While the experience of being Black and living in America varies tremendously, the shared experience of being subject to racism, discrimination, marginalization, and inequality significantly affects the Black communities mental health and wellbeing. 

Recent studies by the Anxiety & Depression Association of North America show that Black people are 20% more likely to experience significant mental health problems than the rest of the population. 

The truth is, our mental health is just as important as our physical health, and it deserves as much care and attention. Yet research consistently shows that societal pressures, racial discrimination, economic disparities within the Black community continue to increase the likelihood of developing mental illness. 

Despite the need for mental health care, only a quarter of Black people seek mental health care, compared to about 52% of non-Hispanic Whites. 

We set out to better understand the disparities impacting the Black community and the significant barriers to mental health care.

Barriers to Mental Health Care in Black Communities

Everyone deserves access to quality and appropriate mental health care. Still, there’s no denying that marginalized communities face substantial racial and ethnic disparities in the mental health care system.

The following factors may prevent Black individuals from seeking mental health care treatment, resulting in more psychological distress, functional difficulties, diminished quality of life, and even loss of life:

Systematic Racism

Systematic racism describes the discriminatory actions, beliefs, and policies ingrained in the systems within which we live, including education, the workplace, housing, the economy, the criminal justice system, and healthcare. 

Systematic racism arrived in the U.S. centuries ago, when European colonists declared ownership of the land that Native Americans inhabited, and enslaved African Americans for generations. 

The policies institutionalized by the settler colonists continue to affect BIPOC communities today. Systematic racism not only puts marginalized groups at a socioeconomic disadvantage, but it takes a harmful toll on their mental health.

Racial Trauma

Licensed Independent Social Worker, Carol Dupre explains that racial trauma, an emotional or physical response to witnessing or experiencing racism, discrimination, or racially charged violence, is one way that systematic racism impacts mental health. 

Over time, these day-to-day interactions with discrimination which marginalized and dehumanize ethnic minorities, can lead to racial trauma. 

It’s common to experience a range of emotions when facing racial trauma, but when left untreated racism trauma can lead to:

• Increased alertness of perceived threats
• Chronic stress
• Anxiety and/or depression
• Low self esteem 
• Aggressive behavior
• Substance abuse 
• Sleep disturbances 
• Difficulty concentrating at work, school, in relationships  
• Feeling disconnected from others

Lack of Diversity in Mental Health Care:

“I hadn’t been aware of the shortage of Black providers in the mental health field until I started to practice counseling,” says Licensed Independent Social Worker, Carol Dupre. 

Carol has experience working with the BIPOC community, and continues to inform herself on community-based intervention strategies and mental health advocacy in the Black community.

Statistics from the Association of Black Psychologists indicate that only 4% of psychologists, 2% of psychiatrists, 7% of marriage and family counselors, and 11% of professional counselors are reported to be Black.

Finding therapy for people of color can be daunting considering the Black community has been widely underserved.  

Carol says that individuals can start by looking for a culturally competent counselor by asking the provider if they have any experience working with the BIPOC community.

Access to Healthcare Coverage:

Housing, employment, education levels, and access to healthcare are all necessary factors that contribute to mental health outcomes. There’s no denying that barriers within these systems disproportionately affect people of color. 

According to data from the U.S. Census Bureau’s Household Pulse Survey, 8.1% of Americans 18 and older lacked health insurance coverage. Black Americans made up 9.2% of the data, while non-Hispanic white Americans made up 6%. 

These disparities in health care may be tied to employment and economic mobility. Unemployment rates are typically higher for the Black and Hispanic communities in the U.S. than for whites. 

One way that Black communities have been subject to racial disparities is through redlining, the discriminatory practice of denying care, credit, or development in minority neighborhoods. This prevents minority communities from building wealth and economic mobility, to access services such as mental healthcare.

Mistrust of the Healthcare System:

Throughout history, the Black American community has been subject to experimentation in the name of “advancing” medicine, without concern for long-term and short-term consequences. 

The Tuskegee Syphilis in the Negro Male, a study which involved 600 Black men, whose consent was not confirmed, when there was no treatment for Syphilis, demonstrates why people in the Black community have a difficult time trusting the healthcare system. 

Research continues to show that Black people are often misdiagnosed at a higher rate for schizophrenia. Other studies have shown that, 

• A Black person’s pain isn’t taken as seriously by doctors
• The Black community often has longer wait times when seeking medical care
• Physicians spend less time with their Black patients

Mental Health Stigma:

“There’s a remaining stigma around mental health in the Black community. Whether it’s anxiety or depression, there’s a mindset that Black people can “survive” sadness or anxiety without needing help from another person. The mindset to ‘suck it up,’ or ‘be strong and never allow other people to see you break,’ is especially prevalent among Black men and can be passed down through generations,” says Carol.

There might also be narratives passed down in families or communities where the “crazy” friend had to get hospitalized for their mental health condition. Younger generations might start to believe that having a mental health condition means you can’t function in society. 

Similarly, if someone who commits a crime is said to have a mental health condition, it may perpetuate the belief that people with mental illness are violent. The disproportionate number of incarcerated Black Americans, over 37%, stokes the fear that if a Black person were to acknowledge their mental health condition, they would be met with legal repercussions rather than recovery.

Where Do We Go From Here

While there’s a lot of work to be done, conversations addressing mental health, systematic racism, and barriers to health equity are a critical step forward. Conversations can lead to awareness, action, and systematic change that works for people regardless of their race, culture, age, gender, sexual orientation, religious beliefs, or socioeconomic status.

Taking the First Step Toward Healing

Turning to a mental health professional is the first step to overcoming any mental health concerns. To feel supported, it’s important for every individual to meet a qualified provider who understands your unique needs and references for treatment.

At HBH, we’re here to help you connect with an experienced and qualified BIPOC counselor. 

To start working with one of our therapists online or in-person from our offices in Amherst, Franklin, Natick, West Springfield, and Wilbraham, contact us today at (413) 343-4357.

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