Mental health is not only a touchy subject worldwide, but it is especially difficult to discuss mental health in the black community. The black experience today has shaped many stigmas within black families and society, including those that are mental health professionals. One day in therapy I expressed the fear I have when I am driving home late at night and notice a cop in my rearview mirror. I explained that I can feel myself nearly about to have a panic attack from the pure anxiety and lump in my throat from the fear that I may be pulled over… or killed.
After expressing these fears my therapist says, “I’m sorry. Can you please explain more about what this fear feels like for you, so that I can understand more?”
At that moment, I was not angry with my therapist for not understanding, I realized as I am a black client speaking with a white therapist, she will never truly understand the all too common fear experienced by someone who is not white in this everyday situation. Furthermore, I did not feel like it was my job to teach her. I felt as though I was teaching her about my own culture’s trauma rather than expressing my feelings of anxiety and receiving the help I needed.
After my explanation she says, “I’m sorry there is nothing I can really say to take that fear away because that is the reality of our climate, but I can show you techniques to get through those feelings of anxiety.” This was not the first session I chose to bring up my black experiences, but it was the last. I was not looking for a bandage to cover up the trauma and anxiety our community has to face daily. My particular therapist’s lack of cultural competence did not allow her to give me what I needed at that moment. It was not about an anxiety technique to cope with the idea that I may be next and to find ways to accept it. Instead, it was about validation and attempting to discuss these fears further in order to feel more safe in a space where the odds are against me.
From that point on I realized two things: I would prefer to work with a therapist of color. Unfortunately there is a lack of BIPOC (Black, Indeginious, and People of Color) in mental health professions. Next, there is a need for cultural competency of therapists and all of those in helping professions. Everyone’s experiences are different and people of color have a harder time sharing their experiences, especially regarding something as vulnerable as mental health. It is also okay to be referred to another therapist who can better serve a patients needs.
Why does the black community experience trouble opening up about mental health?
Throughout history and the current climate, it is very difficult to be vulnerable and open about mental health, especially being Black. From stigmas within our community, a lack of cultural awareness and affordability, it can be difficult for those in the Black community to reach out for help. Only one in three Black adults who need mental health care receive it. Statistics show that they are also less likely to receive guideline-consistent care, less frequently included in research, and are more likely to use emergency and primary care instead of mental health professionals compared to their white counterparts. All these obstacles make it extremely difficult for those in the Black community to put their trust in mental health specialists and get the help they deserve. There are three main reasons the Black Community has trouble discussing Mental Health.
3 main reasons the Black Community have trouble discussing Mental Health:
- Stigmas within the black community
Growing up in a Black household you are taught to keep issues within the family. You are told “everyone does not need to know our business”. In the Black community it is safer to discuss personal information within groups deemed as safe such as with family members, close family friends, and spiritual groups. Seeking additional help from outside sources is another way for Black people to feel misunderstood and misrepresented in the realms of identity, values, and experiences.
The main issue surrounding mental health or other health conditions is the fear of labels. Negative attitudes regarding mental health within the Black community are staggering and still seen as abnormal. For example, a study showed that 63% of Black people believe mental illness is a form of weakness. Labeling is a huge issue because it reinforces stigma and separates us further from being included and feeling ostracized more than we already feel from society.
- Lack of cultural awareness within mental health professionals
Cultural awareness is the ability to understand, analyze and sympathize based on traditions, values and beliefs within your culture or another culture. To make it simple it is the ability to put yourself in someone else’s shoes to recognize what they deal with on a day-to-day basis regarding their culture.
Lack of cultural awareness within the mental health field is a major deterrent for those wanting to seek professional help. Some examples include:
- According to research done through the University of Michigan, Black men are five times more likely to be misdiagnosed with schizophrenia than any other group. This has been going on since the 1960’s.
- Studies show that individuals with major depression are also more likely to be diagnosed with schizophrenia which can be extremely harmful, especially when medication is thrown at you for a mental illness that you do not have. Not only is there a risk of misdiagnosing but there is also a risk of missing diagnosis and ignoring possible symptoms if mental health professionals are not culturally competent.
- Black teens are 50% more likely to show signs of bulimia than their white peers but do not get diagnosed.
- Black women are also at a greater risk for postpartum depression but are less likely to receive treatment.
- Another key point that slides under the radar is that Black people are more likely to describe their mental health problems by using physical symptoms so if you professionals are not aware of this, symptoms can go unnoticed.
In 2018, studies show that 11.9% of Black adults in the United States had no form of health insurance. Low socioeconomic status is a major contributing factor to seeking out treatment. Like other minorities, Black people of a lower socioeconomic status suffer in multiple ways as seen through healthcare, education, and other socioeconomic resources all of which contribute to poor mental health.
Lack of affordability also contributes to another stigma: the idea that therapy is for the rich.This is a really harmful sentiment. Black adults who live below the poverty line are 2x more likely to report serious and alarming psychological distress than those who are at a higher status economically. They report more feelings and sadness and hopelessness than their White peers. Money should not be the reason people do not receive Mental Health care… but it is. There are always options to receiving care and black people need to spread more awareness and resource options amongst the community.
From stigmas within our own communities, lack of cultural awareness, and affordability, it can seem like there are many barriers to receiving adequate mental health assistance if you are black. Becoming more aware of these barriers is a major contributing factor to change.
Healthcare professionals need to acknowledge racial bias and cultural incompetence to best address the cultural awareness and competency. Mandatory cultural awareness education should be required of all healthcare providers. Every provider should be aware of their biases to address the inequality of care.
Overcoming Barriers to Mental Health Treatment for the Black Community
Black community- it is our job to educate our family members and friends by having those uncomfortable conversations about mental health. That way our healthcare can be interpreted as less of a weakness and more of a strength. Finally, please be patient with yourself and seek appropriate mental health professionals and resources that contribute to your overall well-being.
African American Patients. (n.d.). Www.psychiatry.org. https://www.psychiatry.org/psychiatrists/cultural-competency/education/african-american-patients
African-Americans more likely to be misdiagnosed with schizophrenia, study finds: The study suggests a bias in misdiagnosing blacks with major depression and schizophrenia. (2019). ScienceDaily. https://www.sciencedaily.com/releases/2019/03/190321130300.htm
Artiga, S., Orgera, K., & Damico, A. (2020, March 5). Changes in Health Coverage by Race and Ethnicity since the ACA, 2010-2018. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/changes-in-health-coverage-by-race-and-ethnicity-since-the-aca-2010-2018/
Black Mental Health: Statistics, Resources and Services | Wake Forest University. (2020, September 14). WFU Online Counseling. https://counseling.online.wfu.edu/blog/black-mental-health-resources/
Mental & Behavioral Health – The Office of Minority Health. (2019). Hhs.gov. https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=24
NAMI. (2017). African Americans | NAMI: National Alliance on Mental Illness. Nami.org. https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Black-African-American
Ward, E. C., Wiltshire, J. C., Detry, M. A., & Brown, R. L. (2013). African American Men and Women’s Attitude Toward Mental Illness, Perceptions of Stigma, and Preferred Coping Behaviors. Nursing Research, 62(3), 185–194. https://doi.org/10.1097/nnr.0b013e31827bf533
Why Do Black People’s Mental Illnesses Get Misdiagnosed? (n.d.). Healthline. https://www.healthline.com/health/racism-mental-health-diagnoses
About the author
Jessica Christion is an aspiring Marriage and Family Therapist to serve youth and their families. Her goal and passion is to spread mental health awareness through casual conversation and comfortability. She also enjoys writing poetry and has authored a book of poetry called Aliens Blood.