Ebony Bellamy Nicole Cardoza Ebony Bellamy Nicole Cardoza

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It's Friday! And we're rounding out the week with our first of many stories on the racial disparities of mental health diagnoses and treatment. It comes at no surprise, but I was still shocked to read the psychological impact of the protests is profound, noted in this recap of the current state of Portland. As our nation rallies for change, it is also grieving and trying to heal. Adequate mental health resources are critical for us to move forward, and I appreciate Ebony's insights below.

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By Ebony Bellamy

Lately, the news has been flooded with stories about Black celebrities and their mental health. From Kanye West’s strange, erratic behavior (New York Post) to Tamar Braxton’s possible suicide attempt (Essence), their actions have accelerated conversations surrounding Black mental health and the disparities Black people face to receive adequate treatment. 
 

Compared to white people, Black and African American 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 percent reported having a mental illness within the past year (Mental Health America). That’s over 7 million people. 
 

Unfortunately, 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 percent 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 percent to 41 percent, 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 and African Americans between the ages of 18 and 25 and 50.1% of adults between the ages of 26 and 49, who have 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’ which was 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 with 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 and African American 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 posttraumatic stress disorder and mood disorders (Counseling Today).

This overdiagnoses of schizophrenia caused people to believe the Black psyche should be perceived as unwell, immoral, and inherently criminal (Counseling Today). 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 and African American 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 and African American men was six times greater than that of white men. The imprisonment rate for Black and African American 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 and African American 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 and African American 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 or African American (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 and African American 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 and African American adults deal with a severe mental illness.

  • Black and African Americans are less likely to seek psychiatric help because of a lack of trust, limited access to affordable insurance, and a history of discrimination.

  • Black and African American 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.

  • Only two percent of psychologists are Black or African American.

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