Sarah is an African American woman who receives a visit from the psychiatric home health nurse. A referral for a mental health assessment was made by the public health nurse, who noticed that Sarah was becoming exceedingly withdrawn. When the psychiatric nurse arrives, Sarah says to her, "No one can help me." I was an evil person in my youth, and now I must pay." How might the nurse assess this statement?
a. Sarah is having delusions of persecution
b. some African Americans believe illness is God's punishment for their sins
c. Sarah is depressed and just wants to be left alone
d. African Americans do not believe in psychiatric help