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Patricia L.

2681-C Delk Road
Marietta, GA 30067

October 5, 2011

Dekalb County
Community Development Department
1250 East Ponce De Leon Avenue
Decatur, GA 30030

Re: African American Women Mental Health Issues: Stigmas and Perceptions- A program to
empower African American women and provide appropriate culturally sensitive, effective, and
sufficient care

Dear Chris Morris:

This letter is written to you in an appeal for funding for culturally sensitive mental health
services and facilitieswithin the DeKalb County and locally surrounding areas. There are current
barriers that are preventing African American women from seeking and acquiring appropriate
mental health services.

The benefits of providing these services will include, comprehensive exams for underserved
populations, decrease the mortality and morbidity rates of said population, build a network of
competent providers within the community, and increase and improve overall quality of life.

The population who would benefit from these services would be the African American women
and African American female adolescents. My focus is on the African American adult women
because their mental health directly impacts the future mental health of their daughters.

Currently among the African American communities, women are not seeking mental health
services because of the stigmas and perceptions associated with having a mental disorder. This is
causing severe emotional distress on the women, their family, and the community as a whole.
Having a mental illness is very taboo among most African Americans. So you have women with
these illnesses raising families, working fulltime and trying to maintain a balance. Nevertheless,
the absence of treatment or the lack of thereof, causes these women to lose their jobs; their
families suffer, and strain on the community.


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Project Planner and Developer


African American Women Mental Health Issues: Stigmas and Perceptions- A program to
empower African American women and provide appropriate culturally sensitive, effective, and
sufficient care

Submitted to:

DeKalb County Community Development Department, 1250 East Ponce De Leon Avenue,
Decatur, GA 30030

Submitted by:

Patricia L. Hill, 2681-C Delk Road, Marietta, GA 30067, (770) 896-9500

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The goals of the program are to empower African American women, foster local community
support, and reduce stigmas and perceptions about mental health illnesses.

The plans to achieve these goals first involve increasing the awareness and knowledge about
mental health disorders and clearing up the misconceptions about the disorders. The program
will use the competenciesand resourcesthe African American women already have and expound
on them as well as teach new skills and provide new resources.

The first objective of empowerment consists mainly of increasing positive attitudes, building
self-esteem, and developing healthy support systems. This will be achieved by getting the
women to open up and talk to one another through means of focus groups and exercises
involving interpersonal communication skills. During the group sessions, the women will be
given skill building exercises to complete individually and also will be participating in partnered
activities. Each activity will contain real life scenarios that involve a dialogue and discussion.
This will build each woman’s confidence level and provide insight on various ways to deal with

The next step is to foster local community support. To do this task involves using social
networks that are already inside the community by creating awareness, educating the population,
providing accurate, adequate, and appropriate information.There’s an Ethiopian truism that says,
"When spider webs unite, they can tie up a lion." By working with community groups and
significant local representatives, we can affectthe community. Because of the spiritual and
religious influence established in these communities, the plan will incorporate biblical values and
collaborate with ministers.

The ministers will help us gain the trust, commitment, and loyalty of the community. The plan is
not a replacement to the local church; it is to be a supplement to the church teachings. With this
collaboration and partnership involving the church and its religious leaders there should be a
25% decrease in depression, anxiety, and stress related disorders and/orbehaviors. This will be
evident from the doctors’ reports, police reports, and neighborhood clinics accountability logs.

Lastly, the reduction of stigmas and perceptions as regardsto mental health problems in African
American women. In our efforts to combat these issues, we have engaged local radio, television,
and newspaper personalities to come into the community biweekly and listen to the concerns of
the people. This has enabled important discussions to take place and issues to be brought to the
forefront. Community leaders speak on the misrepresentations of the community, while the

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personalities ask questions and seek resolutions. This type of intervention is beneficial for
everyone involved. Because the media plays a big part in getting information out and creating
images, perceptions, and attitudes.

This part of the plan can be measured by the new television shows, commercials, advertisements,
music videos, newspapers articles, magazines and all other media outlets that are being aired.
The print, visual, and audio media will begin to portray African American woman in a better
more positive perspective when it comes to telling their stories. A 30% decrease in negative
images, stories, and songs.

Statement of Need

Surgeon General, David Satcher’s 2001 report Mental Health: Culture, Race, and Ethnicity
investigated the inequalities in mental health care and treatment among racial and ethnic
minority groups. His report listed three main issues for these differences: minority groups have
less access to care, they are less likely to receive treatment for mental disorders, and the care
received is of insufficient quality.

According to Trevor (2006), minority populations were less likely to access mental health care
because of stigmas about mental disorders. African American women are exposed to double
stigmas, the fact that they have a mental illness and that they are part of racial minority group.
These women not only suffer from the stigma of having a mental illness but the perception of the
illness is also of high concern. Historically, African American women were seen as very
aggressive, strong willed, hard workers, and the back bone of the family, therefore to have a
mental illness would contradict those characteristics and place shame on the women and her
family. So it is better to deny or not acknowledge that a problem exists.

For an African American woman to have a mental illness in the opinions of the community,
society, church, family, and individuallysymbolizes that she is weak, lacks faith in God, is not a
good mother, dysfunctional when it comes to maintaining relationships and ill equipped to
function in society. These perceptions contributes to the African American woman’s low self-
esteem, identity, self-worth, and self-perception, thus adding stress and strain on her emotions
causing psychological problems.

Because of situations comparable to the Tuskegee Experiment and incidents like Sara Bartman
(Hottentot Venus), there is mistrust between medical entities and African American women.
Moreover, African American women tend to rely on the church, the family and friends, and
neighbors to cope with emotional stressors.

In a study done by Cristancho (2008) and Miranda (2003), there are also system level barriers
that prevent African American women for gaining access to mental health treatment. These

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barriers include inaccessibility to location and transportation, no health insurance, child care
issues, availability of services, and absence of culturally competent staff.

Because African American women tend to reside in rural or inner city areas, their access to
suitable, sufficient, and quality care is limited to none. These areas tend to be breeding grounds
of violence, drugs, unemployment, illiteracy, and single and teen parents. These neighborhoods
lack healthy food options, safe playgrounds, viable jobs, inadequate housing, and liquor stores at
every corner. These women don’t perceive a way out of this environment or a way to change it.


My program will provide a way for African American women to empower themselves and their
communities; recruit culturally competent psychiatrists, psychologists, and therapists; create
networks of providers; mobilize neighborhood watches and patrols; encourage support groups
and peer mentors; draw attention and promote action to build literacy rates; educate; train;
inspire; build unity; increase awareness; develop community pride and ownership; create leaders
and role models; develop policies, implement laws and guidelines on conduct; decrease loitering,
soliciting and the presence of alcohol vendors.

The goal of the program is to reduce the negative stigmas and perceptions attributed to mental
illness amongst African American women and their communities as a whole. By reducing the
stigmas and perceptions there has to be emphasis on uplifting and elevating the community in
which they reside

The beneficiaries of this program are African American women. They will benefit from this
program in several ways:

Better awareness of their mental illnesses

Sense of well-being
Ability to separate the illness from the person
Better quality of life
Positive outlook on life
Improved interpersonal relationships
Decrease in medication intake
Provide support to other in similar situations
Advocate for more services
Educate the public
Recruit culturally competent professionals

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Established networks
Improved coping skills
Ability to provide understanding and knowledge to their children
Put an end to the cycle
Increased safety and security in the community
Partnerships with other external agencies

The community benefits

Awareness of the problem

Decrease violence
Creation of support groups
Increase in grocery stores and community gardens
Implementation of neighborhood watches and patrols
Creation of youth centers and social activities
Partnership and involvement with churches and religious organizations
Decision making authority of vendors moving into neighborhoods
Enforcement of neighborhood curfews for ages 18 and below.
Accountability of residents
Job training programs and skills training
Increase in employment
Creation of new jobs in the area
Cooperative agreements
Volunteer agreements
Job sharing partnerships
Suitable and affordable housing
Accessible health care services
Affordable childcare
Accessible transportation
Community health insurance programs and grants
Decrease in money spent for vandalism, crime, teen pregnancy, substance abuse, robberies, and
Decrease in cost of hospital visits and medication
Decrease in unlawful soliciting and loitering

The most vulnerable populations that will be influenced by this program will be youths ages 13-
21; middle age 30-45; and the elderly 65 and above.

This program will be saving the community $1.5 million dollars a year.

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This program will incite businesses to invest in the community and sponsor programs to maintain
the functionality of the residents. The African American women who are helped with this
program will invest to be sponsors, funding sources, and affiliates of the program.The networks
and partnerships established will become financial donors. The program encourages each
recipient to give back to the program the services they have received in order to support other
African American women.

Within the program there is a system of charity and giving and a spirit of compassion and
empathy amongst participants.

This program ensures re-investment in the community and its residents as well as instills a sense
of community pride, ownership and participation. The residents will have sustained an
environment built on trust, privacy, mutual respect, dedication, and commitment to one another.
It guarantees success because the residents begin to support one another and have a vested
interest and loyalty to the health, viability, and welfare of the community.

Sources of revenue:

Donations (money, clothes, equipment)
Community Yard Sales
Car Washes
Bake Sales
Social Events
Charitable Gifts
Vending Machines

Budget for Outreach Center

Building (insurance, mortgage) $2500

Utilities $350

Telephone $150

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Internet $150

Office Supplies $3000

Computer/Computer supplies $4500

Building Maintenance $2000

Security $400

Childcare $1200

Transportation $2500

Project Management

The program will be managed by the Program Developer and Planning Team. The Program
Developer will develop a curriculum for staff and the planning team will organize the classes to
be scheduled. The two full time employees will be conducting the evaluations and the two part
time employees will be completing the assessments.

The two fulltime employees will be conducting client interviews, intake, and needs assessments.
The two part-time staff members will be coordinating transportation and childcare assistance.
The volunteers will be ensuring that the files are updated, organized and maintained for accuracy
and accountability. The volunteers will assist clients with accessing resources via computer
and/or telephone.

The equipment will remain under warranty and Staples and Office Depot will maintain and
service the equipment. There is also a certified technician who volunteers that will provide daily
monitoring and service on an as needed basis.

The office space will be cleaned daily by volunteers who have their own office cleaning

The outreach center is sort of a self-reliant entity, because most of the services will be provided
by our volunteers who are specialist/certified in Computer IT, housekeeping, maintenance,
cooking, teaching, accounting, law enforcement, electrical wiring, plumbing, counseling, and
HVACfor little to no charge.


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The evaluation process will be done on an ongoing basis. The outreach center’s goal is to
empower and provide a network of culturally sensitive mental health services. When evaluating
the empowering of individuals we would conduct focus groups quarterly to receive feedback
form the participants. Also we would be conducting routine checks on client’s files to ensure
they are current on doctor visits, medication, therapy, and training. The information that was
provided during the intake will be compared to the information up to date. This will give a road
map on how the program is working and what processes need improvements.

In addition, we would have individual meetings with our clients to discuss which goals they have
achieved and which ones they are currently working on. The discussions would be another
evaluation tool to gauge where the client’s progress is from where it was during the beginning of
the program.

Furthermore, there would be open discussions where the women would have the opportunity to
engage the community regarding their newfound independence and share their stories without
fear from stigma or perception.

Because the program is an outreach center, we can only tract those services that are provided in-
house. We would have to depend on the client and the network providers to supply or furnish us
with their assessments for our staff to evaluate. However, when we refer clients out, we have a
written agreement with those providers to send us their progress notes. That is why our staff has
to be certified and trained in HIPPA. We take our services very seriously and our intent is to treat
each person with respect, professionalism, tact and courtesy.

Our ultimate outcomes from the program are to have educated and provided the tools and
resources needed to empower the African American woman to seek mental health services;
decrease stigmas and increase positive perceptions. This program should inspire other
communities to begin a dialogue about mental health issues among their African American
women population.

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Shim, R.S., Compton, M.T., Rust, G., Druss, B.G, &Kaslow, N.J. (2009). Race-ethnicity as a

predictor of attitudes toward mental health treatment seeking. Psychiatric Services, 60

(10), 1336-1341.

Trevor, J., Schraufnagel, B.S.., Wagner, A.W., Miranda, J., & Roy-Barne, P.P. (2006). Treating

minority patients with depression and anxiety: What does the evidence tell us? General

Hospital Psychiatry, 28, 27-36.

Nadeem, E., Lange, J.M., Edge, D., Fongwa, M., Belin, T.,& Miranda, J. (2007). Does stigma

keep poor young immigrant and U.S.born Black and Latina women from seeking mental

health care?Psychiatry Services, 58 (12), 1547-1554.

Ward, E.C., Clark, L.O., &Heidrich, S. (2009). African American women’s beliefs, coping

behaviors, and barriers to seeking mental health services. Qualitative Health Research,

19 (11), 1589-1601.

Perkins, K.R. (1996). The influence of television images on black females’ self-perceptions of

physical attractiveness. Journal of Black Psychology, 22 (4), 453-469.

Anglin, D.M., Alberti, P.M., Link, B.G., & Phelan, J.C. (2008). Racial differences in beliefs

about effectiveness and necessity of mental health treatment. American Journal of

Community Psychology, 42(1-2), 17-24.

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Pender, N.J., Murdaugh, C., & Parsons, M.A.(2010). Health promotion in nursing practice, 6th

edition. Upper Saddle River, NJ: Pearson/Prentice-Hall.

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