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African American’s view of Mental Health Introduction Mental illness in any culture can be viewed with astigmatism, which is based on cultural beliefs. People have various ways of coping with instabilities of the mind and are deeply influenced by the environment in which they have been exposed to or by the experiences in which they have lived. Admission The patient of interest is an African American female eighteen years of age with bipolar type I and Speaker’s disorder.
She was brought to the hospital by her mother ND step-father, and she was admitted on a voluntary status to the psychiatric mental health hospital for increasing agitation, mood liability, self-harm thoughts, as well as threats toward her family. Her mother reported her aggression increased after the patient discontinued her responder medication. The patient’s mother had been married to her step-father since 2005. The patient has four siblings living in the home whose ages are 17, 14, 2, and 1.
The patient reported that her relationship with her 17 year old sister was the worst with frequent aggressive behaviors such as hitting and yelling. The patient reported suicidal ideation with no plan and depression, she was told by her family that they did not care if she killed herself. She also admitted that she was not taking her medication as prescribed and skipping a few days because she would forget. The patient said she felt “shy’ because she was the only African American on the unit. In 2010 patient had four previous psychiatric hospitalizing.
The patient’s Diagnostic & Statistical Manual of Mental disorders (ADSM): Axis l, bipolar disorder type I mixed with Speaker’s disorder, Axis II, deferred, Axis Ill, seizure disorder and phenolphthalein’s shunt in place, Axis ‘V, psychosocial stress: severe, and Axis V, global assessment of functioning (GAFF) of 35. Cultural Views The African American culture and its view of mental illness is no exception, as with all other cultures there are spiritual and religious beliefs about what may be the cause of mental illness.
In this culture mental illness is not viewed as a health problem, it can have causes such as the “blues,” a weak mind, or a troubled spirit (American Psychiatric Association, 2010). Many are reluctant to seek help for a mental illness due to the stigma of being perceived inferior to others and as a threat to society. In the African American community “mental illness is associated with shame and embarrassment, and both the affected individual and the family hide the illness” (Headrace ; Ward, 2009, Attitudes section, Para. 1).
Previous healthcare experiences or hearing about someone else’s experiences of being misdiagnosed has led to other measures of coping with mental illness and mistrusting the healthcare provider (National Alliance of Mental Illness, 2011). African-Americans seek support through other pathways such as through their family, communities, and their religion ether than going to a physician or psychiatrist for treatment (American Psychiatric Association, 2010). African Americans family dynamics are composed of close kinship, the care of the family is equally shared by both the mother and the father.
Therefore; “family participation in a support group or a church group can improve the families ability to care for family members with mental disorders and cope with the emotional distress of being a caregiver” (American Psychiatric Association, 2010). The religion chosen by the majority of African-Americans is Christianity, which has a deep influence on how mental illness is perceived and treated. In Christianity, mental illness is viewed as being taken over by spirits and can be rid of with prayer. The use of prayer and community involvement is often used as a form of coping with stress.
Another factor to consider is the way in which mental illness is expressed as compared to other cultures, such as a sudden collapse which is a way of showing mental distress or emotion (National Alliance of Mental Illness, 2011). Mental Exam The patient appeared to be clean, anxious, and restless during the interview. She was shaking her leg and moving around a lot in her chair. The patient was operative; however she was evasive and vague when answering questions and would respond with, “l don’t know. ” The patient would occasionally slur her words during the interview.
Her affect was incongruent as she was smiling while speaking about hitting her mom. She admitted to feeling anxious, with a racing heartbeat and a shaking leg, and she stated she was anxious about where she will go after discharge. She denied symptoms of a panic attack such as hyperventilation, sweating, and a heart attack feeling. The patient had depression since 2005. She denied changes in appetite, energy, or sleep, body mass index (IBM) was 26. She felt hopeless and helpless from an unknown cause. She denied suicidal ideation at the time of interview.
She has a history of attempted suicide in 2008 by taking too many scaremongering (Trilateral), four pills more than the usual dosage. She didn’t remember treatment, only that she was taken to the hospital. Denied homicidal ideation, however she had a recent history of violence in the past year of hitting her mother when she was upset; she identified her triggers as others cursing, yelling, or kicking her or when others hit her first. Her thought content was intact, she denied delusions and hallucinations.
The patient was alert and oriented to person, place, and time. Her immediate memory was intact, her recent memory was good, but she had poor memory of past events; she stated she could not remember a memory of being four or five years old. Her intellect was good, she was in the twelfth grade and was earning good grades. Her insight was fair; she stated her treatment goals were to be safe, take medication, not curse, or say racist or mean things. The patient’s information was not completely reliable due to her evasiveness and vagueness when being interviewed.
Her Judgment was fair; she stated if she saw someone steal at school she would tell the teacher or tell a cop. She denied any use of illicit substances. Priority Focus The priority focus for the patient was medication compliance. The patient admitted to occasionally skipping days and said she would forget to take her medications as directed by her psychiatrist. As a consequence to her medication non-compliance the patient was a danger to herself and to others by being physically aggressive and verbally abusive toward others.