioral problems with many of these problems beginning in early adolescence and childhood. Initially, problems were never identified as related to mental health needs and subsequently unaddressed or inappropriately addressed. Just prior to successfully accessing mental health services, an event that was categorized as the &quot;Last Straw&quot; occured in one of two ways and mental health services were accessed. Distinct differences were identified between females and males. These differences were in relation to level of life disruption, avoidance techniques used, family relationships, and choice of inpatient and outpatient service use. Conclusion: The complexity of the lives of this population has been poorly articulated in the literature. The duration of mental health problems was lengthy and unrecognized by the individual as well as their significant others and their communities. Health professionals missed multiple opportunities for early intervention. Participants must be able to not only identify they had a significant problem but must also decide what type of services they needed based on meager information. Access into mental health services was confusing and required multiple attempts before success was achieved. Implications: Findings offer insights into mental health promotion and intervention strategies. Emphasis on early recognition as a problem solving technique is critical to maximize benefit to this population in an environment of financial constraint. Many areas for future research were identified.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T11:14:00Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T11:14:00Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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