Shedding Light on Black History & Mental Health

There’s no denying that mental health care in Black communities across America has been woefully neglected. Black and African American (B/AA) people have been left to deal with the abhorrent history of slavery, colonialism, segregation, oppression, misogyny, stereotyping, and blatant racism. The aftermath of this is proving devastating, as research continues to show an increased risk of B/AA people developing mental health conditions relative to other populations.

According to the Columbia University Department of Psychiatry:

• Since 2021, an estimated 16% (4.8 million) of B/AA people in the US report having a mental health condition  
• Of the 4.8 million, about 1.1 million report having experienced a serious mental health condition or episode in the past year
• Members of the Black and African American community living below the poverty level are 3 times as likely to develop a serious mental health condition than those above the poverty line

Research conducted by Mental Health America shows that the prevalence of serious mental health conditions increased among B/AA people of all ages from 2008 – 2018. 

It’s plausible that the Black community in this country is at an increased risk of developing mental health conditions at a disproportionate rate as a result of historical, social, political, and economic forces that affect their psychological wellness. Couple this with the known stigma that’s associated with mental health care and the Black community, and the problem is more evident than ever. 

Continue reading to learn how we can all contribute to breaking the stigmas surrounding mental health care in Black communities. It’s the only way we can progress society towards adequate and accessible mental health care for all members of the B/AA community.

The History of Mental Health in Black Communities

Mental health doesn’t discriminate based on skin color, gender, or race. Anyone can develop a mental health condition, regardless of their history or background. However, someone’s background can put them at higher risk in terms of receiving the mental health care and mental health treatment they may need.

The barriers preventing members of the Black, Indigenous, and People of Color (BIPOC) community from getting adequate and effective mental health care run the gamut. Everything from socioeconomic inequities, to the presence of culturally incompetent mental health care providers, to the realities of a fundamental lack of trust within the healthcare system as a whole are at play.

“Cultural incompetence and implicit bias of health care providers likely contributes to underdiagnosis and/or misdiagnosis of mental illness in BIPOC. Language differences between patient and provider, stigma of mental illness among BIPOC, and cultural presentation of symptoms are some of the many barriers to care that explain these errors in the diagnostic process.”

– Talkspace therapist Dr. Karmen Smith LCSW, DD

According to research, socioeconomic status is directly linked to high risk of mental health conditions. Things like poverty, unemployment, and lack of affordable housing are all linked to a significantly higher likelihood of developing a mental health condition. Historical systems of oppression have led to constant socioeconomic challenges within the BIPOC community. Further research has found that the socioeconomic status of an individual is frequently influenced by factors such as race and ethnicity, and minority racial groups are more likely to experience multidimensional poverty than their White counterparts.    

Some research estimates that up to 17% of Black adults have a mental health condition. Further, in terms of mental health care in Black communities, it’s been well-established that BIPOC groups are less likely to reach out for mental health help and that they’re more likely to:

• Be misdiagnosed
• Receive lesser quality care
• Stop seeking help early
• Not have adequate resources and access to care 

 Black Pioneers in Mental Health

To this day, there’s still a disproportionate number of BIPOC mental health professionals. Some research shows that an estimated 86% of psychologists are White, compared to just 4% who are B/AA. 

Through the years, though, there have been numerous Black mental health champions and Black psychologists who’ve contributed greatly to our understanding of the inadequacies pertaining to mental health care of B/AA people. Some of them include: 

• Dr. Andrea G. Barthwell, MD, a family practice physician in Oak Park, IL, who’s recognized as a leader in the mental health field of addiction treatment. She’s known for her focus on integrating government policy into communities.
• Dr. Lula A. Beatty, PhD, was awarded a 2019 Presidential Citation recognizing her leadership in enhancing public understanding about health disparities between B/AA individuals and the rest of the population.
• Dr. Gayle K. Porter, PsyD, a clinical psychologist who provides evidence-based interventions and resources that strengthen cultural competence among the Black community.
• Dr. Howard C. Stevenson, PhD, a clinical psychologist, Professor of Urban Education, Professor of Africana Studies, and Director of the Racial Empowerment Collaborative.
• Dr. Francis Cecil Sumner, PhD, (1895 – 1954) the “Father of Black Psychology,” who was the first African American to earn a PhD in psychology in the USA.
• Dr. Nadine Burke Harris, MD, MPH, FAAP, appointed as California’s first-ever Surgeon General, Dr. Harris is an award-winning physician noted for her groundbreaking work in identifying the impact of childhood trauma and toxic stress later in life.

Despite the brilliant progress forged by these and numerous other B/AA mental health professionals, there’s still a destructive stigma linked to the mental health concerns and care for the Black community. 

The future lies in expanding our knowledge about the historical and current tribulations that all members of the BIPOC community face daily. We must work diligently to destigmatize mental health care in Black communities and remove the barriers so many continue to face.

Paving a New Future for Accessible Mental Healthcare in Black Communities

It’s unfortunate it even needs to be noted that members of the BIPOC community should be privy to the same quality of mental health resources as the rest of the US populace. Access, affordability, and effectiveness should be a given, regardless of socioeconomic status or any other factors at hand.

That’s why it’s so imperative that mental health and other healthcare professionals, and the general population, join together to eradicate the stigma associated with mental health in Black communities.

“Alvin Poussaint, former clinical professor and dean of psychiatry at Harvard Medical School, author of Why Blacks Kill Blacks, and activist argued for changes to the diagnosis manual to list bigotry as a mental health disorder. He stated, ‘The real reason the psychiatric association hasn’t made racism a mental health issue is because it hasn’t been a mental health issue for them.’ To pathologize racism, he said, would require its members ‘to look at their friends, their relatives, and themselves in an uncomfortable light.’ Advocating for the inclusion of hateful aggressive acts of bigotry in the diagnostic manual could help identify individuals and groups to protect them and their targets from their delusional agenda.

– Talkspace therapist Dr. Karmen Smith LCSW DD

Great advancement can be best achieved by helping everyone, including those in Black communities, understand that positive mental health is a basic necessity of life, just like food, water, sleep, and physical exercise. All humans deserve — and require — these fundamental needs in order to enjoy even a marginally contented existence.

We also need to have more B/AA mental health professionals at all levels — from reception nurses at hospitals to clinical psychologists and others. The field currently suffers tremendously from a quite limited level of cultural competency. 

Increasing mental health awareness in Black communities regarding the essential importance of accessing and using mental health resources can be instrumental in overcoming the disparities between BIPOC and other communities.  The movement of making therapy for people of color more widely accessible is one that needs to be prioritized.

While the history of mental health care in Black communities is bleak, the future can be bright, as long as we work to change things. Yes, it will require effort and persistence to remove the barriers that have been in place for so long, but it is possible. The solution begins with honoring Black, African American, and BIPOC history and destigmatizing mental health care in these communities. 

Sources:

1. Vance, PhD T. Addressing Mental Health in the Black Community. Columbia University Department of Psychiatry. https://www.columbiapsychiatry.org/news/addressing-mental-health-black-community. Published 2019. Accessed July 20, 2022.

2. Black and African American Communities and Mental Health. Mental Health America. https://www.mhanational.org/issues/black-and-african-american-communities-and-mental-health. Accessed July 19, 2022.

3. Hudson, Ph.D. C. Socioeconomic Status and Mental Illness: Tests of the Social Causation and Selection Hypotheses. American Journal of Orthopsychiatry. 2005;75(1). https://www.apa.org/news/press/releases/2005/03/low-ses. Accessed July 19, 2022.

4. Mental Health Resources For Black, Indigenous, And People Of Color. Mental Health America. https://www.mhanational.org/bipoc-mental-health. Accessed July 19, 2022.

5. Lin, MPP L, Stamm, PhD K, Christidis, PhD P. How diverse is the psychology workforce?. APA’s Center for Workforce Studies. 2018;49(2):19. https://www.apa.org/monitor/2018/02/datapoint. Accessed July 19, 2022.6. “Ethnic and Racial Minorities & Socioeconomic Status.” American Psychological Association, American Psychological Association, July 2017, https://www.apa.org/pi/ses/resources/publications/minorities.