In honor of Black History Month, I would like to address a great concern in the African American community. There are high rates of mental illness and low treatment due to numerous reasons discussed in this article.
People all over the world are suffering from mental health-related illnesses. Mental illness affects all backgrounds, ethnicities, and religions.
In America alone, around 45 million people identify as African American and comprise 14% of the entire American population. But on average, African Americans are 20% more likely to suffer from mental illness when compared to the general population.
African American adults report feelings of sadness, anger, disappointment, and worthlessness at a higher rate when compared to White adults. African Americans are more likely to be the victims of serious crimes making them more susceptible to Post-traumatic Stress Disorder (PTSD), trauma, and death by suicide.
Common Obstacles African Americans Face / Lack of Mental-Health Treatment
There are many obstacles and unmet needs that cause severe forms of distress within the Black community. Some of the major elements are:
Intergenerational Trauma
Intergenerational trauma caused by 300 years of slavery combined with discrimination and poor economic conditions has led to the poor state of psychological, social, and physical health among African Americans.
The psychological trauma that African Americans endured across the more than 300 years of their enslavement has been carried on to the present generation and is linked to our existing overall condition of poor physical and mental health. For instance, statistics show that the prevalence of high blood pressure, prostate cancer, diabetes, and premature heart disease deaths in adult African Americans are double than amongst White Americans.
African Americans are suffering considerably from higher psychological stress and PTSD, which is associated with poor health, physical ailments, depressive symptoms, and chronic disease. Comparable social health statistics indicate higher homicide rates, and Black men are 5 times as likely to be incarcerated than White men. Furthermore, 5 percent of the African American male population is incarcerated in many states. Illegal drug use and intimate partner violence rates are greatest within African American communities.
Implicit discrimination in the United States is common and is associated with negative health outcomes for African Americans. Today’s policies aimed at tackling discrimination and poverty may have little effect, as they specifically address today’s inequalities while doing little to assess the effect of historical injustices on African American health.
Cultural Beliefs
The majority of African Americans (around 85%) describe themselves to be “fairly religious.” Their religious beliefs sometimes hinder their ability to seek psychotherapy. Religious people that are uninformed of mental illnesses sometimes consider it to be “punished by God.”
Most often, our communities can cause even more distress by treating people inappropriately for their mental health concerns. Many are less educated when it comes to mental illnesses such as depression, anxiety, and other forms. This absence of information leads to negative beliefs and shame when it comes to reaching out for psychological help.
Most Black communities are still unaware of the fact that they can seek help for their psychological issues. Some are fearful of others within the community finding out about their problems and being judged. Some lack faith in therapy treatments, while others don’t consider mental illness to be an issue that can be treated in the first place.
Poverty and Lack of Resources
Poverty and lack of resources is another significant barrier for the Black community. Poverty accompanies stress, hunger, homelessness, and an inability to find employment, leading to inadequate healthcare. These factors serve as further catalysts for many other mental illnesses.
According to a survey done in 2014, the poverty rate for African Americans was around 26%. Poverty is often the most contributing factor in mood disorders, thus, almost 40% of African Americans are homeless. Religious beliefs and being uninformed of mental illness, paired with poverty makes treatment the least preferred option for African Americans.
Insufficient funds and resources also make it more difficult for African Americans to reach out for help from mental health professionals. Even in cases where the individuals suffered from severe depression, most of them had never sought professional help. Mainly the reason for their neglect was the cost of treatment and lack of resources.
Denial and Social Stigma
Experiences of stigma are prevalent among African Americans and often serve as one of the major barriers in seeking mental health treatment. People who show signs of depression are often mistreated for expressing the problem. Some are even called “crazy” for their mental struggles.
Many thought that being Black and depressed was considered insignificant because they believed they wouldn’t get the same attention that White people do. This creates a sense of denial and not admitting the struggle with depression.
Statistics show that 40% deny having any mental illness despite severe psychological symptoms, 38% report embarrassment for being depressed, 31% refuse to get help, 17% fear their community’s judgment and don’t disclose mental health problems, and 69% of African Americans deny depression to even be a real problem.
Racism and Violence
Despite the progress made throughout the years, racism is still a challenge for many people of color living in the United States. Negative stereotypes and attitudes of rejection still prevail and cause physical as well as psychological harm to African Americans. The tension between different races causes a lack of trust and confidence when reaching out for help.
A mistrust in authorities is often seen because of the racism that follows. African Americans are also more susceptible to violence that cause Post-traumatic Stress Disorder at a higher rate, and death by suicide. The violence and rejection from other communities make it more difficult for African Americans to reach out for help.
The biased treatments of patients depending on their race, financial, and social factors also hinder many people of color from seeking help.
Lack of Similar-Race / Culturally Competent Professionals
African Americans are reluctant to seek help due to the lack of Black professionals in the Mental health field. The absence of a familiar face when seeking treatment makes African Americans more hesitant to start therapy. Because of their lack of confidence and mistrust in a mental health professional of a different race, African Americans may not benefit properly from their sessions.
Less than 3% of all mental health professionals are Black. Therefore, finding the right provider is also a concern. Are they experienced in dealing with the problems of African American patients? Are they culturally competent?
Cultural competence is the capacity to comprehend, interact, and engage effectively with individuals across cultures. Cultural competence involves being mindful of one’s own way of thinking, cultivating positive attitudes about cultural differences, and acquiring knowledge of different cultural traditions and belief systems.
This will strengthen the therapeutic relationship as many of the mental illnesses experienced correlates with discrimination, trauma, poverty, etc. and it needs to be addressed in therapy. Many non-Black therapists are unaware, afraid, or uncomfortable bringing these topics up, leading to African Americans dropping therapy once they get the courage to go.
The lack of cultural competence can cause misdiagnosis and mistreatment. Due to this, African Americans may sometimes receive poor quality of care from their therapists.
“For decades, Black men have been misdiagnosed and over-diagnosed with schizophrenia as their emotions are read as psychotic.
Black teenagers are 50 percent more likely than their white peers to show signs of bulimia, but get diagnosed significantly less, even if they have identical symptoms.
Black mothers are at a greater risk for postpartum depression, but are less likely to receive treatment.” Source
One solution is training mental health professionals on how to deal with Black mental illness.
How Can We Create Change?
Most communities need to understand that Mental-health issues are normal and there’s no shame in seeking help for your distressing thoughts. Knowing the root of these problems will help develop positive approaches so Black people too can live mentally healthy and meaningful lives.
The success of any approach to reduce intergenerational trauma and its effects need to be addressed in contexts of the broader picture of Black and White relations in the US. Nonetheless, the current ideas of collective accountability for the past era of slavery and White privilege from racial inequality is largely unacknowledged or resisted by most White Americans.
Furthermore, research suggests one way out of this situation is to stress a communal worldview and morality between African and White Americans in order to minimize the effect of inter-group conflict.
On average, African Americans are more vulnerable to mental illness. There are several contributing factors stopping them from gaining access to the care they need. Lack of knowledge, racism, poverty, oppression, violence, and so forth all contribute towards this neglect in treatment.
We as a community also need to support each other more, stop calling those in need “crazy,” and end the stigma on seeking treatment so that we can heal and do better in society as a whole.
References
https://www.mhanational.org/issues/black-african-american-communities-and-mental-health#10
https://adaa.org/african-americans
https://www.letserasethestigma.com/african-american-communities
https://www.nami.org/find-support/diverse-communities/african-americans
‘African American Health and Posttraumatic Slave Syndrome: A Terror Management Theory Account’, in the Journal of Black Studies.
Disclaimer
The contents of the Bell OCD and Anxiety Treatment Center (BOATC) site, such as text, graphics, images, and other material contained on the BOATC Site are for informational purposes only. Yes, I am a Licensed Marriage and Family Therapist in the state of California, but I’m not your therapist and this article does not create a therapist-client relationship. This article provides mental health information and should not be seen as professional advice. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your psychotherapist, physician, or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the BOATC Site.