Toward a Culturally Relevant Framework
for Interventions with African American Families
Howard C. Stevenson, Donna-Marie Winn,
Chanequa Walker-Barnes, and Stephanie I. Coard
Recent commissions and task forces on the reduction of mental health disparities for and the ethical treatment of ethnic minorities have consistently called for an increase in cultural competence in the application of psychological services (American Psychological Association, 2003; U.S. Department of Health and Human Services, 2001, 2003). Notably, the surgeon general has urged the mental health profession to pay more attention to how culture may influence the role of the clinician; the stigma and the prevalence of, expression of, and coping with mental illness (U.S. Department of Health and Human Services, 2001). Recent statistics reveal that as compared with the national rate of 33% of adults needing mental health care who actually receive it, the rate for African American1 clients is much lower, and in most studies, is half of whatever rate is found for European Americans (Swartz et al., 1998). It is not clear whether this unmet need reflects inadequate opportunities for African Americans to access the mental health system or a culturally inappropriate service system that African Americans shun. Most likely, both factors play a role in the unmet mental health needs of African Americans.
The costs for such high rates of unmet mental health care needs among African Americans are substantial. Researchers have demonstrated that ethnic minorities have been found to bear the brunt of the burden of unmet mental health needs that lead to poorer health out-