Culturally Sensitive Education for Mental Health Providers Treating African American Adults with Major Depression

Background: African Americans (AAs) or Blacks in America are over-represented in groups or populations that are at risk for mental illness. About 20% of AAs are more likely to report serious psychological problems than their Caucasian counterparts. Urban AAs in the United States currently engage in medication therapy and psychotherapy for treatment resistant depression (TRD) however, they minimally engage in the use of electroconvulsive therapy (ECT) as a treatment option. Significance: AAs may be limiting their treatment options by opting out of ECT for the treatment of TRD. Culture may play a role in the decision-making process for AAs seeking treatment for TRD. Purpose: The purpose of this quality improvement project (QI) was to explore cultural influences of health-related decision-making among AA adults. Upon determination of cultural factors that may impact AA health-related decision-making, a culturally sensitive education session was developed and offered to mental health (MH) providers who care for patients with TRD at a Phoenix, AZ, clinic. Methods: This is a descriptive study design. Cultural factors influencing health-related decision-making among AA adults in their selection of treatment modalities for severe depression were explored in this QI project. Aim 1: AA adults with TRD receiving care at an urban mental health clinic in Arizona were administered a self-administered questionnaire (SAQ) on how culture impacts treatment related decision making. Aim 2: Responses from the questionnaire were analyzed and compiled. Aim 3: A culturally sensitive education session was developed with a goal of educating Nurse Practitioners and Physicians at the Phoenix, AZ, clinic who care for AA adults with TRD. Analysis: Univariate descriptive statistics were utilized to analyze responses from the structured SAQ. Thematic commonalities were used to analyze six qualitative/open-ended questions to obtain a description of the categorical thematic responses. Implications for Nursing: Findings from this QI will offer contributions to the scientific nursing database and offer a resource to inform ECT providers on how culture impacts decision making among AA adults with TRD