Depression in Men among Black Minority Ethnic Groups - Literature review Example

DEPRESSION IN MEN AMONG BLACK MINORITY ETHNIC (BME) GROUPS Depression in Men among Black Minority Ethnic (BME) Groups Component One: Literature Review Introduction Depression is a common mood disorder that causes someone to feel prolonged sadness, loss of interest, and a negative sense of general wellbeing (Birch, 2012 pp. 23). Depression is also known as clinical depression, major depressive disorder, or simply major depression. Individuals affected by depression can experience a low mood, which can affect their thoughts, behaviors, and feelings, leading to aversion to activity. Individuals suffering fro0m depression may also feel anxious, helpless, hopeless, restless, guilty, or worthless. Consequently, they may lose interest in some of the activities they found pleasurable and have challenges concentrating on certain issues, and experience difficulties in making decisions. If not proper addressed in the early stages, the affected individuals can experience insomnia, fatigue, reduced energy and suicidal thoughts, which can lead to one committing suicide (Bécares, Nazroo, & Jackson, 2014 pp. 2332). Depression is often associated with psychiatric syndromes like major depressive disorder as well as a reaction to some major shocking life events such as bereavement. It may also be linked to effects of withdrawing from drug use and other bodily sicknesses. Depression among men in Black Minority Ethnic Groups in the UK remains a largely overlooked topic in public health research. Despite the high levels of risks involved in depression among this section of the population, the men in BME communities remain a relatively invisible group when it comes to those seeking or receiving help for depression. Statistics indicate that men from the BME are less likely to access any formal help for diagnosis and treatment of depression (Brittian, et al., 2013 pp. 138). Nevertheless, population-based statistics imply that this section of the population has relatively higher numbers of undiagnosed depression in comparison to the men from majority White communities. These discrepancies call for attention towards some of the previously unexamined factors that militate against the men from the BME from accessing the help they need. Existing research also shows a strong connection between the influence of gender, deprivation and ethnicity in managing depression. There are several issues of concern for this group of the population, especially given that the wider population of older men including older men in BME communities has been neglected from the mainstream policies and government health strategies. Consequently, older men in BME groups are often underserved when it comes to accessing mental health help. This problem is further worsened by the fact that most of the strategies from the government targeting the BME groups often aim at managing physical health challenges such as diabetes, lung and coronary diseases. The aspect of mental health has been largely ignored by the government when addressing the health issues of the BME groups. As such, the men in the BME communities have continued to suffer the most from preventable and manageable mental health conditions such as depression. Background Most of the adult people from the BME are of good health physically. However, the situation worsens as they get older and become susceptible to numerous health conditions including physical disabilities and other illnesses. Similarly, issues such as loneliness and social isolation, bereavement, relocation, and increased poverty can lead to depression, which can affect the daily function of the affected individuals. However, depression in older people aged over 65 years is often neglected and treated as a normal aspect of ageing; hence they do not receive the attention and treatment they need. The men from BME communities suffer the most due to different socio-economic factors that militate them from accessing the necessary help. According to (Tobler, et al., 2013 pp. 340) the two most important factors in relation to depression in men in BME groups are under-detection and under-treatment. The whole concept of depression in men across all BME communities in the UK is not fully understood among professional healthcare providers. Therefore, this makes it difficult to determine the potential for treatment and provision of appropriate intervention becomes difficult. Nonetheless, there are also other factors that are likely to impede access to treatment for depression. These factors include reluctance to seek professional help due to associated stigma, lack of knowledge concerning the nature of depression, and expansive discrimination in the systems for delivering health among others (Brittian, et al., 2015 pp. 50). Recent projections of the population of the BME communities suggest that they are likely to increase in number in the coming years. Therefore, this makes it necessary to address these issues imminently in order to protect the future generations. Key Issues for Understanding in this Research When discussing the issues involved in depression and mental health among men in BME communities, it is essential to look at the socio-economic differences between the black minority groups and the white majorities (Doyle, Joe, & Caldwell, 2012 pp. 225). Issues such as discrimination based on race and color as well as stereotypes have contributed immensely to differences in accessing health for the minority groups. This is important because most studies have pointed to the prevalence of poverty and other demographic factors like regional distribution as the main causes of dispariti8es in the rates of depression between the BMEs and the White majorities (Williams, Hagerty, & Ketefian, 2005 pp. 36). These kinds of conclusions often leave out important information that can lead to resolving issues affecting depressing in men among BME groups. While on a general level, the minority groups suffer the most when it comes to depression, it is the male figures from these communities that suffer the most. Another important factor that makes it necessary to study depression in men from BME communities is the impact that depression has had on this section of the population. According to the 2011 national census, black minority communities account for about 3.3% of the population. This comprises of Black British, African, and Caribbean communities living across the UK. This has contributed to the increased ethnic diversity in the UK in recent years. Therefore it is necessary to protect these groups or community in order to maintain the rich diversity of the nation. As such, it is essential to ensure that their health needs are adequately addressed in order to bring them at par with the white majority groups (Walsh, 2009 pp. 46). Addressing this challenges faced by the men in BME communities will go a long way in reducing the cases of suicide and preventable deaths resulting from depression and other mental illnesses. It is also in line with international policies to make health services accessible to all sections of the population regardless of their racial, cultural, or ethnic differences. Therefore, al government public health policies should incorporate the issues affecting minority groups such as the men in BME communities (Sue, & Sue, 2013 pp. 73). There is need to increase their access to diagnoses and treatment processes that will help them manage their depressive conditions. Given the varied statistics relating to depression among men in BME communities, it is apparent that action needs to be taken to protect these men. Their plight can also be associated to the challenges faced by the wider BME community in relation to issues such as social stereotypes, discrimination, and legal issues. Contemporary Themes in Literature Despite the topic being neglected from public research for a long time, may researcher have taken up key issues relating them to depression in men across BME communities. In the past few years, a lot of studies have been covered in this area. However, there seems to be many gaps in literature regarding the causes and responses of men in BME groups to depression. This section of the essay analyzes some of the main issues that feature prominently in literature. One key theme that features prominently in literary studies concerning depression in men among BME groups is suicide. Despite a general reduction in the levels of suicide across the UK, there has been an increase in numbers of black male committing suicide in the past few years. Research has been able to establish a strong link between depression and suicide growing rates among men in BME communities. About 75% of the men affected by depression often end up committing suicide (Riolo, Nguyen, Greden, & King, 2005 pp. 999). Several factors are believed to have contributed to this situation, among them the difficulties in accessing medical help for BMEs. Another key issue that features in literature is the inability of strategies currently in place to mitigate the problem (Head, 2013 pp. 57). Depression is one of the most serious concerns in public health administration in the country. Despite the disorder being so common among the populations, the strategies and mechanisms employed thus far have been ineffective in mitigating the effects of the disorder. There are various limitations in implementing government strategies across all citizens in terms of addressing the diverse nature of courses and responses to depression. As such, certain sections of the population, most notably the Black Minority Ethnic communities continue to experience huge challenges with regard to managing depression (Jang, Park, Kang, & Chiriboga, 2014 pp. 330). Therefore, a deeper understanding of the topic will help in developing and setting up appropriate strategies and mechanisms for improving the quality of lives for the BME communities. This is because the BME group comprises of a significant portion of the population as well as a rich history of the country, hence deserve to be treated in a similar manner to other sections of the country’s diverse population. There are several challenges that exist in managing depression among patients. These challenges have made it difficult to mitigate the challenges imposed by depression as certain sections of the population are often left out (Eaton, & Johns Hopkins Bloomberg School of Public Health, 2012 pp. 33). For instance there exist widespread gender differences in accessing resources for managing depression. Research shows that women are better placed to receive help in managing depression as compared to men. About 30% of women get help in managing depression as compared to only 15% of the men across all communities in the country (Conrad, & White, 2010 pp. 77). Depression is also more common in women, with about one in every four women treated with depression at some point in their lives. On the other hand, only one in ten men have been diagnosed with depression. Similarly, doctors are more inclined towards treating women as compared to men, even in situations where there are common symptoms for the depression. Consequently, men suffer the most when it comes to depression as their issues and challenges affecting are often neglected. As such, about 75% of the men who suffer from depression end up committing suicide (Chesin, Moster, & Jeglic, 2013 p-p. 320). This trend has remained constant for the majority of the past decade, thereby calling for a shift in the strategies for managing depression in men. With this background, it is also important to bring in the element of Black Minority Ethnic (BME) groups in the management of depression. From a general point of view, the rates of depression are more common among minority ethnic communities due to the differences in historical, biological, and environmental factors. Furthermore, the challenges in accessing health available resources for the minority groups have also contributed to this problem (Donovan, et al., 2013 pp. 340). Research indicates that the rates of depression and other mental problems are about 60% higher in minority groups as compared to the majority white population. Similarly, the impact of depression in minority groups is far much greater (Kim, 2014 pp. 7). A majority of the depression related suicide deaths come from the minority groups. Caribbean’s and the Black African communities are three times higher to be diagnosed with depression in comparison to White communities. Similarly due to cultural stereotypes and perceptions, Black minority groups are likely to be ignored in the treatment of depression (Grant & Potenza, 2007 pp. 83). This is because most people perceive Black men either to be stronger or to be aggressive; hence it may be a challenge distinguishing whether the symptoms of depression are real or whether they are part of the person’s character. Another important factor for consideration in managing depression is age differences (Newell & Gournay, 2008 pp. 91). Depression is more common among older people across all races and ethnicities. About one in every five older people aged over 65 years are depressed. Significantly, most of these people are often left in care homes or in confinement within the community. As such, they do not receive the help they need in managing depression. Psychologists estimate that about 70% of the cases of depression in older people are related to poor physical health. In conclusion, relating the three factors discussed above shows that older man from black minority groups suffer the most from depression. Depression in men among the Black Minority Ethnic (BME) communities is a major issue of public health concern in Britain. This section of the population has been neglected for a long time in the history of the country, calling for imminent actions to be taken to protect them. In this regard, the inquest into the various issues that affect depression in men from BME groups has formed a greater portion of public health research in the past few years. Major themes discussed in various literary studies include issues such as discrimination in accessing public health, historical context of depression and mental health from a racial and ethnic perspective, factors that count for higher rates of depression among BMEs, stigma associated with treating depression among men in BME. Bibliography Bécares, L., Nazroo, J., & Jackson, J. (2014). Ethnic Density and Depressive Symptoms Among African Americans: Threshold and Differential Effects Across Social and Demographic Subgroups. American Journal Of Public Health, 104(12), 2334-2341. Birch, M. (2012). Mediating mental health: Contexts, debates and analysis. Farnham, Surrey: Ashgate. Bostwick, W. B., Meyer, I., Aranda, F., Russell, S., Hughes, T., Birkett, M., & Mustanski, B. (2014). Mental Health and Suicidality Among Racially/Ethnically Diverse Sexual Minority Youths. American Journal Of Public Health, 104(6), 1129-1136. Brittian, A. S., Su Yeong, K., Armenta, B. E., Lee, R. M., Umaña-Taylor, A. J., Schwartz, S. J., & ... Hudson, M. L. (2015). Do Dimensions of Ethnic Identity Mediate the Association Between Perceived Ethnic Group Discrimination and Depressive Symptoms?. Cultural Diversity & Ethnic Minority Psychology, 21(1), 41-53. Brittian, A. S., Umaña-Taylor, A. J., Lee, R. M., Zamboanga, B. L., Kim, S. Y., Weisskirch, R. S., & ... Caraway, S. J. (2013). The Moderating Role of Centrality on Associations Between Ethnic Identity Affirmation and Ethnic Minority College Students’ Mental Health. Journal Of American College Health, 61(3), 133-140. Chesin, M. S., Moster, A. N., & Jeglic, E. L. (2013). Non-Suicidal Self-Injury Among Ethnically and Racially Diverse Emerging Adults: Do Factors Unique to the Minority Experience Matter?. Current Psychology, 32(4), 318-328. Conrad, D., & White, A. (2010). Promoting mens mental health. Oxford, England: Radcliffe Pub. Donovan, R. A., Huynh, Q., Park, I. K., Kim, S. Y., Lee, R. M., & Robertson, E. (2013). Relationships Among Identity, Perceived Discrimination, and Depressive Symptoms in Eight Ethnic-Generational Groups. Journal Of Clinical Psychology, 69(4), 397-414. Doyle, O., Joe, S., & Caldwell, C. H. (2012). Ethnic Differences in Mental Illness and Mental Health Service Use Among Black Fathers. American Journal Of Public Health, 102(S2), 222-231. Eaton, W. W., & Johns Hopkins Bloomberg School of Public Health. (2012). Public mental health. New York: Oxford University Press. Grant, J. E., & Potenza, M. N. (2007). Textbook of mens mental health. Washington, DC: American Psychiatric Pub. Head, J. (2013). Black men and depression: Saving our lives, healing our families and friends. New York: Harmony Books. Jang, Y., Park, N., Kang, S., & Chiriboga, D. (2014). Racial/Ethnic Differences in the Association Between Symptoms of Depression and Self-rated Mental Health Among Older Adults. Community Mental Health Journal, 50(3), 325-330. Kim, M. (2014). Racial/Ethnic Disparities in Depression and Its Theoretical Perspectives. Psychiatric Quarterly, 85(1), 1-8. Newell, R., & Gournay, K. (2008). Mental Health Nursing: An Evidence Based Approach. London: Elsevier Health Sciences UK. Riolo, S. A., Nguyen, T. A., Greden, J. F., & King, C. A. (2005). Prevalence of Depression by Race/Ethnicity: Findings From the National Health and Nutrition Examination Survey III. American Journal of Public Health, 95(6), 998–1000. Sue, D. W., & Sue, D. (2013). Counseling the culturally diverse: Theory and practice. Hoboken: John Wiley & Sons. Tobler, A. L., Maldonado-Molina, M. M., Staras, S. A., OMara, R. J., Livingston, M. D., & Komro, K. A. (2013). Perceived racial/ethnic discrimination, problem behaviors, and mental health among minority urban youth. Ethnicity & Health, 18(4), 337-349. Walsh, L. (2009). Depression Care Across the Lifespan. Chichester: John Wiley & Sons. Williams, R. A., Hagerty, B. K., & Ketefian, S. (2005). Depression research in nursing: Global perspectives. New York: Springer Pub. Co. Component II: Component Two: A written Critique of Skills Development I have benefited immensely from this course in terms of acquiring knowledge and skills that can enrich my professional practice in different settings in mental health. During the duration of SK5203: Mental Health and substance misuse, we engaged in various activities and exercises as well as learnt a lot of information that has not only widened my understanding of mental health, but also helped me acquire critical skills. Most of the concepts we learnt in class were accompanies by specific examples and illustrations that made everything practical and easier to comprehend. The interactions with the instructor and fellow classmates were also informative and influential in terms of shaping my personal perspective of delivering mental healthcare in the community. As such, the course was an eye opener for me in discovering the entire world of mental health. Prior to joining the course, my knowledge and experience with mental health issues was only limited to different perceptions I had gathered from my environment. However, by attending this course, I have been able to understand the fundamental concepts in mental health and I am in a position to apply the concepts in professional practice efficiently. I found the course interesting and fascinating in terms of the knowledge I gained. Each time, I seemed to stumble across a new concept that dazzled my mind and aroused my interest in learning more about it. Consequently, I ended up learning more than I has actually expected. The resulting effect is that by bathe end of the course, I had vacated some all of the misconceptions I had about mental illness and drug misuse prior to joining the course. For instance, prior to joining the course, I had engaged with different people with mental health issues. However, with such a limited knowledge, I was not able to discern the challenges they faced or distinguish one mental illness from another. One of my close family members was diagnosed with depression in the latter stages of his life. The depression, which persisted for quite some time, arose from bereavement after losing one of his parents. At that point, I could see him go through the struggles associated with depression, but I could not understand the severity of the ailment. For example, he became increasingly withdrawn, anxious, sad, and paranoid. Fromm time to time, he spoke about dying to be reunited with his parent who had passed on. At the time, I did not recognize depression as a major mental disease. I presumed it was a natural consequence for someone experiencing grief and a natural part of life. However, after going through this course, I can look back and appreciate the knowledge I have gained. This is because I have been able to learn that mental illnesses vary in various respects such as degree of severity. There are mild mental illnesses and extremely serious mental disorders. As such, depression is categorized as a mild mental illness while extreme disorders such as schizophrenia and other personality disorders can be categorized as extreme mental disorders. Therefore, I was able to learn that mental illnesses can range from mild illnesses that affect one’s normal psychological functions to very serious mental disorders. With this knowledge, I am now better placed to help people suffering from a wide range of mental illnesses. I am better equipped at identifying the various courses and symptoms of different kinds of mental illnesses and offering responsive mechanisms to mitigate their impact. Similarly, this course has also enriched my understanding of drug and substance misuse. After going through numerous literatures written on the topic, I was able to understand and relate the elements of drug abuse to mental health issues. Misuse of drugs can lead to one suffering from various kinds of mental health illnesses (Smith, 2012 pp. 25). Similarly, some mental health disorders can make an individual vulnerable to misusing drugs. Before attending the course, I had held many beliefs and opinions about people who abused drugs. For instance, I believed that everybody had a decision to make with regard to using or misusing drugs. Therefore, the drug abusers knew what they were doing and that it was their own personal decision. As such, it was justified that they faced the consequences of their actions. However, after understanding the concepts gained from the course, I now realize that such perceptions are only misconceptions with no scientific basis. In order to understand the whole concept of drug misuse, it is crucial for one to approach it from a holistic perspective. I realized that there is a cause-effect relationship between mental illnesses and drug abuse. Therefore, in order to understand one aspect of it, one has to determine the courses and the effects of each so as to make a conscious decision and develop mechanism of addressing or intervening from one end. Furthermore, I have a teenage son, who is also vulnerable to drug abuse and eventual mental illness. Besides, anyone from any background can fall victim of drug abuse and mental ailments. This is also contrary to public onions and misconceptions that such issues can only be associated with poor people in the society. For teenagers like my son, challenges such as peer pressure can induce one to drug abuse without the knowledge of parents and other adults around them. Any teenager can fall victim to peer pressure regardless of their background and wealth. I was able to understand this aspect of managing drug abuse and mental illnesses after reading a wide range of literature relat6ed to the course. Similarly, individuals suffering from trauma are also vulnerable to drug abuse. This is because they may see the drugs as an avenue of escaping their traumatic experiences. In addition to the various issues I leant from the course as explained above, I was a.so able to understand the social/medical model in managing mental illness. We were introduced to this model of health management in class by the instructor during one of the lectures. The social/medical model is an emerging approach for managing health. This model assesses several factors within one’s environment that can predispose them to different illnesses (Cooper, 2011 pp. 46). For instance, the model looks at factors such as lifestyles of individuals and other environmental factors that can make one susceptible to diseases. The model is used for purposes of identifying predisposal factors in order to devise appropriate responsive strategies and interventions to prevent the individuals from suffering from the disease. Also, the model states that certain diseases emanate from a social perspective, that is, there are various structures with in the society that make it difficult for patients to manage their sicknesses and disabilities, thereby making teem suffer more some diseases can be prevented if the society changed its approach for managing illnesses (Scheid, & Brown, 2010 pp. 113). Generally, the social/medical model of health is mainly concerned with public health issues and how the society can manage its public health systems to prevent prevalence of certain ailments. After learning about the social/medical model of health, I was able to determine how to use it in managing mental illness. The first point in implementing the model is trying to look at various issues in the society that can cause mental illnesses. For example, issues such as drug abuse, grief, trauma, discrimination, poor living standards, and lack of sufficient knowledge can contribute to certain individual contracting either mild or severe mental sicknesses. With this background in mind, one can develop appropriate strategies for managing the situation by addressing each of the issues identified. This can help to prevent mental sickness or help sick individuals manage their situations effectively. As part of this course, I engaged in the process of gaining practical skills to complement the theoretical knowledge I have gained. This was at my area of placement, where I was posted in one of the busiest mental health facilities around. This was quite a challenge for me in terms of implementing my theoretical knowledge practically, as well as an opportunity to learn new things and ideas in a workplace environment. This exercise was very fruitful because I was able to gain immensely for the activities I was involved in during the period of the placement. While at the facility, I was able to learn how to work in teams for the purpose for providing the best mental health outcomes for patients. Managing the health of mentally ill patients is quite challenging and often required a team process, including the families and close friends of the affected people to be successful. As such, this team process requires one to develop skills such as communication and relationship skills in order to be effective in relating with others in the work environment (Zastrow & Kirst-Ashman, 2010 pp. 84). Similarly, working in such a busy environment helped me develop a number of other skills which will come in handy during my future professional practice. For example, I was able to develop and shape my leadership skills, decision making skills and strategic planning skills. During the placement, I engaged in various activities in different capacities that provided me with a holistic professional development. I was in charge of certain projects, for instance, designing treatment plans for different patients. Roles such as these required me to exercise my leadership and decision managing skills, as well as strategic planning to ensure that the programs went as expected. Nevertheless, the most important aspect or lesson that I gained from my placement was managing different kinds of patients. For instance, during my process of engaging with various clients or patients, I came across one patient who was suffering from paranoid schizophrenia. This was the first time I was meeting a patient with such a medical condition and I grew apprehensive towards working with her. She was very unpredictable in terms of her mood and general behavior. This totally scared me because I could not determine what she was about to do. My first impression of her was that she would be very aggressive and resist most of the treatment strategies that I would prescribe top her. On the contrary, she turned out to be very friendly. I opted to use a person-centered approach in communicating with her. This approach requires that the healthcare providers let the patients talk without being interrupted. This was very effective because the patient was very welcoming and open to medical questions. From our initial engagement, I was able to determine that she was already under medication for her aggressive behavior. She was receiving daily injections to help manage her aggressiveness. She also told me that her aggressiveness had brought her on the wrong side of the law after she assaulted the police on one occasion. At this point it was crucial not to judge her and let her air out her concerns for me to be able to help her make positive choices during the treatment process. During this process, I was able to learn how to interact with patients using different approaches such as the person-centered approach. Secondly, I also learnt that it is important not to let personal prejudices and judgments affect the treatment process. Had I let my initial judgment of the patient’s aggressiveness affect the treatment, I would never have discovered that she was very friendly and cooperative. Similarly, I learnt that different patients react to treatments differently. Patients such as this one are willing to get help in managing their condition can make it easy for healthcare providers in implementing various treatment programs. One aspect that I want to focus on in my future practice is improving my knowledge of different mental sickness. From the first day of the course, I have been able to develop and cultivate a strong passion for understanding mental ailments with an objective of helping people manage their conditions through different strategies. After meeting different kinds of patients during my placement, this passion has only grown. I would like to focus on understanding complex mental cases such as paranoid schizophrenia that I was confronted with during my placement. Furthermore, I intend to use my already acquired skills and knowledge to participate actively in creating awareness of mental health sicknesses. Furthermore, I would also involve myself in research in the field to help uncover important knowledge that would enhance the processes of managing mental illnesses. Bibliography Cooper, D. B. (2011). Intervention in mental health-substance use. London: Radcliffe Pub. Scheid, T. L., & Brown, T. N. (2010). A handbook for the study of mental health: Social contexts, theories, and systems. Cambridge: Cambridge University Press. Smith, G. (2012). Psychological interventions in mental health nursing. Maidenhead: Open University Press. Zastrow, C., & Kirst-Ashman, K. K. (2010). Understanding human behavior and the social environment. Belmont, CA: Brooks/Cole Cengage Learning. Read More