Disparities Affect Black Males
Correcting educational and health disparities and addressing undiagnosed mental health needs in the African American community will be vital in overcoming the increasing incarceration rates of black males and juveniles in the United States. This was the conclusion of a panel of experts who discussed untreated mental disorders in this population yesterday morning during a workshop titled “Incarceration of Black Males: The Effects of Untreated Bipolar, ADHD, and Substance Abuse Disorders.”
In addition, cultural roadblocks, media depictions of the “super thug,” and the booming prison industry all contribute to the acceptance of over-incarceration of black males in America, the panel agreed.
“At any given time, one-third of black men are in the legal system, including incarceration, probation, or parole,” said Otis Anderson, M.D., a psychiatric specialist with Tri-Lakes Behavioral Health, Batesville, Miss. “There’s a huge industry in locking people up.”
Napoleon B. Higgins, M.D., CEO and President of Baypoint Behavioral Health Services in Houston, presented chilling statistics of the overwhelming growth of the penal system in Texas. Between 1980 and 2004, there was a 566 percent increase in the prison population and a 1,600 percent increase in corrections spending, he said.
Drug use is often cited as cause for the overabundance of black males in the prison system, Dr. Higgins said. However, African Americans make up only 13 percent of daily drug users in the U.S., he said, even though they represent the vast majority of the prison population.
Arrest statistics also paint a troubling picture. For example, 55 percent of crack users in the United States are white but 74 percent of people incarcerated for crack use are black, Dr. Higgins said.
“Drugs are an excuse to put black people in jail,” Dr. Higgins said. “Disparities exist in drug-related incarcerations. Police are hunting out black males because they are the face of violent crime in the media.”
Indeed, all of the panelists cited media depictions of the black male as a violent crime instigator as one of the leading factors contributing to the growing imprisonment of African Americans. “In media and rap music, essentially you can be aggressive, violent, and hypersexual with no consequences to behavior,” Dr. Higgins said. “The promotion of that manic-type ‘super thug’ drives a lot of kids to believe that people actually live like that.”
When black males are incarcerated, there is a lack of diligence in diagnosing and treating mental illness and disorders, said Rahn K. Bailey, M.D., Chairman of Psychiatry and Behavioral Sciences at Meharry Medical College, Nashville. But in many cases, mental disorders such as ADHD that could have been diagnosed and treated in childhood are left undiscovered until a person has landed in the penal system.
“The reality is African American males are people, too,” Dr. Bailey said. “They have clinical psychiatric illnesses such as ADD, ADHD, bipolar disorder, and schizophrenia and they need to be treated.”
Dr. Bailey advocates for early diagnosis and treatment, but says cultural issues within the black community provide a roadblock for early intervention and treatment of many mental disorders. For example, there’s a huge social stigma attached to ADHD diagnosis and treatment.
“Parents need to be educated that this is not a bad thing or an albatross around their child’s neck,” said Dr. Bailey, who also cited the need for psychiatric organizations working with minority patients to make sure the information distributed in the community is appropriate and culturally sensitive.
When a diagnosis is made and treatment is offered, other challenges include cultural, environmental, ethnic, and genetic factors that play into the toxicity, metabolism, and side effects of medication.
Johnny Williamson, M.D., Chief Medical Officer Clinical Director of the Pediatric Psychiatric Unit at Hartgrove Hospital, Chicago, highlighted some of the drug-related interactions associated with genetic and cultural factors. For example, African American children are more likely to experience high blood pressure when taking a stimulant for ADHD, he said.
Dr. Williamson recommended rational psychopharmacotherapy, treating each person individually, discussing the factors that will impact treatment, and establishing an effective treatment alliance. “I’ve only seen a positive benefit when I’ve been able to be knowledgeable about, discuss, and include in my treatment some aspect of talking about what a person’s culture, desires, preferences, and understandings are,” he said.