In 2019, the Center of Disease Control and Prevention reported that 47,500 US citizens committed suicide (Suicide, 2022). Of this 47,500, over half identified as Black. This is an estimate of 4 out of 6 suicides committed by People of Color (POC) and 2 out of 6 being Caucasian, Hispanic, and other ethnicities. The collective data indicates that POC may experience mental health difficulties at a higher rate than other ethnic groups. M. Phillip Murry suggests that POC are 20% more likely to be diagnosed with a mental illness compared to their Caucasian counterparts (Murray, 2017). Despite POC reporting higher rates of mental health disorders in comparison to Caucasians, this same study concluded that only 25% of Black people seek professional treatment for their mental health whereas 40% of Caucasians (Murry, 2017). A primary reason for this disparity is stigma relating to mental health in the Black community.
These stigmas include being labeled as crazy and associated with signs of personal weakness. In her book Our Own Voices, Vanessa Jackson presents personal accounts demonstrating a belief that those who are experiencing mental health disorders are crazy (Jackson, 2002). PhD Monnica Williams discusses how concerns of being viewed as weak or “crazy” is one obstacle that POC experience toward pursuing professional mental health care (Williams, 2011). A survey regarding POC’s beliefs about mental illness showed that of two hundred and seventy-two participants, 63% reported they felt a mental illness is a sign of personal weakness (Ward, 2013). Alvidrez interviews showed the majority of Black women interviewed supported mental illness as a sign of personal weakness. By examining several reports regarding stigma, one can conclude that there is great concern of personal deficits being associated with mental illness in the Black community.
Literature Review
There are multiple qualitative and quantitative studies that indicate that being labels as “crazy” is a common mental illness stigmatic view. Jackson’s book shares personal accounts of oppression, survival, and recovery in the mental health system. During the development and utilization of Insane Asylums in the United States from the 1800s and 1900s, many POC were institutionalized for criminal acts, disorderly social conduct, physical disability or impairment, and mental health disorders. In these asylums, POC were often misdiagnosed with “insanity” and received treatment that is considered cruel and unethical (Jackson, 2002). The labels perpetuated by white doctors are a leading contributor in the racial stigmatization of Black mental health being labeled as insane or crazy. PhD Monnica Williams discusses the stigma of being labeled insane or crazy. She elaborates on how the fear of being labeled as crazy causes people of color to avoid acknowledging symptoms of mental illness (Williams, 2011).
Another common stigma that is mental illness as a sign of weakness. A survey of two hundred and seventy-two participants to determine stigmas associated with mental illness in this community (Ward, 2013). The results demonstrate that many participants were not comfortable with acknowledging signs or symptoms of mental illness. Alvidrez also found that Black communities report that stigma as a significant barrier in their pursuit for professional mental health treatment and that Black women are more likely to associate causes or symptoms of mental illness with other explanations.
Community Indicators
In the United States, 13.4% of the population identify as Black or African American. Of this 13.4%, 16% of them reported having a mental health disorder. To put this in perspective of individuals, this means that over seven million POC struggle with mental illness. Of this estimated seven million, 22.4% or one million people reported a severe mental health disorder (Mental Health America). In comparison to the 6.8% of their Caucasian counterparts, 12.3% of POC reported challenges receiving mental health services (Rockville, 2018). This percentage of the population demonstrates the disparities in Black communities receiving care.
Further addressing the disparities in mental health difficulties and diagnosis in the Black community, as a collective, POC report a higher rate of depression, anxiety, Post Traumatic Stress Disorder (PTSD), and schizophrenia compared to Caucasians (Murry, 2017). POC living below the poverty line are three times more likely to experience severe mental illness in comparison to those living above the poverty line. POC are also more likely to experience a traumatic event which increases the risk of developing mental health disorders such as Depression, Anxiety, and PTSD. It has also been shown that POC are four times more likely than Caucasians to be misdiagnosed with a psychotic-disorder such as Schizophrenia, Psychosis, and Bipolar Disorder with Psychotic features (Schwartz, 2014).
Barriers to Care
Considering the statistical evidence, POC are less likely to pursue and receive mental health care compared to Caucasians. This is due to a variety of reasons including but not limited to stereotypes and stigma, mistrust of the health care system, lack of representation, and poor quality of care. As previously discussed, historical records show that POC have been labelled as “insane” or “crazy” when experiencing a mental health challenge. This label has developed into stigma in the current Black community, perpetuating the belief that those who are experiencing mental health disorders are “crazy” (Jackson, 2002). Asurvey regarding POC’s beliefs about mental illness showed that of two hundred and seventy-two participants 63% reported they felt a mental health condition is a sign of personal weakness (Ward, 2013).
Mistrust in the health care system is evident in the Black community due to the variety of disparities and mistreatment by medical providers (Murry, 2017). Misdiagnoses of a mental health concern can lead to inaccurate treatment provided by professionals. When receiving a diagnosis including psychosis symptoms, individuals may fear they might be involuntarily hospitalized (Williams, 2011). On top of these misdiagnoses, it has been shown that POC are offered medication and/or therapy at lower rates than the rest of the US population (Murry, 2017). This lack of quality care can lead to POC to avoid seeking mental health treatment.
A lack of representation and inadequate cultural competency also creates mistrust in the health care system. Individuals receiving medical care are more likely to feel comfortable with a provider they can identify with. According to the American Psychiatric Association, it was concluded that only 4% of psychologists are POC (Lin, 2018). This lack of representation not only impacts Black client’s comfort levels with a mental health professional, but also reinforces a lack of cultural competency in the mental health field due to POC having unique experiences that differ from Caucasians.
Conclusion
Despite the Black community reporting higher rates of mental illness than other ethnic identities, they are less likely to pursue professional care (Murray, 2017). By examining the culture, we can understand how historical events, socioeconomic status, and social role dynamics have perpetuated mental health stigmas in the Black community. One intervention to resolve the issue of stigmas is further community education and services for youth and adults.
Throughout her career, Meghann Simpson, BA, has provided professional support to youth, adults, and older adults for mental, emotional, and behavioral health needs. She graduated with her Associates in Social Science at Suny Erie Community College with a certification in Human Services. She will be graduating this year from University at Buffalo with a Bachelors in Interdisciplinary Social Science and a Minor in African American Studies. Meghann has pursued several certifications including Mental Health First Aid and Peer Advocacy. Her work experience includes youth peer advocacy, residential youth support, group facilitation, crisis intervention, Clubhouse program supervisor, and other voluntary community services.
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