The way individuals perceive their own mental health can differ by ethnicity, according to a new University study.

Conducted by the University’s School of Public Health and the Department of Psychiatry, the study found that when African American and Afro-Caribbean communities were evaluated for anxiety and depression, the two groups had different ideas of what constituted a mental health issue.

Shervin Assari, research fellow in the Department of Psychiatry and lead author of the study, said in some groups, certain mental health disorders have more significance than in others.

“I found that people have anxiety or depression or they don’t,” Assari said. “But the type of psychiatric disorder that may influence my perception of my mental health may be different than yours or other people’s.”

The study’s two focus groups — African American and Afro-Caribbean communities — were asked to self-evaluate their mental health. For the roughly 3,600 African American individuals studied, anxiety but not depression was more likely to result in reporting mental health issues. In contrast, for the approximately 1,600 Afro-Caribbeans in the study, depression was a more common indicator for self-reporting mental health challenges, as opposed to anxiety.

Assari said this finding about self-rated mental health could be key to innovation in psychiatric treatment. Specifically, knowing how seriously or not seriously certain groups perceive mental illness can help doctors convince patients to seek treatment, even if they do not see their disorders as problematic.  

“Self-rated mental health or the perception of our mental health is the type of certainty that makes you, if you have a psychiatric disorder, go take care of yourself,” he said. “It has major implications for connecting actual need to providing the care for the population. We are extending our research on group differences on how having that actual need doesn’t really translate similarly to that ‘check engine’ light coming on.”

Assari added that self-rated mental illness can lead to more effective treatment than diagnoses made by psychiatrists. If someone recognizes they feel bad, he said, they are more likely to react to medication for their illness.

“Psychiatrists may diagnose anxiety or depression, but what brings people to take care of themselves is, overall, a very simple feeling,” he said. “There is a mismatch between what psychiatrists diagnose and the perception of the person.”

Julie Ober Allen, a third-year doctoral student in the School of Public Health who has worked on with Assari on other studies, said the new research is crucial, particularly because national surveys don’t often provide breakdowns within racial groups. The Institute of Medicine, for example, has recommended questions that group ethnicities within a racial group together.

“The Institute of Medicine really wants to include a single mental health item, but this study suggests that in doing so we would really limit our capacity to provide services and to identify subgroups in the population,” Allen said.

Allen said the study is a starting point for changing how people think about mental health within racial groups, but noted that real changes in policy will take significant time.

“A single study such as this is not going to change the development of policy,” she said. “I think the more we can develop a body of research that problematizes some of their recommendations, the more it’s going to push some of the internal folks at the Institute of Medicine to question the value of their recommendations. It’s also going to push their constituency groups to put pressure on them to reconsider.”

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