Cultural mistrust and the rehabilitation enigma for African Americans

Abstract

The accessibility and equity of rehabilitation services offered to African Americans have been identified as priorities in Section 21 of the 1993 amendments to the Rehabilitation Act of 1973. The inclusion of emphases for ethnic minorities in federal rehabilitation legislation is warranted given the disproportionate number of minorities with disabilities in relation to their overall representation in the general population. For example, Walker (1988) reported that although African Americans comprise only 12% of the U.S. population, the comparative incidence of disability (15%) for African Americans is considerably higher than for White Americans (8%). Moreover, Bowe (1992) reported that 24%, or one-quarter, of all severely disabled adults of working-age (16-64) are African American. Despite the potentially large client pool of African Americans with disabilities, the rate of rehabilitation service provision to African Americans can be two to three times lower than for White Americans within both the public and private sectors (Walker, Akpati, Roberts, Palmer & Newsome, 1986). Similarly, Herbert and Cheatham (1988) reviewed research pertaining to rehabilitation service delivery to African Americans and found that African Americans were less likely to be accepted for services in comparison to White Americans. Furthermore, their review revealed that if accepted, African Americans' cases were more likely to be closed without job placement. Also, if job placement occurred, African Americans generally received lower weekly incomes. Brewington, Daren, Arella, and Randell (1990) identified three factors which may serve as obstacles to successful vocational rehabilitation for persons with disabilities. These three factors are the client, nature of the rehabilitation program, and society. As described by Brewington et al., client variables may consist of factors such as temperament (motivation), interests, work experience, educational level attained, and skills possessed. Program variables may include availability of resources and quality of staff. Finally, societal factors may include attitudes which are prevalent in society that can affect the success or failure of service delivery. Although the interplay among the three factors is an intricate one, client variables have a profound influence on successful rehabilitation and may help to explain the low representation and poor success of African Americans in rehabilitation. Atkins (1986) noted that a client enters the rehabilitation process with a specific set of beliefs, attitudes, values, and goals which are determined, to a large extent, by the client's previous life experiences. For example, most African Americans with disabilities are aware of negative stereotypes held by members of the majority society against African Americans. In addition, many African Americans with disabilities have encountered prejudice and racism. These experiences shape their world view, including attitudes toward the rehabilitation process. One attitude that African Americans with disabilities may bring to the rehabilitation process is cultural mistrust (Atkins, 1988; Grier & Cobbs, 1968; Terrell & Terrell, 1981; Triandis, 1976). According to Terrell and Terrell (1981) cultural mistrust refers to African Americans' mistrust of White Americans and traditional American systems (e.g., government, schools, law enforcement). Atkins (1988) asserted that African American clients may approach the rehabilitation process with mistrust and guarded optimism, and that this mistrust may translate into low expectancy for success. Consequently, cultural mistrust may negatively affect one's perception of rehabilitation; thereby reducing the likelihood that African Americans will seek rehabilitation services for employment and disability adjustment. The purpose of this article is to examine cultural mistrust as both an impediment to rehabilitation entry and as a barrier to successful rehabilitation completion for African Americans. …

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