I’m Not Crazy

Recently, the unrequited love/stalker flick “Obsessed” handily beat the schizophrenic/savant/magic Negro movie “The Soloist” in box office sales. By all accounts African American audiences were largely responsible for that difference. That means either Obsessed was a just a more interesting movie than The Soloist and/or that Black folks are just way more comfortable with the image of White psycho woman than a Black psychotic musician. If the latter is true, it would be all too consistent with how African Americans regard the condition of mental illness in everyday life.

Forensically trained medical doctors, such as me, are tasked with assessing and treating a variety of mental health disorders. {snip} One of the most common and exhausting challenges we face, in general and in forensic psychiatry is the issue of non-compliance with treatment or in too many cases, no treatment at all. And as you may have surmised, many of the people in this circumstance are African America.

So why do we delay or not seek the appropriate treatment for mental/emotional anguish, symptoms or discord? {snip} Why are many racial and ethnic minorities less inclined to seek treatment?

The answers are varied and rooted in many social challenges–coping styles, systematic mistrust, financial constraints, accessibility, lack of culturally similar professionals and a troubling lack of culturally- based research.

Yet the most formidable barrier to treatment is the associated stigma. Regardless of culture, no meaningful discussion about mental illness can occur without recognizing the solid truth of this cluster of negative attitudes or beliefs about mental illness. Studies have found that, in general, ethnic minorities place more stigmas on mental illness than our white counterparts. Our attitudes breed fear, shame, avoidance and discrimination against mentally ill individuals. Our lack of knowledge makes it more likely that mentally ill individuals will be stereotyped as dangerous or unintelligent when often the polar opposite is true.

The mentally ill person’s own attitude or belief system is pertinent as well. It matters if others will see their symptoms as real or imagined. {snip}

The meaning a culture attaches to a psychological condition has real consequences on whether a person will seek any treatment or the appropriate treatment. In general, African-Americans take an active approach to facing personal challenges, as opposed to avoiding them, which is more typical of other cultures. We are more inclined to handle our distress “on our own,” or with the assistance of spiritual guidance.

{snip}