Ending the Mental Health Stigma in the Black Community
The United States Department of Health and Human Services’ Office of Minority Health notes that Black American adults are statistically more likely to experience long-term problems associated with emotional distress than their white counterparts. In fact, feelings of hopelessness, sorrow, and emotional exhaustion are common across non-white communities in the U.S.
And among the 18.8 percent of Black people who live below the poverty line, these emotional stressors become more acute. Black adults living in poverty have reported feeling significant psychological distress at twice the rate of people with higher incomes.
Rooted in history, fresh as today’s news
Historic racism has left many Black Americans with generational trauma, in a way that psychiatrists have found similar to the trauma passed down through the generations of families descended from Holocaust survivors. But the legacy of slavery and Jim Crow are not the only painful encounters with racism that Black Americans face, of course. As should be obvious to anyone paying attention, racism is alive and well in the U.S.
For example, Black Americans are more than twice as likely to live in poverty than white or Asian Americans. Systemic discrimination against Black Americans pervades our education, healthcare, employment, banking, property ownership, law enforcement, and prison systems, and Black Americans are underrepresented in places of power, such as in corporate leadership and government.
An unmet need
Our society is often hostile to Black Americans' mental health, but experts note that only about one in every three Black Americans who could use mental healthcare actually receives it.
The American Psychiatric Association (APA) also finds that Black people in the U.S. are also more likely to use emergency rooms as their means of obtaining primary care for mental, as well as physical, health issues. They are less likely to have access to mental health care aligned with current guidelines. And they are not included in research studies on mental health as frequently as white Americans.
A deadly wild card
Now factor in the added stress that has impacted everyone during the COVID-19 pandemic. COVID has also shown itself statistically worse for Black Americans and other people of color.
Only about 13 percent of the population of the U.S. is Black, but they make up fully one in three among people hospitalized due to COVID. A recent APA report showed that Black Americans are also about 3.7 times more likely to die from COVID than white Americans, and twice as likely to die from the disease than other people of color.
Black Americans are more likely to hold essential front-line service positions (only about 18 percent of Black Americans have telework-friendly jobs) and to live in multi-generational households that limit possibilities for physical distancing. This is on top of systemic health inequities that include underlying health conditions and lack of health insurance.
Let’s sum it up simply: Black people have always been more likely to live in a state of heightened emotional stress. And COVID has only made that worse.
Skewed perception
So why don’t more Black Americans seek out therapy? Part of the reason is a lack of access to mental healthcare in the communities where they live, lack of insurance, and difficulty affording therapy. However, a persistent stigma is also to blame.
On its website, the National Alliance on Mental Illness (NAMI) offers research findings that show there's still a strong negative perspective on issues surrounding mental health in the Black community.
One survey found that more than 60 percent of Black Americans think mental health problems are just indications of some personal failing or spiritual weakness. For many people, there’s a big sense of shame about disclosing their mental and emotional struggles, and that keeps them from getting help. They may feel that the people in their lives will shut them out, or that they’ll suffer some other type of discrimination.
Safeguarding faith as a help, not a hindrance
Another reason for avoiding mental health treatment is, paradoxically, one of the Black community’s many strengths: their faith. Religious faith can fortify and support anyone experiencing any kind of illness. For most people, faith works best as a complement to, rather than a replacement for, professional mental healthcare. But many Black Americans choose to look for help in their faith community, rather than in majority-led healthcare spaces where they can feel disrespected or patronized.
So, what do we as a society do about all this? Here are a few potential solutions:
1. Meet people where they are
Ensure that the mental health professions recruit and retain people of color. Train all mental health providers in the cultural competence necessary to gain the hard-won trust of people of color. Educate Black patients so that they’re comfortable asking for information about potential providers to determine if they’re sensitive to the unique needs of Black Americans. Questions like: How did you learn to build cultural competence in working with Black patients? How do you think your cultural expectations will influence my course of treatment?
2. Resource communities
Draw on the credibility of respected voices in Black American communities: business leaders, clergy, activists, celebrities, mental health experts and other service providers, and fellow Black Americans who have struggled with their own mental health challenges. Give these trusted individuals thorough, accurate information and talking points to help them have respectful, real-talk conversations with their communities about mental health. Build outreach and public education programs at the community level.
3. Find power in vulnerability
As some Black mental health professionals have noted, the roots of Black Americans’ avoidance of mental health-related conversations and treatment may lie in the soul-destroying days of slavery, when it was common for white people to believe Black people were so emotionally uncomplex that they could not become depressed or develop other mental health conditions. As one contemporary Black provider has said, “we learned to ignore mental illness or call it other terms.”
Our society as a whole must acknowledge the full humanity of Black people and work to make mental healthcare accessible to Black Americans. Within the Black community, there are activists, leaders, and ordinary people working today to challenge the old stigmas that are also keeping many Black Americans from getting the mental healthcare they need. We should follow their lead and work to dismantle this dangerous stigma.