The Inner-City African-American Family and the Serious and Persistently Mental Ill Family Member: Strengths or Deficits?

Joseph Guada
School of Social Work
University of Southern California
University Park MC-0411
Los Angeles CA 90089
U.S.A.
Phone: 213-400-5254
Email: guada@usc.edu
 
John Brekke
School of Social Work, Hamovitch Research Center
University of Southern California
University Park MC-0411
Los Angeles CA 90089
U.S.A.
Phone: 213 7400297
FAX: 213 7408905
Email: brekke@usc.edu
 
Purpose: Theorists have speculated that African-American families with a family member with a serious and persistent mental illness (SPMI) have reported lower levels of burden because the families are better prepared to manage long-term stressors. This study evaluates how such families score on the McMaster Family Assessment Device (MFAD). The objective was to assess how well this sample did compared to clinical cut-off points and to other clinical families from available studies, and whether the findings would substantiate the greater strengths of inner-city families that have often been hypothesized, but rarely investigated in the literature.

Methods: Ninety-four families with a member diagnosed with schizophrenia were interviewed face-to-face and assessed with the MFAD, a 53-item self-administered questionnaire that contains seven subscales, and has been normed with clinical cutoff scores.  Family members’ scores were compared using statistical significance tests to the clinical cut-off points as well as to existing samples from other studies.

Results: Families scored equal to or better than the clinical cutoff on five of the seven subscales indicating that they did not have significant clinical problems in these areas. They scored significantly higher on two of the subscales indicating clinical problems in these areas. When comparison groups were available from the literature, this sample scored significantly better than Caucasian clinical families on the MFAD.

Implications for practice: The findings indicate that it should not be assumed that inner-city African American families are more chaotic or dysfunctional than, for example, white middle class families who have historically received more attention in the literature. Although these families probably have similar needs for psychoeducation and support, these should be delivered in an ethnically sensitive manner given the specific pressures as well as strengths of such families.  We advocate a strengths rather than a deficits focus when these inner-city families enter mental health services.