Issues in the psychiatric treatment of African Americans

African Americans constitute about 12 percent of the United States populati on. Sixty percent of African Americans Live in urban areas, and 25 percent have incomes below the poverty level. Issues in the psychiatric assessment and evaluation of African-American patients include diagnostic bias that ha s resulted in overdiagnosis of schizophrenia, Use of screening instruments can help standardize assessment, but appropriate screening instruments that have been evaluated and found reliable in this population must be used. Is sues in treatment and outcome for African Americans include challenges in e stablishing rapport in interethnic situations, racial identity as a focus i n psychotherapy, and awareness of biological characteristics that affect re sponse to medications, Many African Americans live in high-crime areas wher e high rates of drug abuse and violence create chronic stresses, Patients w ith dual diagnoses of chronic menial illness and substance use or abuse nee d targeted interventions. Strategies for prevention and treatment of the ef fects of having experienced. or witnessed violence have been proposed. Addi tional research is needed to clarify the true prevalence of specific mental disorders among African Americans and to determine the most effective comb inations of treatment strategies for various disorders.