Mental illness does not discriminate. One in four Americans will experience a behavioral health disorder in any given year regardless of age, race, religion, gender or economic status. Anyone can develop a mental health disorder. However, there are factors that can increase the vulnerability to and severity of mental health disorders in the African American population and decrease their likelihood of seeking and receiving adequate treatment, including:
Mental Health America points out that, “Despite progress made over the years, racism continues to have an impact on the mental health of Black/African Americans. Negative stereotypes and attitudes of rejection have decreased, but continue to occur with measurable, adverse consequences. Historical and contemporary instances of negative treatment have led to a mistrust of authorities, many of whom are not seen as having the best interests of Black/African Americans in mind.”
Evidence of the historic context that contributes to mistrust within the African American community can be seen in the pseudoscience of “diseases” such as Drapetomia and Dysaethesia Aethiopica, created to maintain the status quo of slavery in the South.
During slavery, an overt display of mental illness often resulted in more frequent beatings and abuse, which forced slaves to disguise or hide their mental health issues (Hastings, Jones, & Martin, 2015). The outcomes of these events have been long-lasting, perpetuating myths about mental illness. Sixty-three percent of African Americans believe that depression is a personal weakness. Family and community members often insist on prayer as a singular solution over seeking professional treatment:
“Why are you depressed? If our people could make it through slavery, we can make it through anything.” “When a black woman suffers from a mental disorder, the opinion is that she is weak. And weakness in black women is intolerable.” “You should take your troubles to Jesus, not some stranger/ psychiatrist.”
(Depression and African Americans, Mental Health America)
In more recent history, the CDC details the Tuskeegee Syphilis Experiment which did not inform its subjects, 600 black men, of the study’s true purpose, and did not provide proper treatment, among other failures. Further support for this barrier of mistrust is explained in Protest Psychosis: How Schizophrenia Became a Black Man’s Disease, (Beacon Press 2010), by author and Vanderbilt University Professor of Sociology and Psychiatry, Jonathan Metzl. Metzl researched Michigan’s Iona State Hospital records and uncovered a disproportionate diagnosis of schizophrenia in African American men during the 1960’s and 70’s, speculating that the much of the misplaced hysteria was attributable to involvement of African American males involvement in the civil rights movements of the time.
2. RELIGIOUS BELIEFS
Some African Americans even see mental illness as a punishment from God. Up to 85 percent of African Americans describe themselves as “fairly religious” or “religious” and they commonly use prayer as a way to handle stress, according to one study cited by the American Psychiatric Association. Spiritual beliefs, family, and community are a great source of emotional support, but can be a barrier to receiving needed professional medical or therapeutic treatment. Faith communities can become a source of distress if they are not educated about mental illness and ways to support individuals and families in their struggle for recovery.
While mental illness is not by any means restricted to individuals of lower economic status, the stressors that can accompany poverty – hunger, homelessness, lack of other basic needs or an inability to find jobs or afford treatment – can be contributing factors. U.S. Census Bureau data shows the 2014 poverty rate for African Americans was 26.2 percent. According to the McSilver Institute for Poverty Policy and Research, “it is well documented that mental illness is exacerbated by poverty. However, more recently, it has been recognized that poverty may contribute to the onset of mental illness.” In a continuing downward spiral, mental illness can increase health care costs, effect overall health, and lead to further impoverishment. African Americans make up 40 percent of today’s homeless population.
African Americans of all ages are more likely to witness or be victims of serious violent crimes. Exposure to violence increases the risk of developing a mental health condition such as post-traumatic stress disorder, depression, and anxiety. African American children are more likely than other children to be exposed to violence, which can have a profound, long-term effect on their mental health.
5. LACK OF PROVIDER CULTURAL COMPETENCY
A lack of cultural competency in the mental health care system can also pose barriers to seeking professional help. Only 3.7 percent of American Psychiatric Association members and 1.5 percent of American Psychological Association members are African American. According to Psychology Today, “studies have shown that African Americans view the typical psychologist as an ‘older, white male, who would be insensitive to the social and economic realities of their lives.'”
Without proper treatment, mental health conditions can worsen and make day-to-day life harder. Silence and stoicism – denying oneself help in order to appear strong – need to be overcome. True strength lies in recognizing the need for help and seeking it out. To make progress in this arena, there needs to be:
- An end to the stigma by increasing awareness of mental health needs in the African American community
- An increase in the number of African American mental health professionals and greater cultural competency in those currently in the field
- Increased education in the faith communities about the role of professional mental health treatments and how they can work together
- A greater focus on prevention, intervention, and maintenance