A Newsletter of the Office of Minority Health

Mental Health and Minorities
September 1997

Culture and Mental Health by Delores Perone, PhD Associate Director for Special Populations National Institute of Mental Health

Empowering Psychologists of Color by Bertha G. Holliday, PhD Director, Office of Ethnic Minority Affairs American Psychological Association

Demographers suggest that by the year 2050, half of the U.S. population will be of Hispanic, African American, Indian, or Asian descent. And as the general population becomes more culturally diverse, the incidence of mental disorders among individuals from diverse racial and ethnic groups will also increase. Clinicians trained in traditional, Western biomedical psychiatry and other mental health professions will face new challenges in evaluating these individuals. This fact alone demands that our scientific understanding of social and psychological functioning and mental disorders must be based on knowledge of these varied groups. The National Institute of Mental Health (NIMH) has been the primary source of support for research to more accurately describe the nature and prevalence of mental disorders among racial and ethnic minorities, and to improve both the accuracy of diagnosis and quality of mental health services. One outcome of research supported by NIMH has been compelling evidence regarding ways in which the varied cultural backgrounds of individuals affect the context and content of both normal and abnormal behavior, the expression of symptoms associated with particular mental disorders, and the process of conducting a diagnostic evaluation. These results have been the scientific underpinning for important work on improving the outcome of the diagnostic process for individuals from diverse backgrounds. NIMH and the American Psychiatric Association have collaborated to enhance the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition or DSM-IV, to ensure the cultural validity and sensitivity of the diagnostic system. DSM-IV includes three types of information specifically related to cultural considerations: 1) discussion of cultural variations in clinical presentations of disorders included in the DSM-IV Classification, 2) description of culture-bound syndromes, and 3) outline for “cultural formation,” an innovative approach that allows clinicians to describe the nature and extent of psychopathogy from the perspective of the patient’s personal experience and social and cultural reference group.The inclusion of this information is expected to promote clinician sensitivity to the relevance of culture and racial and ethnic minority status to psychiatric assessment and the concept of comprehensive treatment.

The U.S Census Bureau is quite unequivocal: Soon after the middle of the 21st century, the majority of the nation’s population will be people of color. In recognition of the numerous implications this future holds for behavioral and health research and services, the American Psychological Association’s (APA) Office of Ethnic Minority Affairs (OEMA) seeks to empower psychologists of color. The office does this by advancing the scientific understanding of culture and ethnicity relative to health and behavior; promoting the development of culturally appropriate models for the delivery of behavioral and psychological services; developing strategies for increasing the number of ethnic minority psychologists; and ensuring that the perspectives of psychologists of color influence the association’s activities and policies. OEMA has been coordinating APA’s 1997 Miniconvention and National Conversation on “Psychology and Racism” (August 15-19, 1997 in Chicago). This project will highlight the growing body of psychological rsearch on racism--especially as reflected in the behavior of institutions and their effects on group differences in access to resources required by healthy people and communities. Issues related to the need for increased numbers of psychologists of color are addressed in Visions and Transformations: The Final Report, which was drafted by the association’s 15-member blue-ribbon Commission on Ethnic Minority Recruitment, Retention, and Training. The report describes the troubling disparity between the current representation of psychologists of color (about 5 to 6% of all psychologists) and the nation’s rapidly changing demographics. Additionally, the report identifies strategies for ethnic minority recruitment, retention, and training, and provides a five-year plan to guide APA’s efforts in this area. APA has received a major National Institute of General Medical Sciences grant to support a systematic approach to minority recruitment and retention through the establishment of five Regional Centers of Excellence in Minority Recruitment and Retention, each consisting of psychology departments at a major research university and two predominantly minority two-year and four-year institutions. For more information, contact OEMA at 202-336-6029. E-mail: bgh.apa.@email.apa.org.