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Responding to Traumatic Stress in Communities of Color

Race and Culture in Mental Health

Our cultural context (race, ethnic group, gender, religion, language, social class and so forth) influences how we understand health and mental fitness.

Our culture also determines what is considered normal and abnormal.

The circumstances in society, such as access to work, shelter, and health care, also influences our understanding of our experience and how we function in our communities and in society.

Anthropological and cross-cultural studies show that
cultural beliefs about what mental illness is, affects its course and treatment

Researchers agree that cultural bias operates in diagnoses since many clinicians (irrespective of racial-cultural group membership) are socialized and taught during professional development to see people of Color as more disturbed then Whites.

Symptoms of disturbance may be experienced and expressed differently by members of distinct cultural groups.

Traumatic Stress-

Health professionals have found in many studies that people who are exposed to various types of life-events may find such events as stressful or traumatic.

Definitions of Trauma

There are two ways to understand and identify extreme stress reactions.

One is to use DSM diagnostic criteria of post-traumatic stress disorder (PTSD) or Acute Stress Reactions (ASR) or other diagnoses.

The other way to understand traumatic stress would be to use broader criteria and to consider the person’s evaluation of the event to determine whether it was traumatic.

DSM - Post-Traumatic Stress Disorder -

An event is life threatening and results in a reaction of intense fear or helplessness or horror, and leads to impairment of functioning (also needed are Criteria B, C, D, E and F). The criterion uses an exposure or dose response model. Relying on external factors and less on subjective evaluation.

Need for broader model of trauma

The criterion for PTSD focuses on the reactions to threatening life events. Some life events may not be seen as life threatening but may produce a traumatic stress reaction.

Because the DSM framework for understanding stress reactions is based on the rather narrow criteria for diagnosis of PTSD or Acute Stress Reactions.

Research on Traumatic Stress in summary:

Some people who are exposed to life events experience the event as traumatic and have stress that leads to psychological symptoms.

The general rates of developing PTSD after exposure to life events are about 5-10%.

People of Color experienced higher rates of PTSD after exposure to traumatic events (rates above 10% between 15% & 40%) and their symptoms were more severe.

Veterans of Color have higher rates of PTSD and other psychological symptom of distress not explained by the specific exposure to war related trauma.

Some of the higher rates of symptoms by People of color are explained by exposure to race-related stress in the form of discrimination and racism

It is suggested that People of Color are confronted with hostility neglect and racism that may heighten the effect of life event crisis

Features of Traumatic Stress – Summary

Traumatic stress involves a reaction to an event that is perceived as negative, sudden and uncontrollable. It may be a form of on-going physical and/or psychological threat that produces fear, anxiety, depression, helplessness and/or PTSD related symptoms.

The threat and stress associated with recent disasters is a source of constant worry for people in communities of Color. The concern may lower self-worth and increase feeling of being in danger.

Thus, institutional policies and procedures can communicate danger as well as lack of attention to a group’s current circumstances.

Traumatic stress is real and may be affecting people without their awareness. Many people of Color are at high risk for symptoms of traumatic stress given prior histories of trauma in their community.

What is needed are procedures to help organizations deal with traumatic stress, broader diagnostic criteria to assess stress reactions, and treatment strategies that are racially-culturally effective for reducing the symptoms of traumatic stress.

Treatment and Training

The training associated with responding to traumatic stress in communities of Color must be grounded in the worldview and cultural patterns of that community.

Crisis Response Operations.

In training people to respond to communities of Color after a disaster the training must
consider and address how people in the respective communities were treated prior to the

What is their receptiveness to the people and agencies involved in the first response?

Has the community reported feelings of distrust and fear as have many community members and organizations have indicated?

Action should be underway to reduce such feelings so as to enhance disaster response to communities of Color.

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