Mental Health Traditions
The family often has a matriarchal structure, and there are many single-parent households headed by females, but there are strong and large extended family networks. There is a continuation of tradition and a strong church affiliation
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within the families and community. Members of the community may be treated by a traditional Voodoo priest, the “Old Lady” (“granny” or “Mrs. Markus”), or other traditional healers, and herbs are frequently used to treat mental symp- toms. Several diagnostic techniques include the use of biblical phrases and/or material from old folk medical books, observation, and/or entering the spirit of the patient. The therapeutic measures include various rituals, such as the read- ing of bones, the wearing of special garments, or some rituals from voodoo (Spurlock, 1988, p. 173). In addition, there are countless culture-bound mental HEALTH syndromes that may be identified in the Black community:
■ West Africa and Haiti—Boufée delirante—the sudden outburst of agitated and aggressive behavior, confusion, or occasional hallucinations
■ Southern United States and Caribbean groups—Falling-Out—sudden collapse without warning
■ North African countries—Zar—person is possessed by a spirit and may shout, weep, laugh, hit his or her head against the wall, or sing
■ West Africa—Brain Fog—physical and mental exhaustion, difficulty concentrating, memory loss, irritability, and sleeping and appetite problems (Fontaine, 2003, p. 119).
Blacks and the Health Care System
To some, receiving health care is all too often a degrading and humiliating experience. In many settings, Black patients continue to be viewed as beneath the White health caregiver. Quite often, the insult is a subtle part of experi- encing the health care system. The insult may be intentional or unintentional.
Table 11–3 Comparison of the 10 Leading Causes of Death for Black or African American and for All Persons: 2004