Screening methods for depression that take context and culture into consideration could be more effective in uncovering clinical depression in African American mothers, according to a study led by a Rutgers University-Camden nursing professor.
The study comes as the nation observes National Mental Health Awareness Month where officials at the Arlington, Va., based National Alliance on Mental Illness — NAMI, notes that one in five people will be affected by mental illness in their lifetime.
NAMI helps to fight stigma, provide support, educate the public and advocate for policies that support people with mental illness and their families.
Although anyone can develop a mental health problem, African Americans sometimes experience more severe forms of mental health conditions due to unmet needs and other barriers, NAMI officials said.
According to the Health and Human Services Office of Minority Health, African Americans are 20 percent more likely to experience serious mental health problems than the general population.
Common mental health disorders among African Americans include:
• Major depression.
• Attention deficit hyperactivity disorder (ADHD).
• Suicide, among young African American men.
• Post-traumatic stress disorder (PTSD) because African Americans are more likely to be victims of violent crime.
Further, African Americans are more likely to experience certain factors that increase the risk for developing a mental health condition:
• Homelessness. People experiencing homelessness are at a greater risk of developing a mental health condition. African Americans make up 40 percent of the homeless population.
• Exposure to violence increases the risk of developing a mental health condition such as depression, anxiety and post-traumatic stress disorder.
• African American children are more likely to be exposed to violence than other children.
Black women are also susceptible to mental health challenges.
In the Rutgers study, referencing well-known theories about the “strong woman complex” in Black women and its relation to depression, “they may not admit when they have certain feelings,” said Rahshida Atkins, an assistant professor at the Rutgers School of Nursing-Camden.
“Face to face, they may not answer ‘yes’ to depression screening questions that ask, ‘Are you depressed?’ or ‘Do you feel sad?'” Atkins said in the study published by Rutgers-Camden News Now.
In these situations, the medical professional may not detect that the patient is depressed and the patient may not receive the treatment that they need.
Health care providers are required to ask all adults these questions during health visits.
The Rutgers University-Camden researcher has found that Black single mothers experience depressed mood because of stressors created by issues including poverty, unstable relationships and housing, parenting and family stressors, and lack of access to high-quality health care for themselves and their families.
“Growing up with a depressed mom is also an adverse childhood experience,” Atkins said. “The emotional, cognitive, and social development of children can be hindered when their mothers are depressed and do not receive treatment,” she said.
Atkins, who studies mental health, health equity, and behavioral health, said much of the research on depressive symptoms shows that African American women and other minority populations often report bodily pain symptoms such as stomachaches, headaches, tiredness or interpersonal difficulties when they are depressed.
She said she believes the women surveyed were more comfortable expressing their depressed mood symptoms because they were putting responses on paper, and they were assured anonymity and confidentiality.
“This isn’t something they often display in front of others or others of their culture, or even in front of me,” said Atkins, who frequently interacts with Black single mothers when conducting community engagement studies.
Since the women did not have to put their name on the forms, “nobody would know what they were writing, so they’re able to be honest about how they truly feel,” Atkins said.