Dual Diagnosis among African Americans

A Review of the Literature

Often times, when we look at an individual we will have a certain interpretation (judgment or thought) of that person based on their race, culture, age, sex, and so on. What happens when you look at an individual that has a mental health diagnosis, a substance abuse issue, has been, or is, incarcerated? Now, what if that individual has all three qualities and the individual has a different race than your own? What will you think of them? What judgments are rushing through your mind - right now? Will that person be treated differently by you? By society? Are you even aware of the despairing thoughts you have about another person. What will the consequences be for that individual? African Americans are suspiciously, and excessively “undiagnosed, minimally treated, and untreated…” which in turn, leads to “serious practice and policy implications that may mitigate or exasperate the inequalities in health that blacks experience” ( Hatcher, S., Toldson, I., Godette, D., & Richardson, J.., 2009, p.1).

“By the mid-year 2007, Blacks were almost three times more likely than Hispanics and five times more likely than whites to be jailed,” and currently 1.1 million of 2.6 million incarcerated individuals are African Americans in the United States (Hatcher, S., Toldson, 

I., Godette, D., & Richardson, J.., 2009, p.1). The study looked at individuals that had been detained, arrested, incarcerated, paroled, and/or released; so throughout this review, the term incarcerated will be used in place of the latter.  So, what does this say about our court system? Let’s look at the issues.

The court system has based its decisions (rulings) on the moral model: to treat individuals. They believe that the deficiencies found in people are due to a spiritual or character deficit. That the individual chooses to do something bad; in turn, they deserve the consequences that result in their actions. By using this type of model, they create a stigma and contribute to the improper treatment of individuals that are incarcerated. This can be seen through the policies that “Play a role in the criminalization of mental disordered persons. Many people with mental illness may be arrested for minor acts that are in fact manifestations of their illness and their lack of treatment” (Hatcher, S., Toldson, I., Godette, D., & Richardson, J.., 2009, p.2). The same can be said of individuals with a substance abuse diagnosis.

As long as individuals cannot receive adequate treatment, they will be unable to function in society in an acceptable manner.

“A 2001 report of the surgeon general discussed disparities in access, treatment, and quality of mental health care form minorities. Contributing factors associated with mental health in the African American community include: 1. Historical adversity; 2. Impeded access to insurance; and 3. The help-seeking traits of African American, whose traditional attitudes toward mental illness are considered a barrier in that they include stigmatization” (Hatcher, S., Toldson, I., Godette, D., & Richardson, J.., 2009, p.2).

Over the last few years, some courts have started using mental health court and drug court to make a difference. There has been some progress, but there needs to be more changes made within the court system. The laws need to be changed to treat a person using a combination of models rather than one model which just incarcerates the person. Incarcerating them does not treat the underlining condition.

In fact, the changes need to be made and implemented to help individuals before they are incarcerated. Treating one diagnosable condition in itself posses’ problems, treating two conditions just exasperates the problems, and when you add racial disparity to the mix… there doesn’t seem to be a great deal of hope.  

“A vast body of literature indicates that African Americans are disproportionately affected by a myriad of socioeconomic problems (including poverty, structural inequality, family disruption, inadequate schools) that increase the likelihood of mental health and behavior disorders, substance abuse…” despite all of this knowledge and information the progress towards improvement are minimal at best (Hatcher, S., Toldson, I., Godette, D., & Richardson, J.., 2009, p.5). Organizations, health care providers, and health care professionals know that the needs of African Americans can be met if a “multidisciplinary approach” is used.

References

Hatcher, S., Toldson, I., Godette, D., & Richardson, J.. (2009). Mental Health, Substance Abuse, and HIV Disparities in Correctional Settings: Practice and Policy Implications for African Americans. Journal of Health Care for the Poor and Underserved: Special Issue: Health Disparity Critical Issues, 20(2A), 6-16.  Retrieved October 15, 2010, from Research Library. (Document ID: 1777631601).