Mental Health of Ethnic Minorities

Mental Health of Ethnic Minorities and Migrants
Currently, we have an inadequate understanding of the prevalence of mental disorders among ethnic minority groups in the United States. One reason is that in the past, institutional populations, in which minority groups are dispro- portionately represented, were overlooked in national studies on the epidemi- ology of mental disorders (U.S. Department of Health and Human Services, 1999). More recently, efforts have been made to address this gap in knowledge. In this final section of the chapter, we will first discuss rates of psychopathol- ogy among four ethnic groups that have been a focus of recent research: Afri- can Americans, Asian Americans, Latino Americans, and Native Americans. Because most research has focused on primarily European American samples, prevalence rates are usually compared to this group. Second, we will discuss the mental health of immigrants and refugees both within and outside the United States.

African Americans
A study by Regier and colleagues (1993a), involving 18,571 adults from five
U.S. cities, examined the prevalence of a variety of mental disorders (including schizophrenia, depression, anxiety disorders, somatization disorders, and anti- social personality disorders) and found that the prevalence of mental disorders was higher among African Americans than among European Americans. Simi- larly, Lindsey and Paul (1989) report that African Americans are more often diagnosed with schizophrenia than European Americans. However, these dif- ferences in prevalence may be due not to inherent cultural differences but rather, to some extent, to socioeconomic (SES) disparities. For instance, when Regier et al. took socioeconomic factors into account, the prevalence differ- ences between African Americans and European Americans disappeared. Regier and colleagues argue that the enormous SES disparities among different ethnic groups in the United States may place those at the lower SES level at higher risk for mental disorders. Other researchers argue that ethnic minorities may also be more likely to be misdiagnosed with disorders such as schizophre- nia as a result of bias and stereotyping (Lewis, Croft-Jeffreys, & Anthony, 1990). Goater, King, & Cole’s (1999) five-year study of schizophrenia in Lon- don found that although the nature and outcome of schizophrenia were simi- lar across whites, blacks, and Asians, black patients were more likely to be de- tained, taken to the hospital by the police, and given emergency injections.

Asian Americans
It is difficult to paint an accurate picture of the prevalence of mental illness in Asian Americans because for many years they have not been included in epi- demiological studies (U.S. Department of Health and Human Services, 1999). Furthermore, being stereotyped as the “model minority” masks the fact thatAsian Americans may also be at risk for poor mental health (Uba, 1994). Some studies indicate that Asian Americans report higher rates of mental illness than European Americans (Takeuchi & Uehara, 1996; Uba, 1994). Nonetheless, studies also show great variation within the Asian American population depending on the specific ethnic background, generational status, and immigrant or refugee status. For instance, Kuo’s (1984) study found that Korean Americans had higher incidences of depression, followed by Filipino Americans, Japanese Americans, and Chinese Americans. Kuo argued that part of the reason may be that Korean immigrants have been in the United States for shorter periods of time and have lower-status jobs and more diffi- culty adjusting to the United States. Among Southeast Asians, Hmongs are more likely to report depression than are Laotians, Cambodians, Vietnamese, and Chinese Vietnamese (Ying, Akutsu, Zhang, & Huang, 1997). Southeast Asians may also be more likely to show lower levels of functioning than Chinese Americans (Uehara, Takeuchi, & Smukler, 1994). Clearly, the wide variation within an ethnic group demonstrates that sweeping generalizations in discussions of possible ethnic groups differences in mental health are not possible nor accurate.

Hasil (Bahasa Indonesia) 1:

Kesehatan mental etnis minoritas dan migranSaat ini, kami memiliki pemahaman yang memadai prevalensi gangguan mental antara kelompok-kelompok etnis minoritas di Amerika Serikat. Salah satu alasan adalah bahwa di masa lalu, populasi kelembagaan, di mana minoritas kelompok yang dispro-portionately diwakili, yang diabaikan dalam studi nasional pada epidemi-ology gangguan jiwa (US Department of Health and Human Services, 1999). Baru-baru ini, upaya telah dilakukan untuk mengatasi kesenjangan ini di pengetahuan. Dalam bagian akhir bab, pertama kita akan membahas tingkat psychopathol-ogy antara empat kelompok-kelompok etnis yang telah fokus penelitian terbaru: Afri - dapat Amerika, Amerika Asia, Amerika Latin, dan penduduk asli Amerika. Karena kebanyakan penelitian difokuskan terutama Eropa Amerika sampel, tingkat prevalensi biasanya dibandingkan ke grup ini. Kedua, kita akan membahas kesehatan mental imigran dan pengungsi di dalam maupun di luar Amerika Serikat.Afrika AmerikaSebuah studi oleh Regier dan rekan-rekan (1993a), yang melibatkan 18,571 orang dewasa dari limaKota di AS, memeriksa prevalensi berbagai gangguan mental (termasuk skizofrenia, depresi, gangguan kecemasan, gangguan somatization dan gangguan kepribadian anti-sosial) dan menemukan bahwa prevalensi gangguan mental adalah lebih tinggi di antara Afrika Amerika dari antara orang Eropa-Amerika. Simi-larly, Lindsey dan Paul (1989) laporan bahwa Afrika Amerika lebih sering didiagnosis dengan skizofrenia daripada orang Eropa-Amerika. Namun, ini dif-ferences dalam prevalensi mungkin disebabkan tidak melekat perbedaan budaya melainkan, sampai batas tertentu, sosial ekonomi (SES) kesenjangan. Sebagai contoh, ketika Regier et al. memperhitungkan faktor-faktor sosial ekonomi, prevalensi berbeda-ences antara Afrika Amerika dan Eropa Amerika menghilang. Regier dan rekan-rekannya berpendapat bahwa kesenjangan SES besar antara kelompok-kelompok etnis yang berbeda di Amerika Serikat dapat menempatkan mereka di SES lebih rendah tingkat pada risiko tinggi untuk gangguan mental. Peneliti lain berpendapat bahwa etnis minoritas juga mungkin lebih cenderung misdiagnosed dengan gangguan seperti schizophre-nia karena bias dan stereotip (Lewis, Croft-Jeffreys, & Anthony, 1990). Goater, raja, & Cole (1999) lima tahun studi skizofrenia di Lon-don menemukan bahwa meskipun sifat dan hasil dari skizofrenia simi-lar di putih, hitam, dan Asia, hitam pasien adalah lebih cenderung menjadi de-tained, dibawa ke rumah sakit oleh polisi, dan diberikan suntikan darurat.Asia AmerikaIt is difficult to paint an accurate picture of the prevalence of mental illness in Asian Americans because for many years they have not been included in epi- demiological studies (U.S. Department of Health and Human Services, 1999). Furthermore, being stereotyped as the “model minority” masks the fact thatAsian Americans may also be at risk for poor mental health (Uba, 1994). Some studies indicate that Asian Americans report higher rates of mental illness than European Americans (Takeuchi & Uehara, 1996; Uba, 1994). Nonetheless, studies also show great variation within the Asian American population depending on the specific ethnic background, generational status, and immigrant or refugee status. For instance, Kuo’s (1984) study found that Korean Americans had higher incidences of depression, followed by Filipino Americans, Japanese Americans, and Chinese Americans. Kuo argued that part of the reason may be that Korean immigrants have been in the United States for shorter periods of time and have lower-status jobs and more diffi- culty adjusting to the United States. Among Southeast Asians, Hmongs are more likely to report depression than are Laotians, Cambodians, Vietnamese, and Chinese Vietnamese (Ying, Akutsu, Zhang, & Huang, 1997). Southeast Asians may also be more likely to show lower levels of functioning than Chinese Americans (Uehara, Takeuchi, & Smukler, 1994). Clearly, the wide variation within an ethnic group demonstrates that sweeping generalizations in discussions of possible ethnic groups differences in mental health are not possible nor accurate.