Problem with Disparity in Foster Care

Just like any other aspect of the human body- the brain can also get sick. Battling with people’s emotions is caused by events in people’s lives, and mental health circumstances go beyond these emotional reactions to specific situations. As an African American and having first-hand insight on how mental illness is treated within our community, mental illness is often frowned upon or shamed. It was/ is more acceptable to disguise mental health under the guise of humor or relative relation.

The medical conditions and mental health issues that cause changes in how we think and feel and in our mood can modify your life because they make it hard to relate to the situation, others and function the way you that is “ordinary. Without appropriate management, mental health conditions can worsen and ruin a person’s life and cause the person, displacement. African American children in foster care with mental health diagnoses experience displacement and disparities for services in the child welfare system.

According to the Health and Human Services Office of Minority Health, “African Americans men are 20% more likely to experience serious mental health problems than any other ethnicity, group or population (African Americans | NAMI: National Alliance on Mental Illness, 2018). Common mental health disorders among this group of people include trouble with depression, attention deficit hyperactivity disorder (ADHD), suicide, among young African Americans, and posttraumatic stress disorder (PTSD) because African Americans are more likely to be victims of violent crime due to the exposure in their environment.

Poverty, living and family arrangement and violence can all cause mental health issues and instead of talking or finding help to deal with said issues, issues tend to get bottled up and erupt in fits of bad and displaced emotion. Thus, this can lead to various outcomes that are neither profitable nor substantial in helping the individual.

With this onset discovery of mental illness and children being removed from the household due to unstable conditions, the rise in children, African American children specifically, entering the foster care system has remained at an all-time high. This is due in fact to foster parents not wanting to take in children that are deemed high risk as well as services offered. Services, such as funding, therapy treatments, and counseling are disproportionate to how they were offered when looking at race.

Key causes of misdiagnosis of mental illnesses in African American children are that African Americans are also more likely to experience certain factors that increase the risk of developing a mental health condition: mental health issues, homelessness, and violence. “People experiencing homelessness are at a greater risk of developing a mental health condition (African Americans | NAMI: National Alliance on Mental Illness, 2018). African Americans account for more than 40% of the homeless population. The risk of developing a mental health condition such as depression, anxiety, and post-traumatic stress disorder stems from exposure to violence, poverty, and poor living conditions.   African American children are more likely to be exposed to violence than another child of any ethnicity group (Agency for Healthcare Research and Quality, 2014).

Another factor to consider is that some studies indicate that African Americans process many medications more slowly than the overall population yet is more likely to receive higher dosages. This incorrect dosage of medication results in a greater chance of negative side-effects and a decreased likelihood of sticking with treatment. Careful attention to common issues in African-Americans can inform the psychiatric diagnostic process pointing to prevention or treatment considerations that would benefit the African-American community at large (Suffering in silence: The stigma surrounding mental illness in the black community, 2015).

African American children in child welfare are not provided with equal services as other racial groups (Suffering in silence: The stigma surrounding mental illness in the black community, 2015). African Americans are continued to be negatively affected by preconception and discrimination in the health care system, historically. Misdiagnoses, insufficient treatment and lack of cultural competency by health professionals cause suspicion and prevent many African Americans from pursuing or continuing in treatment.

Socio-economic influences can make treatment options less available. According to the U.S. Census Bureau, as of 2012, “19% of African Americans had no form of health insurance (African Americans | NAMI: National Alliance on Mental Illness, 2018). The term “disproportionality refers to the ratio between the percentages of individuals in a particular ethnic group or race at a particular decision point or experiencing an event (maltreatment, incarceration, school dropouts) compared to the percentage of the same ethnic group or race in the overall population. The Affordable Care Act is making it easier and more reasonably priced to get insured.

There is a racial disproportionality and disparity in child welfare and African American children in child welfare are not provided with equal services as other racial groups.  For instance, if a child is afraid to sleep in the dark; a professional would assume that this child has been traumatized or experienced trauma in the dark then boom the child is put on medication to help him sleep when in neutrality the child is displaying normal child behavior. Also, there are cultural barriers that would allow a child to be misdiagnosed. In the Asian culture, the children use the bathroom standing up. If an Asian child was placed in the child welfare system they would be considered to have a mental health illness for something they are culturally bonded with. A child of color is more likely to be taken away from their home before a white child.  Children of color have a higher likelihood of being placed in foster care than Caucasian children (Barth, Green & Miller, 2001).  Caucasian children are provided with services and they remain in the home with their family. If a child was Native American child welfare do not have to say so on where the child goes. The tribe of the child makes the decision. African Americans are continued to be negatively affected by preconception and discrimination in the health care system, historically. Misdiagnoses, insufficient treatment and lack of cultural competency by health professionals cause suspicion and prevent many African Americans from pursuing, continuing in treatment and being placed in foster care.   Why is it that African American children aren’t afforded the same rights and services as those of their counterparts in the foster care system? The idea is that these children come from families that are more likely to have risk factors included when the thought of fostering is brought to light. Risks such as unemployment within the family, teen parenthood, poverty or environment, substance abuse, incarceration, domestic violence, and mental illness which then leads to high levels of maltreatment when put into foster care situations. Much of the increased attention to kinship foster care may be generated, in part, by the fact that these providers represent a different group of caregivers than those regularly found in foster care.

Kinship foster care, in the term, means taking in a child that is of relation that foster care parent. These type of foster care situations are presented with better quality services. Between foster care and kinship care, the income-driven towards both families differ. The average annual gross income, including foster care payments, for kinship foster parents, was $32,424 and was $51,320 for foster parents. So, with this information being known; why is it that most African American children are being cast to into the foster care system and end up with kinship foster care yet, they account for more than half of the foster care system? Why aren’t more services being offered to those who take in kinship foster care children? This is the disparity in the foster care system that affects African American children. They are not afforded nor are their families provided the services needed to take care of them thus they return back to the foster care system that is built against them.

Case Findings

The first reason that African American children in child welfare are not provided with equal services as other racial groups is a misdiagnosis of mental illnesses in African American children. Children in the foster care system, up to 80%, have substantial mental health issues, compared to approximately 18-22 % of the total populace. African Americans today are over-represented in our jails and prisons.  Blacks and African Americans account for 60 percent of the prison inhabitants. Black/African Americans also account for 37 percent of drug arrests, but only 14 percent of regular drug users (illicit drug use is frequently associated with self-medication among people with mental illnesses). Because less than 2 percent of American Psychological Association members are Black/African American, some may worry that mental health care practitioners are not culturally competent enough to treat their specific issues (Race and Mental Health in the United States: The Statistics, The Facts (2017).

The second reason that African American children in child welfare are not provided with equal services as other racial groups is due to cultural barriers. African Americans, especially women, are more likely to experience and reference physical symptoms related to mental health problems. For example, you may describe physical pains and discomforts when talking about depression. A health care provider who is not culturally competent might not recognize these as symptoms of a mental health condition. Additionally, men are more likely to receive a misdiagnosis of schizophrenia when expressing symptoms related to mood disorders or PTSD (African Americans | NAMI: National Alliance on Mental Illness, 2018).

The third reason that African American children in child welfare are not provided with equal services as other racial groups is a misdiagnosis. “Misdiagnosis can happen with any mental health disorder” says Gabrielle Moss, a writer for Bustle. “[For example], a 2009 meta-analysis of 50,000 patients published in the Lancet found that general practitioners only correctly identified depression in patients in 47.3% of cases. Research also reveals that cultural and ethnic factors can play a significant role in mental health misdiagnosis. “African-Americans, for example, are more likely to receive misdiagnosis of schizophrenia and less likely to receive accurate diagnoses of depression or other mood disorders [according to a U.S. surgeon general’s report]” writes Erica Goode in The New York Times, “And while rates of mental illness in Asian-Americans do not differ significantly from those found in other groups, mental health professionals may hold the stereotype that they are ‘mentally healthier,’ a bias that contributes to inadequate treatment and prevention (The Dangers of Mental Health Misdiagnosis: Why Accuracy Matters, 2017).

Given this bias and the negative impact they have on our care, it is easy to understand why so many African Americans distrust health professionals in general and avoid accessing care. A word of advice:  don’t let the fear of mistreatment by culturally unaware professionals prevent the seeking of medical care.

Solving the Problem

An end to the stigma by increasing awareness of mental health needs in the African American community would help combat the thought that mental health is a weakness. An escalation in the number of African American mental health specialists and greater cultural experience in those currently in the field would help with the problem of misdiagnosis. Only 3.7 percent of American Psychiatric Association members and 1.5 percent of American Psychological Association members are African American. According to Psychology Today, “studies have shown that African Americans view the typical psychologist as an ‘older, white male, who would be insensitive to the social and economic realities of their lives’  (5 Factors That Affect Mental Health in African American Communities, 2017).

Improved education in the faith populations about the role of professional mental health treatments and how they can work together. In the African American community, faith is the end all be all of the cures. When you’re short on funds, people pray about it. In times of need, pray about it. Something not going right in life, people are told to pray about it. Countless stories are spoken where the ‘magical cure’ is to pray the bad thoughts away. A greater focus on prevention, intervention, and maintenance in mental health, “it is well documented that mental illness is exacerbated by poverty. However, more recently, it has been recognized that poverty may contribute to the onset of mental illness. In a continuing downward spiral, mental illness can increase health care costs, affect overall health, and lead to further impoverishment. African Americans make up 40 percent of today’s homeless population (5 Factors That Affect Mental Health in African American Communities, 2017).

Recommendations

My first recommendation to overcome this cultural barrier would be to instill sensitivity training to healthcare professionals. It should be taught what symptoms to look for in various cultures. For example, just because two people appear to have an allergen to a material, how they react differs. One would be treated with a different specialty program than the other. Among the African American population, it seems and proven that most symptoms are categorized in a way that is not conducive to their health history. Thus, leading to mistrust of medical professionals. Traditionally, African Americans have been and continue to be damagingly affected by preconception and discrimination in the health care system. Misdiagnoses, insufficient treatment and lack of cultural understanding cause misgiving and prevent many African Americans from seeking or staying in treatment.

The next recommendation would be to remove the stigma of mental illness within the black community. The thought of one being depressed is met with cynical intimidation in the thought that if minor necessities are afforded you, then there is no need to feel sadden. Feelings are often bottled up or otherwise rarely spoken of within African American households. Humiliation and judgment prevent Black/African Americans from seeking treatment for their mental illnesses. Research indicates that Black/African Americans believe that mild depression or anxiety would be considered “senseless in their social circles. “Why are you depressed? If our people could make it through slavery, we can make it through anything. “When a black woman suffers from a mental disorder, the opinion is that she is weak. Feebleness in black women is inexcusable. “You should take your troubles to Jesus, not some stranger/ psychiatrist. (Depression and African Americans, Mental Health America, 2017). Furthermore, many believe that deliberations about mental illness would not be applicable even among family.

Conclusion

The best recommendation is the thought of inclusion within the field of mental health. The macroaggression African Americans received from those in the medical field as well as in the community has created a stigma of not being able to freely express their selves. There are many women and men who feel they would then be mocked in social circles and settings to access their feelings. During slavery, an unconcealed display of mental illness often occasioned in more frequent beatings and abuse, which forced slaves to disguise or hide their mental health issues (Hastings, Jones, & Martin, 2015). The outcomes of these events have been long-lasting, prolonging myths about mental illness. Sixty-three percent of African Americans are certain that depression is a personal weakness.

With proper guidance, trust and faith in relinquishing the stigma on mental health, there is a great chance in the advocacy in reporting, caring for and a better understanding of mental health issues within the African American community. Embarrassment, lack of trust, and socioeconomic status remain barriers in mental health. In the African-American community, family, community and spiritual beliefs tend to be great sources of strength and support. Exploration has found that many African-Americans rely on faith, family and social communities for emotional livelihood rather than turning to health care professionals, even though medical and/or therapeutic may be necessary. A cultural modification is needed to substitute a climate in which friends and loved ones can seek non-judgmental support for a mental health condition. This could make the difference in helping others feel empowered to get the help they may need.

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