Increasing Knowledge and Mental Health Service Use among African Americans through Evidence- Based Practice and Cultural Injection Vector Engagement Practice Approaches

ntroductionLo, Cheng, and Howell (2014) have empirically verified the reality that African Americans are more likely to experience mental illness than their Caucasian counterparts. Formulating solutions to the problem of low mental health service use by African Americans requires an understanding of the history and the strategic intent of the deinstitutionalization of the mental health system in America. Additionally, no history of the legacy of the deinstitutionalization of mental health treatment in America would be complete without a thorough review of the experiences of African Americans (U.S. Department Health & Human Services, 2001; Wade, 1993).Beginning in the 1840s, Dorothea Dix successfully advocated for better living conditions for the mentally ill in response to witnessing the unsanitary and perilous conditions that many mentally ill patients experienced (Unite For Sight, 2013). For more than forty years, Dix worked diligently to bring attention to these deplorable conditions and lobby for change. Her success in fundamentally changing the system of care for individuals with mental illness led to the institutional patient care model, which at the time was considered the most successful and humane approach to caring for the mentally ill. The institutional model provided relief to families who were struggling with a family member suffering with mental illness. However, with little regulation and poor funding, the institutional care model proved over time to be both inefficient and inhumane.Historically, the participation of African Americans in mental health treatment was virtually nonexistent, with a few noted exceptions. From the start of the American slave trade through the eighteenth century it was a common belief that African Americans were unlikely victims of mental health disorders (Jackson, 2002; U.S. Department of Health and Human Services, 1999). The absence of a historical chronology of well-established case study accounts and reports of the mental health experiences of African Americans has been attributed to both politics and scientific racism. As far back as Benjamin Rush, heralded as father of American psychiatry, a former dean of the medical school of the University of Pennsylvania and signer of the American Declaration of Independence, African Americans with mental illness were viewed as encountering a condition referred to as negritude, a condition that was analogous to leprosy. The prescribed treatment to cure African Americans of this destabilizing mental health affliction was for the victim "to become white" (Jackson, 2002, p. 2).Other historical accounts of the African American experience in mental health systems illustrate a plethora of abuses and mistreatment. As a result, two additional mental disorders were developed that were specific to African Americans (Jackson, 2002): drapetomania and rascality, scientifically labeled dysaethesia aethiopica. As reported by Jackson, the former was a problem that manifested as a compulsion by African Americans to run away. The second destabilizing condition was accompanied by the onset of lesions and other physical manifestations. The treatment of choice for each of these distinguishable disorders was to whip victims until they were cured of these debilitating maladies.The abolishment of the American slave trade witnessed a surge in the admission of African Americans to mental health facilities (U.S. Department of Health and Human Services, 2001). By the end of the eighteenth century, the rise in psychiatric hospitalizations was tied to beliefs of Theophilus O. Powell, superintendent of a Georgia psychiatric asylum, who reasoned that freedom was a major threat to the protective factors that slavery provided for African Americans. In his infinite wisdom, Powell postulated thatfreedom, however, removed all hygienic restraints, and they were no longer obedient to the inexorable laws of health, plunging into all sorts of excesses and vices, leading irregular lives, and having apparently little or no control over their appetites and passions (Jackson, 2002, p. …