The Connection Between Black History and Mental Health

While all communities face mental health challenges, numerous historical factors have contributed to higher rates of severe and persistent mental health conditions among Black Americans. Long-standing economic imbalances, combined with a lack of access to quality health care and education, have created significant barriers to mental health among Black people today.

It should come as no surprise that exposure to racism and discrimination is a contributing factor to negative mental health outcomes. Research shows that ongoing stress and trauma that result from experiencing bigotry are directly correlated to anxiety, depression, and post-traumatic stress disorder (PTSD). Even non-confrontational experiences – like someone crossing the street to avoid you or being watched with more scrutiny while shopping – can cause these traumas.

The healthcare system itself has also historically exhibited racism and bias towards the Black community. It’s essential for anyone in treatment to feel connected to their therapist in order to build trust and ensure the best outcomes. But Black individuals often face healthcare providers who are not culturally competent – meaning they lack the ability to understand and respect the beliefs, values, and histories of the Black community. Whether conscious or unconscious, this cultural bias results in treatment that is often poorer, and as a result, Black patients are more likely to be misdiagnosed. These factors have understandably fueled distrust among Black Americans toward the mental health profession as a whole.

The statistics surrounding mental health within the Black community are striking:

• Black Americans are 20% more likely to experience serious mental health problems than the overall population¹
• Adult Black Americans are more likely than others to report having feelings of sadness and hopelessness.²
• 16% of Black Americans (4.8 million individuals) reported having a mental illness and 22.4% of those (1.1 million people) reported a serious mental illness³
• Only one in three Black adults who need mental health care receive it, compared to one in two White adults.² (Among adults with any mental illness 48% of Whites versus 31% of Blacks)
  • Reasons include incorrect diagnosis by doctors and a lack of Black mental health professionals
• Most common ethnicity of mental health professionals is White (74.2%), followed by Black or  African American (7.9%)
• Only 3.7% of members in the American Psychiatric Association and 1.5% of members in the American Psychological Association are Black⁴

Compounding the factors above, stigma associated with mental health issues exists within the Black community. The origin of this stigma traces back to slavery, when it was a common belief that enslaved people were biologically different and lacked the ability to develop mental health disorders. This mindset left Black people to misjudge their symptoms as “stress” or “exhaustion” – a perspective that was then passed from generation to generation, ultimately leading to misinformation, underestimation of the impact mental health conditions have, and racial bias in treatment recommendations.

Because of these factors, the decision to seek treatment is frequently not an easy one to make. More than 60% of Black people believe a mental health condition is a sign of personal weakness and that asking for help can be perceived as demeaning the experiences of those who have endured more difficult conditions related to racism.⁵ In studies, Black people stated depression or anxiety was considered “crazy” in some Black social circles, and that mental health discussions are not appropriate, even within families. As a result, Black people may more frequently experience shame about mental health struggles or fear loss of social standing due to their conditions.

To begin breaking down these barriers, it’s imperative to provide better education about mental health. Normalizing mental health issues can help people understand that seeking treatment is no different than receiving care for physical health.

It’s also important that mental health providers know how to properly care for members of the Black community. Clinicians who are aware of cultural norms can help reduce fear and ensure that Black patients receive the care they need. Healthcare professionals can engage in cultural competency courses or identify educational opportunities to better understand the communities they serve.

During Black History month – and beyond – people both inside and outside the Black community can help effect change through education and support. Here are some ways to do that:

• Visit a Black or African American Historical Site. Take a trip to a local Black history museum or visit a historically significant place.
• Expand Your Vocabulary. Take time to understand key terms. E.g., “BIPOC” (Black, Indigenous, & People of Color).
• Read Books & Stories by Black Authors. Diversify what you consume by including works from Black writers and storytellers.
• Follow Black Creators on social media. From fashion bloggers to opinion leaders, engage with Black creator voices to see their perspective.
• Support Black-owned Businesses. Patronize Black-owned businesses or eat at a Black-owned restaurants.
• Donate to Black Groups and Charities. Help keep Black history alive by contributing financially or volunteering.
• Ask and Listen. Don’t be afraid to ask members of the Black community about their mental health. Talking openly and genuinely listening to your family and friends can encourage them to speak out about their feelings and seek help.

Taking actions like these can be small, but important, steps in helping address the inequalities and barriers Black Americans face within the mental health care system. By addressing the most pervasive mental health misconceptions and obstacles in the Black community, we can create meaningful change and ensure everyone is able to get the help they need.

Sources

1. United States Department of Health and Human Services, Mental and Behavioral Health – African Americans, May 2021.
2. Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health. 2008-2015.
3. Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, January 2022.
4. National Alliance on Mental Illness, African American Mental Health, September 2021.
5. Center for Disease Control and Prevention. National Health Interview Study, November 2019.