According to the National Alliance on Mental Illness (NAMI), 1 in every 5 adults in the United States experience a mental Illness1. In Black communities however, mental health disorders diagnoses are often higher than their counterparts. The Office of Minority Health identified that
20% of Black Americans are more likely to experience severe mental health problems2 with only 1 in every 3 Black Americans receiving treatment and care for them3.
Acknowledging available research is helpful to paint the picture of the need for change, but without understanding the historical context and challenges that exist due to the complicated history of Black Americans, health professionals often fall short of providing culturally-relevant mental healthcare and resources that aim to reduce disparities and improve mental health for Black Americans.
Brief History
In order to effectively address mental health disparities in Black communities, it is important to understand how historical events have played a role in the mental health disparities we see today, to better aid health professionals to adjust their practices to provide better care and
resources.
Historical hardships that include slavery, institutional-racism, race-based medical and health practices, and barring Black Americans from educational, social, and economic resources have all manifested themselves into the socioeconomic disparities we see being experienced by Black
Americans today4. The, now termed, Social Determinants of Health, are health-impacting factors outside of physical biology that impact physical, mental, social, and emotional health of people. With a large portion of the history of Black Americans being rooted in racism and oppressive practices, many have become linked to poor mental health and a distrust of medical
professionals.
Challenges to Mental Health Care for Black Americans
Recognizing the history of Black Americans will give better context as to why certain challenges exist in providing care and treatment for mental health disorders. Including the aforementioned hardships, Black Americans have also endured many forms of stigmatization and biases by providers and health professionals that have fueled mental healthcare inequities and inequality.
Stigmas
Today, movements surrounding caring for your mental health, and seeking therapy and/or treatment are trending and beginning to increase in global visibility, yet, Black American communities still face continued mental health hardships. Stigmas associated with mental health disorders such as depression and anxiety continue to remain a taboo topic within the community. In a study conducted in 2013 on Black American men’s and women’s attitudes toward mental health, it found that 63% of Black Americans believe that depression (and similar mental health disorders) are a sign of “weakness”. Additionally, Black American men specifically
believe mental health disorders are a lack of motivation, while older adults believe that depression is a sign of both weakness and lack of inner strength5. These findings represent not only feelings about mental health disorders that exist but also how challenging it is for those who are struggling to seek help.
Health Professional Bias
Historical practices of race-based medicine have influenced the support and treatment of people of color and more specifically Black Americans in our healthcare system. General bias, implicit bias, and lack of cultural awareness found in the mental healthcare system, continues to increase the mental health disparities among Black Americans. These biases along with a lack of knowledge surrounding colloquial communication or general understanding of the communities in which professionals provide care continues to drive a distrust of the medical community which can lead to misdiagnoses and poor treatment of mental health disorders.
Breaking Down Barriers and Providing Culturally Competent Care
Understanding the history and challenges that exist surrounding mental health in the Black community, the question remains, how do we work toward reducing these disparities and addressing mental health disorders among Black Americans?
Here are three ways to begin the work:
1. Acknowledging your own conscious and unconscious bias.
We may think that we do not have biases, but the fact is, we all do; it’s human nature. The goal of acknowledgment is to ensure that our pattern of thinking is not aligned with stereotypes rooted in racism and prejudice, but rather be aligned with community and cultural awareness so we can provide the best diagnosis and care plan.
2. Seek out assistance from peers.
Health professional are encouraged to work across sectors to provide medical care and treatment. Caring for an individuals’ mental health is no different. If you do not have experience working within the Black community/working with Black/African-American patients, there is no shame in seeking support and advice from peers. This not only aids you
in providing a diagnosis, treatment, and/or the appropriate referral (if needed), but it also signifies to the patient that you are willing to work above and beyond, ultimately improving patient-provider trust.
3. Self-Education. Self-Education. Self-Education.
A sign of humility and growth is when we realize that we do not know everything and that is okay because we can learn. Educating oneself on cultural norms, challenges, and overall thoughts on mental health in communities of color can help us to be better providers and ultimately better contributors to society. Many organizations like BEAM or the Black
Emotional And Mental Health Collective offer trainings that provide education and tools on mental health and healing in the Black community.
With mental health being an ongoing topic of discussion, especially with the onset of the COVID-19 pandemic, prioritizing mental health has become more important than ever. We hope this article has given you some food for thought and resources to share with your networks as we work to address the disparities in mental health among Black Americans.
Mental Health Resources for Black Americans
- National Alliance on Mental Illness (NAMI)
- Therapy for Black Girls
- Therapy for Black Men
- Black Mental Health Alliance
- Black Mental Wellness
- The Boris Lawrence Henson Foundation
Sources:
I. National Alliance for Mental Illness. (n.d.). Mental Health Facts-IN AMERICA. Retrieved February 03, 2021, from https://www.nami.org/nami/media/nami-media/infographics/
generalmhfacts.pdf.
II. Anxiety and Depression Association of America. (2020). Mental health resources for the black community. Retrieved February 03, 2021, from https://adaa.org/finding-help/blackcommunitymentalhealth
III. National Alliance for Mental Illness. (2021). Black/African-American. Retrieved February 02, 2021, from https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Black-African-American
IV. Office of the Surgeon General (US); Center for Mental Health Services (US); National Institute of Mental Health (US). Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2001 Aug. Chapter 3 Mental Health Care for African Americans. Available from: https://www.ncbi.nlm.nih.gov/books/NBK44251/
V. Ward, E., Wiltshire, J., Detry, M., & Brown, R. (2013). African American men and women’s attitude toward mental Illness, perceptions of stigma, and preferred coping behaviors. Retrieved February 02, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4279858/
