Helping Professionals Working with African Americans with Co-Occurring Disorders
by Vinnie Haley, Ph.D., I-CAADC, SAP, LCDP, LMSW
Helping professionals who provide treatment to African Americans with Co-Occurring Disorders [CODs] (i.e., substance abuse and mental health problems) have experienced mixed outcomes when working with this marginalized population (Huz et al., 2017). In brief, these professionals achieved optimistic results by providing community-based services (e.g., declines in criminal offenses, improvement in quality of life, and family functioning (Bond & Drake, 2015; Browne et al., 2015). Landess and Holoyda (2017) indicated that in general, many helping professionals have diverse skill sets with comprehensive knowledge, which is useful across various systems of care (e.g., mental health, substance abuse, criminal justice, etc.). Brown et al. (2015), also suggested that these workers are particularly successful in using alternative treatment models and have diverted those with CODs to specialized treatment programs in the community (i.e., OBOTs, IOP, and MAT).
Although these results are promising, not all researchers have reported similar findings. Nijdam-Jones, Nicholls, Crocker, Roy, and Somers (2017) found that despite these individuals receiving community-based services, their clients experienced increased police contact, exacerbated stigma within the AA community, and disproportionate instances of misdiagnoses compared to the general population. Experts in the field have attributed these types of misdiagnoses to the lack of cultural awareness/sensitivity among clinicians working with this group. (Hack, Larrison, Bennett, & Lucksted, 2019).
In summary, helping professionals who focus on culturally-related interventions can better support an already complex client base of African Americans with CODs – who face severe gaps in overall healthcare. Subsequently, since the onset of the Covid-19 pandemic, the gap has widened for this group (SAMHSA, 2021). Evidence supports the critical need for practitioners to be knowledgeable of current culturally-centered interventions (Hack et al., 2019). After completing a 3-year case study in Delaware, my findings supported past literature and illuminated significant problems in three key areas when working with African Americans with CODs: 1high levels of misdiagnoses within this population; 2unexplained treatment attrition; and 3a need for robust and culturally-centered programs targeting African Americans with problems with substance abuse and mental illness.