"No one wants to be around someone who is mentally ill," said Janet E. Taylor, MD, MPH, psychiatrist and consumer strategist during a presentation Clinical Implications: Understanding Depression and Bipolarism to Reduce the Stigma Associated with Mental Health, to the National Black Nurses Foundation, Inc.

"We have made great advances in mental health, but one of our biggest challenges is to overcome the stigma," said Taylor, who has also taught at Harlem Hospital Center, part of the New York City Health and Hospitals Corp. She was among the distinguished guests who participated in the program Mental Health: Policy, Clinical and Spiritual Implications.

M. Joycelyn Elders, MD, professor emeritus at the University of Arkansas College of Medicine, Little Rock, and the 15th U.S. surgeon general, gave the keynote address Mental Health: The Burden of Disease on Healthcare Disparities and Policy - Implications for Parity in Healthcare.

"We say the words, but we don't understand the problem," she said. "It's time to get the secrets out of the backwoods and address mental illness as a disease."

It is ironic the stigma associated with mental illness thrives in a country where, in any given year, up to 30 percent of Americans complain of mental health disorders, according to studies from the National Institute of Mental Health and the National Comorbidity Survey. The studies also found that up to 50 percent of Americans will experience mental health symptoms at some point in their lives.

Mental Illness & African-Americans

Although every person, regardless of race or ethnicity, should seek help if they have a mental health problem, minorities and especially African-Americans often fail to get the diagnosis and treatment they need.

In 1999, Former Surgeon General David Satcher, MD, PhD, said in Mental Health: A Report from the Surgeon General, that minorities have less access to, and availability of, mental health services. In treatment, minorities often receive a poorer quality of mental healthcare, and they are underrepresented in mental health research.

"Our long history of scientific racism has led to healthcare disparity," Taylor said. "Medical books are filled with claims that poor outcomes are natural to the African-American population. That idea still underlies the understanding of mental illness in our community."

Other myths, such as African-Americans do not suffer from depression, continue to thwart proper diagnosis and treatment of their mental illnesses.

"It was believed only a free man could get depressed because slavery kept [African-Americans] happy," Taylor said. "Scientific racism has denied us access to healthcare."

Consequently, published clinical research and statistics on depression in the African-American community is scarce. Misdiagnosis continues. For example, depression, not to be confused with "having a bad day," is characterized as 2 weeks or longer of a depressed mood or loss of interest in pleasure. Changes in sleep and eating habits also may occur.

For a long time, African-American women, who may have been chronically depressed were not correctly diagnosed. Their behaviors had not changed, Taylor said. African-American women who gained weight were also not diagnosed with depression. The common notion was women lost weight when depressed.

Early Intervention

Overcoming myths and stigmas can improve healthcare access, eliminate disparities and promote awareness.

"We need to recognize mental illness and treat it early," Elders said. "We need to take care of children and treat mental disabilities as serious as physical."

Currently, 10 percent of school-aged children have mental disease; 50 percent of mental illness in children can be diagnosed before age 14; and 80-90 percent of these illnesses can be treated.

Nurses can play a critical role in reducing the stigma of mental illness. By providing clear and consistent information based on science, they can engage their communities to train develop policies to improve access and eliminate disparity.

"I remember the days when people didn't talk about venereal disease, cancer and HIV," Elders said. "To make advances, we need to lead, listen and learn about mental health to achieve total parity. When you are dancing with a bear, you can't just get tired and sit down. You have to keep going."

Nancy Malaga is regional editor at ADVANCE.