When rapper Jay-Z referenced his therapist in his newest album, “4:44,” it gave hope to many in the Black community: “My therapist said I relapsed” is a line from his song “Smile.” Because mental illness has historically been a taboo topic for the community, that line gave important visibility to the issue: Black Americans have mental health needs, too.
According to the National Alliance on Mental Illness (NAMI), 18.6% of Black adults have a mental illness and are 20% more likely to experience severe mental illness than the rest of the population. Factors such as homelessness and exposure to violence increase the prevalence of mental illness in the Black community — who comprise 40% of the homeless population and are more likely to experience violence than other groups. This can lead to anxiety, depression, and post-traumatic stress disorder.
The Black community faces systemic problems in accessing care for mental illness. These problems are rooted in historical, cultural, and societal bedrocks, and can affect Black Americans’ ability to receive treatment. Below are some of the central issues:
Stigma from inside and outside the community. One perception both within and outside the Black community is that they are able to handle more pain because of the trauma Black people have historically endured. Therefore, mental illness is sometimes dismissed and ignored when it occurs. For many Black men, this is especially problematic, as they are encouraged to be masculine and hide their emotions. Stigma occurs within the medical community as well: one study found that many medical students and residents gave at least some credence to inaccurate statements about different races. Other studies have found that Black patients are sometimes diagnosed with more severe mental illnesses than white patients with similar symptoms.
Historical mistreatment of the black community in the medical field. According to Sheppard Pratt’s own Dr. Kimberly Gordon, medical director of the Berkeley and Eleanor Mann Residential Treatment Center, some Black Americans have an inherent lack of trust in the medical establishment for fear of involuntary hospitalization, being used as “guinea pigs” in medical research, or being otherwise harmed as their community has been in the past.
Lack of Black therapists. For many, having a therapist from the same race or culture is important when receiving treatment. But it is not always possible for those in the Black community to access a Black therapist, meaning that those in need of mental health care may not get it. Less than 2 percent of members of the American Psychological Association are Black, making it more difficult to find therapists who understand a diversity of needs.
Importantly, mental health care providers should be culturally competent, meaning that they are aware of and incorporate cultural values and practices of different groups into the treatment they provide. Some Black patients have experienced microaggressions and racism from therapists, making greater cultural competency extremely important.
The roadblocks on the path to treatment are not always easy to overcome. But it’s possible, first and foremost, through further dialogue and acknowledgement of the stigma around mental illness in the Black community. Prominent figures like Jay-Z speaking out about their mental health are essential in bringing the conversation to light as well — and that conversation has only just begun.