DNP 896: Manuscript Draft #1

Abstract

The cultural views of groups considered to be ethnic and racial minorities in the United States towards health conditions, including mental health disorders, are believed to impact their health behaviors, including help-seeking behaviors. This study examines how the stigmatization of mental health stigma influences health-seeking behaviors among minority racial-ethnic groups. Descriptive statistics were utilized to describe a sample of 32 individuals from the minority groups. The findings indicate that ethnic and racial minority groups have a stigma towards mental health issues, which has significantly led to poor help-seeking behaviors: DNP 896: Manuscript Draft #1.

Black people, especially men, have the highest levels of negative views towards mental health issues with low levels of willingness to seek related health care services. Although a larger study focusing on developing community-specific evidence is required, there is a need for culturally sensitive, multi-level interventions to improve mental health-seeking behaviors and mental health outcomes among ethnic and racial minorities.

Keywords: Mental health stigma, racial and ethnic minorities, mental health-seeking behaviors, cultural barriers, healthcare disparities

DNP 896: Manuscript Draft #1

Mental health disorders contribute immensely to the burden of disease and are a major cause of disability globally (Rehm & Shield, 2019). At the same time, the United States experiences significant gender, age, and race-related mental health disparities in terms of access to health services and outcomes of mental health. Socioeconomic and geographic barriers have further increased these disparities (Mongelli et al., 2020). Racial-ethnic minorities, regardless of other demographic factors such as sex, age, and social status, experience major mental health disparities.

Recent evidence indicates that community-specific perspectives on mental health are leading to negative views on mental health disorders with a significant impact on acceptance of the existence of mental health issues and mental help-seeking behaviors (Schomerus et al., 2019). This necessitates the need for a deeper exploration of how stigma influences the mental health help-seeking behaviors of individuals from racial-ethnic minority backgrounds.

Problem Statement

Despite the high rates of mental health and addictive disorders among Americans, population groups considered to as racial-ethnic minorities, including African Americans, Hispanics, Asians, and Native Americans, hold negative views towards mental health issues, which potentially impact their mental health help-seeking behaviors. This project has explored how stigma is an influencing factor in the mental health-seeking behaviors among these ethnic-racial minority groups.

Background and Significance

Racial-ethnic minorities face significant social, economic, geographic, and cultural barriers to accessing mental health care (Green et al., 2020; Lu et al., 2021). These barriers are a causal factor to the present-day underutilization of mental health services and disparities in mental health outcomes among ethnic-racial minorities. Besides these systemic and structural barriers, social and cultural views among racial-ethnic minorities are noted to stigmatize mental health issues, reducing service utilization and further widening the racial mental health disparities (Alemu et al., 2023).

Since mental health is a factor for physical health and well-being, it is a critical time to explore how cultural and social perspectives on mental health determine health- and help-seeking behaviors, especially among racial-ethnic minorities. Therefore, this project explores such cultural views and helps create awareness of mental health stigma as a barrier to mental health utilization and contributes to efforts to design culturally sensitive interventions for ethnic minorities.

Purpose

The primary purpose of this project is to explore the impact of mental health stigma on mental health-seeking behaviors among racial-ethnic minorities. Specific objectives are:

• To identify major cultural factors for mental health stigma
• To evaluate the role of cultural views on mental health utilization
• To develop evidence-based recommendations to improve practice in multicultural mental health settings

Synthesis of Evidence

Stigma is viewed as a factor in mental health utilization and the efficacy of care interventions (Hatzenbuehler & Pachankis, 2021). Most of the research is centered on racism and institutional stigma as factors for mental health and related health behaviors (Kapadia, 2023). However, stigma can be manifested beyond public and institutional stigma, to include self or internalized stigma (Ahad et al., 2023).

Although some research has explored mental health stigma from a personal or internalized perspective and its influence on health-seeking behaviors, such as research by Fante-Coleman & Jackson-Best (2020) and Lu et al. (2021), Holder et al. (2019) and Eylem et al. (2020) argue that there lacks comprehensive evidence on internalize or personal stigma on mental health help-seeking behaviors. The multi-component nature of stigma also means that the majority of evidence on mental health stigma interventions is generalized, creating gaps in intervention effectiveness. Current research also lacks longitudinal data on existing interventions.

Concepts and Theoretical Framework

The Health Belief Model serves as the project’s guidance. The theory was chosen because it clarifies the relationship between health behaviors and beliefs about disease, such as self-efficacy, perceived barriers to action, advantages to action, severity, and susceptibility (Anuar et al., 2020).

Project design

Design and Implementation

A Mixed-methods study was conducted through an interprofessional collaborative effort utilizing quantitative surveys and qualitative interviews.

Data Collection

A questionnaire design for this project and semi-structured interviews were used to collect research data.

Population, Sample and Sampling, and Setting

The study was set in a local community health center. A total of 32 participants were selected using convenience sampling. The participants were drawn from individuals aged above 18 years who identified as either group considered to be an ethnic-racial minority in the US. An IRB approval had been obtained for the study.

Data Analysis and Results

Data was analyzed using Minitab 20 Statistical Software. Individuals from minority racial-ethnic groups (n=32) participated in the study. 78.1% were female and 21.9% were male.

More men were more likely to agree with negative statements on mental health and mental health-seeking behaviors. Evidence shows that views on mental health vary across genders, with men having more negative views (Otten et al., 2021; Sagar-Ouriaghli et al., 2019). Further, blacks strongly agreed with statements on mental health stigma, especially from community views on mental health and its influence on health-seeking. This shows that stigma may vary across cultures.

Relationship of Results to Framework, Aims, and Objectives

The findings of this project align with the HBM framework on the influence of beliefs on health behaviors. The results also support the project’s objectives, including the need to explore mental health stigma and health-seeking behaviors and the necessity for cultural competence in mental health settings.

Strengths, Limitations, Recommendations, and Implications for Future Practice

The main strengths of this study are that it employs a mixed-methods and an interprofessional collaborative approach. However, it utilizes a small sample group limiting results generalizability. Subsequently, future research needs to use a larger sample size and focus on community-specific data on internalized and community-level stigma and related health behaviors. These findings can inform future research and the design of culturally sensitive mental health care.

Dissemination Plan

Findings of this project will be disseminated by being published in a peer-reviewed journal and through conference presentations and workshops.

References

Ahad, A. A., Sanchez-Gonzalez, M., & Junquera, P. (2023). Understanding and Addressing Mental Health Stigma Across Cultures for Improving Psychiatric Care: A Narrative Review. Cureus, 15(5). https://doi.org/10.7759/CUREUS.39549

Alemu, W. G., Due, C., Muir-Cochrane, E., Mwanri, L., & Ziersch, A. (2023). Internalised stigma among people with mental illness in Africa, pooled effect estimates and subgroup analysis on each domain: systematic review and meta-analysis. BMC Psychiatry, 23(1), 1–19. https://doi.org/10.1186/S12888-023-04950-2/FIGURES/11

Anuar, H., Shah1, S. A., Gafor1, H., Mahmood1, I., & Ghazi, H. F. (2020). Usage of Health Belief Model (HBM) in Health Behavior: A Systematic Review. Malaysian Journal of Medicine and Health Sciences, 16(SUPP11), 2636–9346.

Eylem, O., Eylem, O., De Wit, L., Van Straten, A., Steubl, L., Melissourgaki, Z., Danlşman, G. T., De Vries, R., Kerkhof, A. J. F. M., Bhui, K., & Cuijpers, P. (2020). Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis. BMC Public Health, 20(1). https://doi.org/10.1186/S12889-020-08964-3

Fante-Coleman, T., & Jackson-Best, F. (2020). Barriers and Facilitators to Accessing Mental Healthcare in Canada for Black Youth: A Scoping Review. Adolescent Research Review, 5(2), 115–136. https://doi.org/10.1007/S40894-020-00133-2/FIGURES/1

Green, J. G., McLaughlin, K. A., Fillbrunn, M., Fukuda, M., Jackson, J. S., Kessler, R. C., Sadikova, E., Sampson, N. A., Vilsaint, C., Williams, D. R., Cruz-Gonzalez, M., & Alegría, M. (2020). Barriers to Mental Health Service Use and Predictors of Treatment Drop Out: Racial/Ethnic Variation in a Population-Based Study. Administration and Policy in Mental Health and Mental Health Services Research 2020 47:4, 47(4), 606–616. https://doi.org/10.1007/S10488-020-01021-6

Hatzenbuehler, M. L., & Pachankis, J. E. (2021). Does Stigma Moderate the Efficacy of Mental- and Behavioral-Health Interventions? Examining Individual and Contextual Sources of Treatment-Effect Heterogeneity. Current Directions in Psychological Science, 30(6), 476–484. https://doi.org/10.1177/09637214211043884

Holder, S. M., Peterson, E. R., Stephens, R., & Crandall, L. A. (2019). Stigma in Mental Health at the Macro and Micro Levels: Implications for Mental Health Consumers and Professionals. Community Mental Health Journal, 55(3), 369–374. https://doi.org/10.1007/S10597-018-0308-Y/METRICS

Kapadia, D. (2023). Stigma, mental illness & ethnicity: Time to centre racism and structural stigma. Sociology of Health & Illness, 45(4), 855–871. https://doi.org/10.1111/1467-9566.13615

Lu, W., Todhunter-Reid, A., Mitsdarffer, M. L., Muñoz-Laboy, M., Yoon, A. S., & Xu, L. (2021). Barriers and Facilitators for Mental Health Service Use Among Racial/Ethnic Minority Adolescents: A Systematic Review of Literature. Frontiers in Public Health, 9, 641605. https://doi.org/10.3389/FPUBH.2021.641605/BIBTEX

Mongelli, F., Georgakopoulos, P., & Pato, M. T. (2020). Challenges and Opportunities to Meet the Mental Health Needs of Underserved and Disenfranchised Populations in the United States. Focus: Journal of Life Long Learning in Psychiatry, 18(1), 16. https://doi.org/10.1176/APPI.FOCUS.20190028

Otten, D., Tibubos, A. N., Schomerus, G., Brähler, E., Binder, H., Kruse, J., Ladwig, K. H., Wild, P. S., Grabe, H. J., & Beutel, M. E. (2021). Similarities and Differences of Mental Health in Women and Men: A Systematic Review of Findings in Three Large German Cohorts. Frontiers in Public Health, 9, 553071. https://doi.org/10.3389/FPUBH.2021.553071/BIBTEX

Rehm, J., & Shield, K. D. (2019). Global Burden of Disease and the Impact of Mental and Addictive Disorders. Current Psychiatry Reports, 21(2). https://doi.org/10.1007/S11920-019-0997-0

Sagar-Ouriaghli, I., Godfrey, E., Bridge, L., Meade, L., & Brown, J. S. L. (2019). Improving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-Seeking. In American Journal of Men’s Health (Vol. 13, Issue 3). https://doi.org/10.1177/1557988319857009

Schomerus, G., Stolzenburg, S., Freitag, S., Speerforck, S., Janowitz, D., Evans-Lacko, S., Muehlan, H., & Schmidt, S. (2019). Stigma as a barrier to recognizing personal mental illness and seeking help: a prospective study among untreated persons with mental illness. European Archives of Psychiatry and Clinical Neuroscience, 269(4), 469–479. https://doi.org/10.1007/S00406-018-0896-0/METRICS

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

---

Manuscript Draft #1