2 mental health and disorders mental health and di

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MENTAL HEALTH AND DISORDERS
Mental Health and Disorders: A Trending Epidemic on the
Chicago Southside
Kehinde Adeyemi
College of Nursing and Health Sciences, Lewis University
NURS 53400-005: Population Health
Dr. Kathy Dunn
January 30, 2021
Abstract
Aims: Notable awareness is growing on the rising trend of
mental health disorders in individuals on the Chicago south side
areas. While giant strides have been made towards a population-

2. based approach to mental health, research has show n
ineffectiveness in the areas of policy interventions by
government officials, policy makers and healthcare system
administrators.
African-Americans of all ages are more likely to be victims of
serious violent crime than non-hispanic white individuals,
making them more likely to meet the diagnostic criteria for
post-traumatic stress disorder. African-Americans are also
twice as likely as non-hispanic white individuals to be
diagnosed with schizophrenia. Methodology: Project IMPACT
research study is based on a tool previously used to identify
students at risk for vulnerable mental health status created from
a 12-item general health questionnaire and Antonovsky’s
abbreviated sense of coherence scale. Data of the target
population will be taken from a mental health survey of the
adult African-Americans living on the south side of Chicago,
from multiple credible sources for correlation of facts and
figures following a multistage stratified cluster sampling.
Each participant will fill a paper-based, self-administered,
anonymous questionnaire. The distribution and recollection of
questionnaires will be carried out by health care volunteers who
understand the importance of objectivity and transparency of
the study. Results: The expected result will be an increased risk
for mental health disorders among African-Americans.
Conclusion: Decreasing the risk for mental health disorders
among African-Americans is essential for improving the overall
health of the African-American population.
Keywords: mental health, policy interventions, questionnaire,
posttraumatic stress disorder
Mental Health and Disorders
Definition and Significance of Mental Health
Mental health is an important part of overall health and well -
being. Mental health includes our emotional, psychological, and
social well-being. It affects how we think, feel, and act. It also
helps determine how we handle stress, relate to others, and
make healthy choices. Mental health is important at every stage

3. of life, from childhood and adolescence through adulthood
(Centers for Disease Control and Prevention [CDC], 2020.
African American individuals today are over-represented
in our prisons. People of color account for 60% of the prison
population. African-Americans also account for 37% of drug
arrests. Illicit drug use is frequently associated with self-
medication among individuals with mental illnesses (Kerby,
2018).
CDPH’s 2018 Healthy Chicago survey found that about
178,000 Chicago adults needed
mental health treatment at some point in the previous year
but did not receive services. This
lack of access can be devastating for vulnerable residents —
including our young people and communities of color.
There is a rising trend of mental disorders in individuals on the
Chicago south side areas Research shows ineffectiveness in the
areas of policy interventions through public health policies
and healthcare system interventions.
A complete need for in-depth and complete overhaul of
the mental health crisis in underserved areas needs to be
undertaken.
CDPH’s 2018 Healthy Chicago survey found that
about 178,000 Chicago adults needed
mental health treatment at some point in the previous year
but did not receive services. This
lack of access can be devastating for vulnerable residents—
including our young people and communities of color.
Stakeholders
The burden of mental health disorders is not an individual
affliction. The devastating effects have health and financial
implications for all including the medical centers and
community. Stakeholders in this program includes families,
health care practitioners, advocacy groups, hospitals, churches
and organizations across the length and breadth of Chicago.
Notable stakeholders are the Englewood Mental Heal Clinic,

4. Thresholds, Trilogy Behavioral Health, Access Community
Health Network, Chicago Board of Health, Ann and Robert H.
Lurie Children’s hospital of Chicago as well as the University
of Chicago among many others.
Morbidity
In 2019, there was an estimated 51.5 million adults aged 18 or
older in the United States with any mental illness (AMI). This
number represented 20.6% of all U.S. adults. Young adults aged
18-25 years had the highest prevalence of AMI (29.4%)
compared to adults aged 26-49 years (25.0%) and aged 50 and
older (14.1%). More females with AMI (49.7%) received mental
health services than males with AMI (36.8%)
https://www.nimh.nih.gov/health/publications/my-mental-
health-do-i-need-)
Hospitalizations for behavioral health conditions (mental
health and alcohol/substance use) have seen marked increases in
the past decade and now represent over one in six
hospitalizations. Overall rates of mood dis- order
hospitalizations in Chicago eclipse the national rate by more
than four times. Non-Hispanic black Chicagoans are
hospitalized for mental health-related conditions at two to ten
times the rate of non-Hispanic white and Hispanic Chicagoans.
Residents of East and West Garfield Park, Uptown, Englewood,
Washington Park and Woodlawn have the highest rates of
hospitalizations due to mental health conditions (Healthy
Chicago, 2016). An estimated 526,000 adults in Illinois (5.4%
of the adult population) had a serious mental illness (SMI) in
2012, which is higher than the national rate of 4%. For people
with SMI, it carries significant rates of morbidity and mortality.
Mortality
It is estimated that people with serious mental illness (SMI) die
about 25 years earlier than the general population and that 60%
of this excess mortality is due to chronic conditions. Individuals
with SMI experience significantly higher prevalence rates for
chronic conditions including metabolic disorders,
cardiovascular disease, chronic pulmonary disease,

5. gastrointestinal disorders, chronic viral infections, and
obesity. (ECHO-Chicago: Serious Mental Illness-Winter 2020).
The overall numbers of suicides in Illinois and nationwide have
been rising over the past two decades, according to the federal
Centers for Disease Control and Prevention. The national
suicide rate has increased nearly 35 percent between 1999 and
2018. The rate among African American youth, who make up a
smaller percentage of suicides overall, has increased. (
https://www.injusticewatch.org/author/lakeidra-chavis/) Among
Black populations, suicide rates peak during adolescence and
young adulthood, then decline. This is a different pattern than is
seen in the overall U.S. population, where suicide rates peak in
midlife.
Healthy People 2020 Topic & Objective
The objective of this proposed population based program is
MHMD-5 “Increase the proportion of primary care facilities that
provide mental health treatment onsite or by paid referral
Level of Prevention, Genetic and Environmental Risk Factors
Level of Prevention
There are three categories of prevention: primary
prevention focuses on various determinants in the whole
population or in the high risk group. Early identification of
triggers and at risk behaviors in addition to promoting good
mental help can help stop mental health issues before they
occur. Secondary prevention comprises of early detection and
intervention. This aims to give continuous education and
provide support and intervention for those at high risk. Tertiary
prevention targets for advanced recovery and reduction of
relapse risk. This is done by supporting mental health patients
and providing adequate mental health treatment(NHS Digital.
(2018). Mental health of children and young people in England,
2017)
Genetic Impact
Mental disorders are not uniformly dispersed across the globe.
The magnitude of people diagnosed with mental disorders varies
across geographical spaces, cross culturally, and throughout

6. generations. There is evident variation in the genetic
identification of mental disorders across geographical spaces,
cross culturally, and through time. Studies have shown that an
abnormal production of certain genes are recognized as a
possibly cause of increasing a person’s susceptibility to some
mental disorders. Additionally, studies have presented variation
in the racial/ethnic groups affected by a mental illness.
Specifically, multiple studies have recognized African
Americans as a primary victims of schizophrenia. Moreover, the
exposed environment of individuals have been linked to their
predisposition to mental illness. Hopefully, future studies can
further target the mechanisms causing mental disorders and
acquire prevention techniques.( Sedera Moore, Department Of
Biology, Howard University '16)
Health Determinants/Disparities/Risk Factors
Growing evidence connects economic inequality and poor
mental health ( Platt et al., 2017). Experience of socioeconomic
disadvantage, including unemployment, low income, poverty,
debt and poor housing, is consistently associated with poorer
mental health (Silva et al., 2016; Elliott, 2016; Platt et
al., 2017;).
Mental health problems are particularly prominent
amongst marginalised groups experiencing social exclusion,
discrimination and trauma, leading to compound vulnerability
(Rafferty et al., 2015). Greater inequality within societies is
associated with greater prevalence of mental illness ( Pickett
and Wilkinson, 2010), and economic recessions have had
devastating impacts on population mental health (Platt et
al., 2017)
Smart Goals
Smart goals are specific, measurable, attainable, relevant,
and time bound. It’s a tried and true formula for creating
successful goals. The goals align with personal values and the
end result of them should bring us a feeling of accomplishment
or a reward. Setting SMART mental

7. health goals will bring motivation and fulfillment and improve
wellbeing. To practice on self-love and self-compassion.
The goals include taking care of and be kind to your body
.and making time for mindfulness. Others are finding new ways
to manage stress, anxiety or depression as well as seeking
support (from friends and family or by starting therapy).
Evidenced-based support Practice Support
Several studies have indicated that social skills training has
helped in reducing negative symptoms and improve social skil ls
and functioning. Family psychoeducation has primarily helped
in decreasing illness recurrence, length and rates of
hospitalization and increase illness knowledge while increasing
treatment adherence and caregiver burden.
A dialectical behavior therapy approach has also helped in
reducing anger, suicide and self injurious behavior.
Cultural/Health Issues
The culture of the patient, also known as the consumer of
mental health services, influences many aspects of mental
health, mental illness, and patterns of health care utilization.
One important cautionary note, however, is that general
statements about cultural characteristics of a given group may
invite stereotyping of individuals based on their appearance or
affiliation (Mental Health Culture, Race, and Ethnicity. A
Supplement to "Mental Health: A Report of the Surgeon
General.").
African Americans have been found to have positive
beliefs and attitudes toward mental health services, but these
positive beliefs and attitudes do not translate to seeking
treatment. For instance, in one study of racial differences in
beliefs about how the natural course of mental
illness relates to perceptions of treatment effectiveness, African
Americans were more likely than Caucasians to believe that
mental health professionals could help individuals with mental
illness. However, the African Americans were also more likely

8. to believe that mental health problems could improve on their
own (Anglin, Alberti, Link, & Phelan, 2008)
In essence, African Americans are less likely to use
services that seek to treat mental illness.
The ecological perspective of using the social media as a
means of disseminating information and gaining trust among the
African American population of the Chicago South side can not
be overemphasized. Social media is about conversations,
community, connecting with the target population and building
relationships.
Health Literacy
Findings suggest that improving health literacy may be an
effective strategy to improve health status and to reduce the use
of expensive hospital and emergency room services among
elderly patients.
Older adults, adolescents, people with low income and
educational levels, and racial and ethnic minorities are
disproportionately affected by low health literacy (Prins E.
Mooney A. (2019). Literacy and health disparities). African
Americans form the bulk of this group .
Culturally tailored and interactive approaches such as
storytelling and culturally appropriate graphics have been
reported to improve health literacy related to diverse health
conditions in African-American samples (Bertera,
2014; Broussard et al., 2014; Rikard et al., 2012; Ross et al.,
2010)
In addition, interactive and user-friendly digital platforms
such as mobile health applications present considerable
opportunities for reaching African Americans with LHL more
effectively (Anderson et al, 2015)
The use of the television, internet and radio
communication channels will be very beneficial in
dissemination specific health information and interventions in

9. the African American community. In this digital age, there is
hardly any person without cellphone or some form of
communication channel.
Participatory approaches help capture diverse and shared
cultural values, beliefs, and experiences in African-American
communities (Rikard et al., 2012). This will trained healthcare
workers involve walking the streets, engaging at risk population
and offering the much need information.
Agencies for potential Partnership
NAMI, the National Alliance on Mental Illness, is the
nation's largest grassroots mental health organization dedicated
to building better lives for the millions of Americans affected
by mental illness. With a deep understanding of what how the
African American Community on the
Chicago South Side feels about Mental health and associated
disorders, partnering with an organization with experience with
those living with mental health conditions will help educate
to fight stigma and discrimination, fiercely advocate for our
community, and share hope, connection and expertise with
people on their mental health journey.
Aims For Quality Improvement
The Chicago Southside African American community suffers
disproportionately from the lack of awareness and timely
intervention for mental health disorders.
Centering mental health interventions to the specific population
it is intended for will go a long way in reducing the rising rate
of metal health disorders in the community. Adopting a
proactive instead of a reactive approach in treating mental
health will also have a positive impact on the mental health
situation in the community.
Promoting an equitable strategy in treating mental health
disorders without regards to age, gender and race will also
benefit the Chicago south side communities at large.
Program Evaluation Method

10. A similar method used as an assessment tool to identify
students at risk for vulnerable mental health status created from
a 12-item General Health Questionnaire and Antonovsky’s
abbreviated sense of coherence scale and was tested in Hungary
to distinguish between those with high or low mental resilience
will be used.(Bíró, É., Ádány, R., & Kósa, K. (2019). A Simple
Method for Assessing the Mental Health Status of Students in
Higher Education)
Data of the general population will taken from a mental
health survey representative of the adult Chicago south side
population from multiple credible sources for correlation of
facts and figures following a multistage stratified cluster
sampling.
The timing of data collection on mental health is critical
among the target population because stress level fluctuates
during the year. A potential source of bias might be excessive
stress close to or during the winter months when isolation and
loneliness is at the highest. So, data will be collected during the
summer in order to reduce this type of bias. Each sampled at
individual and at risk families will fill a paper-based, self-
administered, anonymous questionnaire. The distribution and
recollection of questionnaires will be carried out by health care
volunteers who understand the importance of objectivity and
transparency of the study.
The questionnaire will include scales on mental health
(sense of coherence, psychological distress, perceived stress,
depression, social support; the scales for perceived stress and
depression, perceived health, health locus of control (how much
can do for own health), demographic (age, sex, residence) and
socioeconomic data (parents’ educational level, family’s
economic status)
The 12-item version of the General Health Questionnaire
(GHQ-12) will be used to detect psychological distress.
Questions will also be answered on a 4-point Likert scale. Cases
will be detected by scoring in the simplest manner which will
assign a score of 1 to each symptom, while lack of a particular

11. symptom is scored by 0 so that the total score varies between 0
and 12. Total score above 4 was set as the threshold indicating
notable psychological distress.
MENTAL HEALTH AND DISORDERS
Data will be entered into a Microsoft Excel database. Data
entry as well as the full database will be checked and cleaned
by removing inconsistent answers. Data from all will be merged
into one database and analyzed together. Categorical variables
will be analyzed using chi-squared test and Fisher’s exact test.
Results will then be compared to that of a representative survey
of the Chicago South side adult population using the two-
sample test of proportion.
The chi-squared test applies an approximation assuming the
sample is large, while the Fisher's exact test runs
an exact procedure especially for small-sized samples.
The basic concept of the assessment tool was that it should
assess both the positive and the negative aspects of mental
health in a non-stigmatizing manner. GHQ has been widely used
as a screening device for identifying minor psychiatric disorders
in the general population (Bíró, É., Ádány, R., & Kósa, K.
(2019).
The tool has the advantage of having a balanced focus on
mental health from an aspect of vulnerability as well as of
resilience; it reliably separates those who are psychologically
definitely at risk from those who can be considered reasonably
resilient. Moreover, it is simple to use and avoids
stigmatization. The test could be easily adapted to an online
format, and based on its results, respondents could get detailed
personalized advice on available supportive services, tailoring
the message to their level of risk (Bíró, É., Ádány, R., & Kósa,
K. (2019).
Executive Summary
Project IMPACT, a multifaceted mental health and
disorders awareness and wellness program with focus on the

12. Chicago Southside African American population will continue
to engage community residents and stakeholders on the need to
address the rising trend of mental health disorders. The
invaluable input from individuals and community partners will
help identify and understand the needs of the community for
meaningful impact.
Driven by collective effort and a shared mission, Project
IMPACT, will collaboratively develop implementation plans
and collaborative action targeted to achieving the shared vision
of Improved mental health, and wellness in the Chicago South
Side Community.
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