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African-Americans, mental illness
This mixed methods study examined the lived experience of African American persons recovering from serious and persistent mental illness (SPMI) and assessed changes in demoralization, engulfment and coping over time. Psychological measures were administered and semi-structured interviews were conducted at three time points (6, 12, and 18 months) with nine African Americans with SPMI. Qualitative analysis was done from an Afrocentric perspective. The interviews were transcribed, read and coded to cluster thematic aspects in each case and across cases. Atlas-ti was used to recode transcripts and retrieve quotes to dimensionalize each essential theme. Four themes were identified: 1) striving for normalcy, 2) striving for a positive and proactive outlook, 3) mastering the challenges posed by mental illness, and 4) leaning on the supports that watch out for and over me. Paired t-tests were performed on the dependent variables of demoralization, coping, and engulfment. There was a significant change in reduction of demoralization and increase in coping from Time 1 to Time 2. There was no significant change in engulfment. These changes are noteworthy as participants averaged 21 years of illness. The relationship between the quantitative results and qualitative findings are discussed. Results have implications for practice and improving recovery-oriented services to African Americans. For example, case managers are advised to consider mental health stigma and anti stigma interventions that are inclusive of racial discrimination and expand their cultural sensitivity to include the sense of endangerment experienced by African American clients. Four African American consultants critiqued the study anonymously.
Social Work in Mental Health