This paper is a case study of an HIV-positive African American male suffering from depression. His case represents some of the special circumstances with which the social work system must deal, particularly when a number of situations come together in the case of a minority client. The client system must be prepared to understand the impact of ethnicity in order to define the problem to be dealt with and formulate an effective intervention model. This paper uses a specific case to investigate and outline some of the problems and pitfalls inherent in working with minority clients who suffer from a common mental health problem, that of depression. Because of its familiarity to the client system, the depressive case appears to offer a routine situation with which the social worker must deal, no matter what the client's background. However, considering the ethnicity of the client stands as an important exercise in both accurate assessment and competent intervention. This paper investigates some of the potential questions and concerns to consider as part of the overall evaluation of even the most routine problem.
Depression is an affective mental health disorder, in which the predominant symptom is a disturbance in mood. The DSM-IV (the Diagnostic and Statistical Manual of Mental Disorders) lists a number of specific symptoms to aid the social worker in reaching this as a diagnosis, including sleeping and eating disorders (sleeping or eating too much or too little), changes in weight, and loss of pleasure. Experts estimate that the average American has as much as a one-in-four chance of suffering from a major depressive episode over the course of a lifetime. The DSM-IV provides the social worker with clear guidelines for assessing clients who are suffering from this common problem.
However, James W. Green points out one of the hazards of relying exclusively on the DSM-IV in diagnosing any specific disorder:
The manual's...