News
May 2010
Earlise Ward Designs New Therapy Approach for Treating Depression in African Americans
Earlise Ward (left) talks with a research participant about African American women’s beliefs surrounding mental illness, coping behaviors, and barriers to seeking treatment. (Photo © Bob Rashid)Earlise Ward, PhD, LP, was riding the bus to the Dane County Mental Health Center when the woman sitting next to her changed her life.
Ward was doing clinical research for her PhD at the Mental Health Center, which provides services to low-income county residents. She was seeing numerous cases of African Americans with mental health issues who were either not seeking care or dropping out of care early on. In researching the literature, Ward had determined that this issue was not specific to Madison, but occurring on a national level. Then, the woman on the bus started talking to Ward about her mental illness and struggles with seeking therapy. It was a very personal story.
Ward, an assistant professor at the University of Wisconsin–Madison School of Nursing and licensed psychologist, looks back now and says that it was probably a career turning point.
"She started to tell me about her experiences as an African American woman having a mental illness,” Ward recalls. “She had struggled over whether she should or should not get help. she was concerned about the stigma. She didn’t want anyone to perceive her as ‘crazy.’ But after giving it some more thought, she realized she had some health problems. so she met with a psychologist, and within the first couple minutes of talking with him, he said she needed to see a psychiatrist to get medication. she was quite offended by that suggestion; she wanted somebody to talk to. In her mind, counseling or psychotherapy would give her the opportunity to talk with a professional about the issues she was struggling with. The woman never went back for treatment.
“As I heard her story I grew even more interested and passionate about this. Here was a woman who obviously was struggling with a mental health problem, struggling with going in to get help—and did go in to get help—but then didn’t receive quality care. So I started thinking about how I could have an impact in that area. What could I do to get more people in therapy and get them to stay in a treatment program?”
Ward grew up in the Caribbean and New York. She completed undergraduate study in international marketing, but switched to counseling psychology as a graduate student. Moving from marketing to psychology really wasn’t that big of a leap, she says. “You use a lot of the same analytical skills. I just found it more personally rewarding—a better fit for my skills and interest in helping others.”
Taking the plight of the woman on the bus to heart, Ward now focuses her research on developing culturally sensitive and relevant interventions for African American adults with mental health issues. African Americans are one of the country’s most widely under treated and under served populations, she says.
Ward has developed an alternative therapy approach for this population, focusing on treatments that have been tailored to the cultural beliefs and preferences of this group. “Oh Happy Day!” Depression Class, which is funded by the National Institutes of Health through the UW Institute for Clinical and Translational Research, is a more culturally sensitive mental health intervention for African Americans with depression. Ward hopes that this alternative model of treatment will motivate African Americans to seek out and stay in therapy. Early pilot testing results have been positive.
Mental illness is a highly stigmatized and misunderstood health problem in the African American community, says Ward. Many African Americans with low incomes do not have health insurance to cover access to care or treatment costs. instead, people use coping strategies that include prayer, going to church, or talking with friends rather than seeking professional treatment from a mental health clinician.
For those who seek treatment, many believe that mental health providers often lack cultural sensitivity and, therefore, provide inadequate care. Based on National Institute for Mental Health research, African Americans account for only 2 percent of psychiatrists and psychologists and 4 percent of social workers in the United States.
According to the National Institute for Mental Health, one in four adults in the United States suffers from a diagnosable mental disorder. research shows that African Americans and non-Hispanic whites experience similar rates of depression within a twelve-month period. However, African Americans experience higher rates of chronic and disabling depression. Overall, only one-third of Americans with a mental illness or a mental health problem get care, yet the percentage of African Americans receiving needed care is only half that of non-Hispanic whites, according to a U.S. Surgeon General’s report. One study reported that nearly 60 percent of older African American adults were not receiving needed services.
“Oh Happy Day!” Depression Class is a twelve-week cognitive behavioral group counseling intervention offered to a group of eight to ten individuals in a community setting rather than at a provider’s office or a counseling center. It is administered by two licensed professional therapists working closely with a trained lay provider.
“We provide overviews of what counseling is; discuss medications, stress management, spiritual coping, and the co-morbidity between depression and diabetes and hypertension; and provide community resources,” Ward says. “It is all done in a group setting, which participants seem to like much better. It combines some of the therapeutic aspects that they were seeking in talking to family and friends or at church, but under the guidance of a mental health therapist and a trained lay person.”
Although results are still preliminary, Ward says that already there are encouraging signs that this community-based group talk therapy approach gets results.
“We have found a significant reduction in symptoms of depression from baseline to week twelve of the intervention,” Ward says. “Six months after starting treatment, we continue to see a reduction in symptoms.
“People said they thought the intervention was very helpful in learning more about depression, symptoms, and treatment options. They felt that this program had helped them learn some valuable coping strategies for reducing the symptoms.”