African-American Women’s Views On Depression Care Shaped By Racism

African-American women’s beliefs about depression and depression care are consistently and systematically influenced by racism, according to a new study conducted at Oregon Health & Science University. The results are published online in the American Journal of Public Health. Study participants were asked about their experiences and beliefs surrounding the relationship between violence and health in general, mental health, depression, and depression treatments. They also were asked to discuss their recommendations for improving depression care. The researchers found one issue dominated discussions about depression care – the participants’ deep mistrust of what they perceived to be a “White” health care system.

“These women were extremely wary of most depression treatments and providers they associated with ‘White’ systems of care. Although they acknowledged that violence, depression and substance abuse adversely affected their health, discussions about health care revolved around their perceptions of racism,” said Christina Nicolaidis, M.D., M.P.H. “Based on our findings, we recommend health and mental health providers endeavor to better understand and acknowledge how racism informs the experiences and perceptions of their patients.”

The expectation of being a “Strong Black Woman” also was a significant barrier to recognizing depression and seeking care. Co-investigator S. Renee Mitchell has used this finding to launch a campaign asking: “Strong Black woman – what are you burying, your feelings or the myth?” The research team also has organized several community depression and violence awareness events titled “Redefining the Blues.

Study participants expressed a desire for community-based depression programs that addressed violence and drug use and are staffed by African-Americans with “real-life experiences.” In response to this request, the research team used their study data to create a community-based, culturally tailored depression-care program, which they currently are pilot-testing at Bradley-Angle House’s Healing Roots Center, a drop-in center for survivors of domestic and sexual violence.

The researchers make clear that their results aren’t reflective of all African-American depressed women, especially those who live in places with larger African-American populations, those with higher incomes and those who have not experienced intimate partner violence.