Suffering in silence: The stigma surrounding mental illness in the black community
Earlier this week, Dustin Dwyer brought us Brianna Darin's first-hand account of conquering depression.
The high schooler shared the steps she took after it clicked for her that she needed help.
But for some, the stigma surrounding mental illness can keep them from seeking the help they may need to achieve mental health.
According to the U.S. Department of Health and Human Services Office of Minority Services, African-Americans are 20 percent more likely to experience serious psychological distress, such as major depression, suicide, PTSD, and anxiety than non-Hispanic whites.
Disproportionate rates of poverty, joblessness, and exposure to violence are some factors.
Yet a study by the American Psychological Association found that young adult blacks, especially those with higher levels of education, are significantly less likely to seek mental health services than their white counterparts.
So why are so many African-Americans suffering in silence?
Shame, lack of trust, and socioeconomic status remain barriers in mental health.
Some reasons that prevent African-Americans from seeking treatment and receiving quality care include:
1. Lack of information and misunderstanding about mental health
According to the National Alliance of Mental Illness (NAMI):
Many African-Americans have difficulty recognizing the signs and symptoms of mental health conditions, leading to underestimating the effects and impact of mental health conditions. Some may think of depression as "the blues" or something to snap out of. Because of the lack of information surrounding mental health issues, it's not always clear where to find help when you may need it.
Education about mental disorders and the treatment process is a critical to reducing barriers to treatment among the African-American community. Suggestions for overcoming this barrier include public education campaigns, educational presentations at community venues, and open information sessions at local mental health clinics.
2. Faith, spirituality, and community
In the African-American community, family, community and spiritual beliefs tend to be great sources of strength and support. However, research has found that many African-Americans rely on faith, family and social communities for emotional support rather than turning to health care professionals, even though medical and/or therapeutic may be necessary.
Psychiatrist William Lawson told NPR’s Talk of the Nation:
African-Americans tend to like to seek treatment or help from those institutions that they're familiar with and trust. Unfortunately, in the past, the church, while it has been very helpful in terms of general medical conditions and putting on health fairs and other support organizations, many times some of the members simply aren't aware that mental disorders of some types are in fact medical problems and need the kind of support and help that can come.
3. Barriers in access to adequate health care make it hard to get help
Racial disparities persist in health care access. In 2012, for example, 40.6% of African-Americans relied on Medicaid or public health insurance, in comparison to 29.3% of non-Hispanic whites, according to the Office of Minority Health. That same year, 17.2% of African-Americans were uninsured, in comparison to 10.4% of non-Hispanic whites. Even if African-Americans can afford a basic checkup, the APA notes, many primary care specialists lack training in the diagnosis and treatment of mental and behavioral health issues. Thus those suffering need access to specialized care.
4. Stigma and judgment in the community may make it tougher to seek help
In the midst of a depressive episode, I had a friend say to me: We are the descendants of those who survived the Middle Passage and slavery. Whatever you're going through cannot be that bad.
Psychologist Monnica Williams wrote in Psychology Today:
African-Americans may be resistant to seek treatment because they fear it may reflect badly on their families–an outward admission of the family's failure to handle problems internally. Something I found in my own studies, is that even among African-Americans who suffered greatly from mental disorders, many held negative attitudes about people who obtain mental health care. No matter how impaired they were, they didn't want to be one of "those people."
Professor and blogger Monica A. Coleman told The Huffington Post:
In many ways, I do think that there is a greater stigma among African-American culture than among white cultures. I live in southern California, and many white people will freely reference “seeing a therapist” in normal conversation. Black people don’t do that. Seeing a therapist is generally seen as a sign of weakness or a lack of faith. There is still an active mythos of “the strong black woman,” who is supposed to be strong and present and capable for everyone in her family — and neglects her own needs. In the midst of a depressive episode, I had a friend say to me, “We are the descendants of those who survived the Middle Passage and slavery. Whatever you’re going through cannot be that bad.” I was so hurt and angry by that statement. No, depression isn’t human trafficking, genocide or slavery, but it is real death-threatening pain to me. And of course, there are those who did not survive those travesties. But that comment just made me feel small and selfish and far worse than before. It made me wish I had never said anything at all.
Growing up I was always told to read the Bible, or pray to "get over" feelings that I now know were depression.
In adulthood, I have learned that it's okay to not be okay.
A cultural shift is needed to foster a climate in which friends and loved ones can seek non-judgmental support for a mental health condition. This could make the difference in helping others feel empowered to get the help they may need.