A Brief Foreword
I believe that it is important to highlight why I am writing about this particular demographic of society as opposed to the stigma surrounding mental illness in general. We are of course human beings and thus all require and are deserving of access to befitting mental health treatment. With this idea in mind why should there be a difference between the way in which a white, working class middle aged woman is treated as opposed to a black woman who lives only a few doors away? Or why should a white, working class man be more privy to having access to certain types of therapy as opposed to a black man of a similar socioeconomic status?
The answer to this question lies hereon out, and I hope it is as intriguing to read as it was for me to research and educate myself about.
To begin with, I would go as far as to say that it is impossible to address the root cause as behind the stigma around mental health issues in the black community without first delving into the rich and complex history of this societal demographic.
Namely, historical adversity is something that has plagued people of colour and their way of life for centuries. I only need to refer to past injustices such as ‘slavery, sharecropping and race-based exclusion from health, educational, social and economic resources’ to highlight just how significant this issue has been and continues to be. While the institutions of racial and cultural oppression have long since been dismantled, the remnants of this dark period of history arguably translates into the various socioeconomic disparities experienced by black people today.
As a result, the institutionalised racism that is embedded in the fabric of society is something that has been and continues to be underestimated by mental health services and subsequently has ramifications of their approach towards treating black people suffering from mental illness.
The Troubling Truth
According to howstuffworks, African Americans are 20 percent more likely to experience serious psychological distress than whites, and on an even more sobering note, suicide is now the third-largest killer of young African American men between the ages of 15 and 24.
If we have indeed come a long way as a society on our understanding and treatment of mental health issues, then why are young African American men taking their own lives in droves? Why are these young people with their whole lives ahead of them choosing to end it before it has even properly begun?
As would be expected the answer is to this question is far from simple. While it is no secret that the biggest cause of death in men under 45 tends to be suicide, this does not adequately explain the disproportion in suicide rates in regards to those of a different ethnic background and/or culture.
‘Every day you are struggling against a known traumatic event called racism. At every turn you’re reminded that you are a second-class citizen and you don’t have access to things that you should. That’s damaging to the psyche’
Secondly there is the inescapable fact that such discrepancies also present themselves in issues such as African Americans making up a eye-popping 40 percent of those experiencing homelessness, despite only being approximately 13 percent of the total U.S. population. Even more eye-opening is the purported evidence that suggests that black men and women make up approximately 1 million of the nation’s 2.3 million incarcerated population – and as we know, being either made to live on the streets or endure imprisonment over a significant period of time actually increases the risk of developing some form of mental illness!
All of this is exacerbated by the fact that many black people are reported to have experienced racial microaggressions on a regular basis. Essentially this refers to situations whereby somebody either intentionally or unintentionally makes racially motivated speech that makes the recipient feel invalidated as a human being. In many cases the effects of these microaggressions are more present on a subconscious level and as a result black people and people of other ethnic origins are arguably more likely to show symptoms of anxiety and depression than a white person. Unfortunately this does not always translate into these people then reaching out for help – or if they do, receiving it in a timely and effective manner!
The Effectiveness Of Therapy
Of course, the act of taking part in therapy itself should be as fruitful for those of African ancestry as it is for those of other ethnic backgrounds. Yet going by the statistics and research available this is unfortunately not the case. Indeed, according to a recent study, it has been deduced that the percentage of African Americans experiencing mental illness who choose or who are even able to gain access to therapy is only half as high as the rate for non-Hispanic whites!
In the case of the United States in particular, those people (especially men) who might be willing to enter therapy for depression may not have the financial resources or the health insurance that would allow them to do so and as a result this substantially invalidates the current health care system in place and the way in which it operates.
‘So you are born out of a legacy of trauma—historical trauma—and in the current day you still experience it. It only makes for individuals to be distrustful of larger institutions’
A similar problem exists in the United Kingdom, where according to the Mental Health Bulletin, only 5,000 black British people per 100,000 accessed mental health services in 2014-2015. Additionally, 12.7% of those in contact with mental health and learning disability services spent at least one night in hospital that year – that’s more than double the percentage of white people who spend time in hospital for similar issues!
We can continually ask questions as to the reason behind these figures and whether they are an indication of institutional racism being a more discriminatory force than many believe or whether these figures are merely an arbitrary result of a complicated and multilayered set of data. Either way, we arrive at the same conclusion – what exactly needs to be done to remedy the way in which mental health services currently operates and save the lives of those who choose to end it all?
Another misfortune is how it is not only the lack of people who have access to treatment or the stigma around mental health issues that is negatively impacting the hearts and minds of the black community – the blame also lies at the centre of the mental health profession itself!
The fact that less than 2 percent of American Psychological Association members are Black/African American is a very telling figure! It implies that even if by sheer good fortune a black person successfully seeks out therapy, there is no guarantee that said therapist will have the cultural knowledge or relevant life experience to actually help them with their problems. It has even been reported that some black patients have even experienced racism and microaggression from the people who are supposed to be helping them – a worrying notion indeed!
All of this has translated into a mistrust of authority figures, whether they be policeman, doctors and yes, even therapists. Considering how arduous and time consuming a task finding the right therapist can be for those who choose to seek out help in general, the above statistics provide an additional, and arguably unassailable barrier for those who happen to be born with a certain skin colour!
Other Forces at Work
While there are undeniably malign forces present in society that sadly prevent black people from seeking out the mental health treatment that they need, it also cannot be ignored that the reason why so few seek out help is as a result of outdated and unhelpful communal beliefs and practises.
For example, according to the National Alliance for the Mentally Ill, an astounding two-thirds of African Americans believe mental disorders like depression can be overcome by faith and prayer alone. While the power of prayer and the sense of unity it can provide is understandably a staple mark in many communities around the globe, one cannot help but wonder if this contributes towards so few black people coming forward in times of need.
‘I grew up with this adage ‘black folks don’t go to therapy, we go to church’
(A participant In the Stuff Mom Never Told You podcast episode “Mental Health in Black Communities, which can be downloaded here )
Additionally, while there is evidence to suggest that religious practises such as worship, holy dancing, and spirituals can be useful resources for African-Americans to manage stress, this does not mean that such practises should replace the medical benefits of receiving the right treatment.
Even disregarding the influence of religion altogether, there is clearly an element of self-suppression being exercised in many parts of the black community due to outdated social attitudes and a misplaced sense of self-determination.
What can be done?
While much of the information above is a damning indictment of society’s inability and/or unwillingness to ensure equality when it comes to mental health treatment, things can and will change if awareness is raised and more importantly, if certain members of the black community choose to act on this knowledge!
For instance, while movements such as Black Lives Matter campaign against violence and systematic racism towards black people in general, it would be ideal for organisations that have specific targets surrounding mental health related situations to achieve a similar social ranking. For instance ‘a specialized public relations effort targeted specifically at African American men, perhaps similar to the National Institute of Mental Health’s “Real Men, Real Depression” campaign, could make a positive impact’ according to Lucida, an organisation that specialises in tailor-based therapy.
In regards to the Church and other religious establishments, there clearly needs to be a correlation between the parishioners who offer emotional support to their Parish to be aware of the symptoms of severe mental ill health and a willingness to point these people in the right direction. Furthermore, by potentially being connected to mental health professionals and providing referrals where appropriate, these faith leaders can provide a safety net for those who suffer with some form of mental illness and have nowhere else to turn. Whether this be through therapy, counselling or another form of treatment, every small step taken to prioritise a person’s mental well being is a significant sign of progress!
‘I come from a legacy of people who fought simply to be and I view my effort to fight my depression as a battle for freedom’
Sherri Williams, Ph.D
Another way of counteracting the severe lack of representation of black people in the mental health profession could be to encourage prospective students to enter this career field. While there is no sure way of telling whether such a directive could ensure progress in this area, an increased representation of the black community in such a respectable and altruistic job role can only be a good thing!
A regrettable truth that society needs to come to terms with is that there is no one-size-fits-all approach when it comes to treating those with severe mental health conditions. As time goes on and our knowledge of mental health continues to expand, it becomes ever clearer that we need to be as diverse in our actions as we are in our acceptance of those from all backgrounds, regardless of race or age or creed.
If black lives really do matter, why are we not talking about this social and institutional barrier that not only stands between progress and equality, but also something that could lead a happy and fulfilling life for black people without them encountering outdated social attitudes and inadequate support when it comes to mental health issues?
In relation to accessing treatment itself, what is also explicit is that the culture and sense of tradition that surround these communities is irreparably intertwined with how likely they are to firstly recognise that they need support and secondly, actually going out of their way to seek such help. Attempting to treat these factors as if they were mutually exclusive is not an optimal approach towards moving forwards with an effective use of therapy in mind.
It will take society much time and effort to overcome the social and systematic barriers that have plagued black people for centuries and ensure a more egalitarian society. . Firstly there must be a coordinated movement within the black community to alter social attitudes towards mental health issues for the better. I mention the black community in particular as young black men and women are unlikely to heed advice from people outside of their social and cultural circles on such a precarious subject matter and understandably so! However there must also be some restructuring in the mental health services to facilitate this change and discontinue using the blunted tools of a bygone age.
In short, the black community must be given ample opportunity to make informed choices about their own mental health and that of their loved ones without social barriers, uninformed attitudes and blatant ignorance obstructing their capacity for growth and change.
What is your stance on the stigma surrounding mental health problems in the black community? Do you agree that institutional racism is still prevalent in society, and if so, how can it be countered? Feel welcome to let me know of your thoughts on this in the comment section below!
Did you know?
Black teens (8.3 percent) are more likely to attempt suicide than white teens (6.2 percent), which is indicative of the disproportionate gap between race and the likelihood to either seek out and/or receive treatment for mental health issues.
While society still has a long way to go in terms of representation, influential black artists and public figures such as Issa Rae, Jay-Z and Kid Cudi have been using their positions to further minority mental health awareness.
The website africanamericantherapist.com allows users to search for black therapists in major cities, if they should wish to engage in therapy with somebody familiar with their cultural background.
In relation to the negative impact of institutional racism, Emilie Aries ( in a podcast hosted by howstuffworks) points to research of Holocaust survivors and their offspring which showed that there is potential for trauma to be internalized and imprinted onto DNA, and possibly passed on to future generations. This phenomenon is called ‘epigenetic inheritance’.
According to this article, studies have demonstrated that having faith is good for your health. Monica A. Coleman, a professor of constructive theology and African-American religions states that ‘people who have faith and pray and have some sense of a greater power tend to heal faster and feel better’ – maybe there is some truth in the power of prayer after all!
Many black people blame much of their distrust of the medical profession on the infamous Tuskegee experiments, a time when ‘African American medical patients were betrayed in the worst way imaginable by professionals who were supposed to be looking out for their health and welfare’.
Emotional support helplines:
Samaritans :116 123
Rethink Mental Illness advice line 0300 5000 927 (Monday to Friday 09:30-16:00; local rate)
Sane Line:0845 767 8000
Mind also has a useful guide of support and services, which can be found by clicking the link right here