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By Ebony Bellamy (she/her)
Over the past few weeks, prominent Black female athletes have unabashedly prioritized their mental health above expectations from competitions and fans. Naomi Osaka, the 23-year-old tennis star who is the world’s highest-paid female athlete, withdrew from the French Open after being fined for declining interviews to protect her mental wellbeing (NYTimes). Sha’Carri Richardson, a sprinter, was suspended from the USA Track & Field team for smoking cannabis while processing the grief of her biological mother’s death (The Cut). And Monday, Simone Biles withdrew from the U.S. Olympics individual all-around competition to focus on her mental health (CNN). These courageous moments only highlight how frequently the mental health of Black people – particularly Black women – is overlooked and disregarded.
Compared to white people, Black people have a higher risk of developing mental health disorders because of the historical, economic, social, and political influences they’ve been systemically exposed to for decades (Columbia University). This race-based exclusion makes their community more likely to experience poverty, homelessness, incarceration, and substance abuse (Mental Health America). And these factors are known to be damaging to a person’s psychological and physical health.
Approximately 46 million individuals identify as Black or African American in the U.S., and of those people, over 16% reported having a mental illness within the past year (Mental Health America). That’s over 7 million people. These numbers have drastically increased since the video of George Floyd’s death was released. Within a week, the Census Bureau reported that “anxiety and depression among African Americans shot to higher rates than experienced by any other racial or ethnic group, with 41% screening positive for at least one of those symptoms” (Washington Post). The number of Black people showing clinical signs for anxiety or depression jumped from 36% to 41%, which means approximately 1.4 million more people started struggling with their mental health (Washington Post).
Yet in 2018, it was reported that 58.2% of Black people between the ages of 18 and 25 and 50.1% of Black adults between the ages of 26 and 49 with a severe mental illness did not receive treatment (SAMHSA). There is a “lack of trust in the medical system due to historical abuses of Black people in the guise of health care, less access to adequate insurance, financial burden, and history with discrimination in the mental health system” (Columbia University). These factors have caused Black people to feel reluctant about seeking psychiatric help when dealing with a mental illness.
In the United States, during the 1800s and 1900s, scientific racism was used as a way to justify slavery and the mistreatment of enslaved people (Counseling Today). During this time, prominent physicians and psychologists were known to discover “new” mental illnesses that only affected enslaved people. Prime examples of this were “drapetomania,” a treatable mental illness that caused Black enslaved people to flee captivity, and “dysaethesia aethiopica,” an alleged mental illness that was the proposed cause of laziness, ‘rascality’ and ‘disrespect for the master’s property’” (Counseling Today). And to treat these “illnesses,” whipping and other forms of physical abuse were recommended.
The mislabeling of mental illnesses for Black people continued well after slavery was abolished. In the 1960s “schizophrenia was described as a ‘protest psychosis’ in which Black men developed ‘hostile and aggressive feelings’ and ‘delusional anti-whiteness’ after listening to or aligning with activist groups such as Black Power, the Black Panthers or the Nation of Islam” (Counseling Today). And today, Black adults are more likely than white people with similar symptoms to be diagnosed with schizophrenia (Mental Health America). Black men, in particular, are overdiagnosed with schizophrenia. They are four times more likely than white men to be diagnosed with it and are underdiagnosed with post-traumatic stress disorder and mood disorders (Counseling Today).
This overdiagnosis of schizophrenia caused people to believe the Black psyche was “unwell, immoral, and inherently criminal” (Counseling Today). White society even used this belief to justify police brutality during the civil rights movement, the creation of Jim Crow laws, and mass incarceration in prisons and psychiatric hospitals (Counseling Today). Unfortunately, this old belief has negatively impacted the way people view Black mental health today.
Black adults with mental health illnesses, specifically those that involve psychosis, are more likely to be placed in jail or prison than people of other races (Mental Health America). In 2016, it was reported that the imprisonment rate for Black men was six times greater than that of white men. The imprisonment rate for Black women was nearly double that of white women (Bureau of Justice). Due to this tremendous incarceration rate, “there are more than three times as many people with serious mental illnesses in jails and prisons than in hospitals” (Counseling Today).
Rather than receiving treatment for mental illness, Black adults are punished and incarcerated for their mental health struggles. This wouldn’t need to happen if access to affordable health insurance was made available sooner. Before the Affordable Care Act (ACA) was introduced in March 2010, “nearly one in three Hispanic Americans and one in five Black Americans were uninsured, compared to about one in eight white Americans” (Brookings Institution). Although the ACA has helped communities of color gain health insurance, there are still 30 million people in America without insurance, and half of those are people of color (Brookings Institution).
“There's a strong relationship between socioeconomic status and health such that people at the lower end, people in poverty tend to have poorer health and tend to have fewer resources ... for dealing with the stressors of life.”
Diane R. Brown, Professor at the Rutgers School of Public Health and author, for HuffPost
Despite more Black adults having access to affordable health insurance, they’re still hesitant to seek help due to a lack of representation in the mental health field. Approximately 60 percent of psychologists are white, while less than two percent of American Psychological Association members are Black (American Psychological Association).
This lack of diversity among providers makes individuals doubt that therapists or psychologists will be culturally competent to treat their mental health struggles (Mental Health America). Researchers recognize that a therapist’s lack of cultural responsiveness, cultural mistrust, and potential negative views from a therapist can significantly impact the level of care and service the Black community receives for their mental health (Columbia University).
To combat this, providers have been practicing cultural responsiveness. Being culturally responsive is when a provider recognizes and understands the role culture plays in their and their patient’s life and use that understanding to adapt a treatment plan that meets their patient’s needs within their cultural framework (Columbia University).
Although mental health facilities have spent the last four decades increasing cultural awareness and cultural competency training (Counseling Today), there’s still a lot of work that needs to be done to ensure Black adults receive access to mental health services and receive adequate care. We can start by understanding how someone’s race and ancestral history impacts their mental health.
Key Takeaways
Black people have a higher risk of developing mental health disorders due to the historical, economic, social, and political influences they’ve been systemically exposed to.
Over 7 million Black adults deal with a severe mental illness.
Black people are less likely to seek psychiatric help because of a lack of trust, limited access to affordable insurance, and a history of discrimination.
Black adults with mental health illnesses, specifically those that involve psychosis, are more likely to be placed in jail or prison than people of other races.