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Engaging African Americans in Depression Care Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016

Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

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Page 1: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

EngagingAfricanAmericansin

DepressionCare

SidneyHankerson,MD,MBALowCountryMentalHealthConference

July28,2016

Page 2: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

WorldHealthOrganiza1on,2015.

Majordepressionisthe#1causeofdisabilityworldwide

Page 3: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

DSM-5 Diagnos-c Criteria of MDD

• Depressedorirritablemood• LackofinterestorpleasureinacIviIes

• 5of9symptoms• Lastsatleast2weeks

AmericanPsychiatricAssocia1on.Diagnos1candSta1s1cManual5.2013.

Page 4: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

AfricanAmericansandMexicanAmericans

havethelowestratesofdepressiontreatment

intheUnitedStates

Hankersonetal.JournalofNa+onalMedicalAssocia+on.2011.Gonzalezetal.ArchivesofGeneralPsychiatry.2010.

Page 5: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

What are Barriers to Mental Health Care?

Page 6: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

What are Barriers to Mental Health Care?

Racism

CulturalDistrust

Page 7: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the
Page 8: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the
Page 9: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the
Page 10: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

Metzl.“ProtestPsychosis.”2010.

Misdiagnosis=Labeling

Page 11: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

Micro-aggressions

NegaIveracialslightsandinsultstowardpeopleofcolor

• briefandcommonplace

• verbal,behavioral,orenvironmental

• inten1onaloruninten1onal

Sueetal.2007

Page 12: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

Share the Story of Your Name

Page 13: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

Community-basedpartnershipsmayovercomebarriers

Page 14: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

Morepeopleseekhelpfromclergy

Hankersonetal.2013Wangetal.2003

Page 15: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

Depression

Screening

withPHQ-9

Page 16: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

Depressionwascommonin3NYCChurches

Men(n=49)

Women(n=62)

MajorDepression

22.5%

17.7%

Hankersonetal.(2015).AmericanJPreven+veMedicine

Page 17: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

Strategies to Increase Engagement

1)  Exploreyourunconsciousbiases2)  Focusontotalbody-wellness3)Mobilizesocialsupportinthecommunity

Page 18: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

Exploreyourunconsciousbiases

Page 19: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the
Page 20: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

Focusontotal-bodywellness

Page 21: Engaging African Americans in Depression Care · Sidney Hankerson, MD, MBA Low Country Mental Health Conference July 28, 2016 World Health Organizaon, 2015. Major depression is the

Mobilizesocialsupport