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Black Mental Health

12 Minutes

Medically reviewed by Dr. med. Sarah Boss
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Mental health issues in the Black community are a major concern that has been ignored for a long time. Black individuals are subjected to various stressors that have the potential to influence their mental health in a negative way including historical trauma and modern-day racism. 

Research has revealed that Black people are less likely to seek mental health services than other populations, even though they are equally as prone, if not more so, to mental disorders. This disparity underscores the importance of raising awareness about mental health and ensuring that Black people can access quality care.

Mental health care is essential for all people, and it is essential for Black people. Unfortunately, mental health issues of the African American population are not given much attention. Mental health problems contribute to the development of stronger people, families, and neighborhoods.

It Promotes Wellness

It is always important to take care of mental health as much as it is to take care of physical health. Mental health refers to the capacity of an individual to deal with stress, relate to others, and make wise choices. Self-care through mental health can improve education, employment, and relationships among black Americans [1]. The above-said is an indication that when the mental health of people is given due consideration, the whole society gains.

It Breaks The Stigma

Disclosing and discussing mental health issues within the Black community can be rather stigmatized. But, when African American men and women can talk about their mental health, then the stigma is reduced. Of course, when people do not feel embarrassed to go out and seek help, they are likely to get the help that they require. Promoting awareness about the Black community’s mental health is a way of ensuring that people are encouraged to seek help when they need it.

It Builds Resilience

One of the ways through which resilience is enhanced is through mental health care. To African Americans, the ability to persevere is crucial in dealing with the adversities of life. Mental health services make it easier for people to deal with stress, grief, or even trauma in a healthy manner. Resilience can be seen as the process through which people gain increased strength and a clearer sense of self and direction, for a successful existence in every sphere [1].

In 2020, Black people with moderate to severe mental illness reported racism as one of the top three causes of their symptoms, more than any other racial group, as reported by Mental Health America [3]. 

In the same year, suicide ranked third as a cause of death in the Black community with 10-24 years with 979 deaths. 

According to the National Survey on Drug Use and Health, about 9% of the American population aged 12 years and above use illicit drugs. 

In 2020, 1 million Black adults had some form of mental illness, yet only 900,000 of them sought help. 

Black people had the highest death rate in 2017 from non-methadone synthetic opioids than any other racial group. 

Black Americans are diagnosed with psychotic disorders more frequently and diagnosed with mood disorders less frequently than they present with depressive symptoms. 

Eichstaedt et al. (2021) showed that the murder of George Floyd in 2020 increased the level of sadness, anger, depression, and anxiety among Black people compared to White people, confirming the results obtained by Bor et al. (2018) that Black adults exposed to police killings are estimated to have 0.14 more poor mental health days per exposure—totaling 55 million more poor mental health days for Black Americans. 

Additionally, the American Psychological Association (APA) revealed that only 16% of the United States psychology workforce are people of color, and only 4% are Black.

According to the National Health Information Survey 2021, about 33.1% of Black and Black/White biracial adults were uninsured, the highest rate across all the racial categories, and 59.4% had public health plan coverage, which was again the highest among these groups.

Several causes of mental health problems in the African American community have been identified. Let’s have a brief look at the most important ones of them.

Historical Trauma

Historical trauma is one major reason why the Black community is vulnerable to mental illness. Slavery, segregation, and racism have left a mark on Black people and mental health. Such injustices have caused deep-seated and generational emotional and psychological trauma.

The effects of this trauma are that it may lead to hopelessness, anxiety, and depressive symptoms. These experiences for many Black people are still seen in their current mental health status.

Racism And Discrimination

Prejudice and discrimination are ever present and play a role in mental health problems in the Black population. Blacks are discriminated in different ways in different facets of life; be it in education, job, or even health care [1].

This constant exposure to racism results in chronic stress, and this is not good for the health of the mind. Racism makes Black people feel angry, frustrated, and helpless, which can lead to mental illness in the Black community.

Economic Challenges

Economic factors also contribute to mental health problems among Black people as well as other people in society. A significant number of Black people and households are economically vulnerable, including being poor, unemployed, and resourceless. These financial issues can lead to mental disorders such as anxiety and depression. 

Economic insecurity can also prevent people from getting and receiving mental health treatment, which only worsens the problem. Black people’s financial problems and mental health issues underscore the need to fight economic injustice to enhance the mental health of black people.

Community Violence

Another cause of mental illness in the Black community is community violence. Black people exposed to violence in their residential areas are more likely to suffer from trauma and this can cause mental health problems. 

Violent behavior leads to conditions like post-traumatic stress disorder (PTSD), depression, and anxiety when one is a witness or a victim. The effects of community violence on an individual’s mental health include fear and stress, which is why this is a major issue for Black people and mental health.

Family Dynamics

The mental health of Black people is also influenced by family relationships. Sometimes, black people may have issues like single parentage, parent stress, or domestic violence which can affect one’s mental health. 

Furthermore, Black culture is embedded with the principles of family and communal support and this can result in the stigmatization of mental health issues. This can make it hard for people to accept that they need help in terms of their mental health and this has been a leading cause of mental illness in the Black community.

Cultural Expectations

Cultural norms can also play a part in mental health in the Black community. Black people are expected to be strong and not show any signs of weakness, and this is prevalent in the Black community [1]. 

The urge to stay strong and ‘carry on’ results in the denial of emotions and the manifestation of mental disorders. It also means that people will not go for treatment, thus leaving the Black community with high rates of unaddressed mental health issues.

Compared to other communities and ethnicities, the Black community is at a higher risk of developing some mental health conditions due to the causes mentioned above. Let’s have a look at some of them.

Depression

Black people suffer from depression like any other mental health disorder. It influences emotions, cognition, and ways of managing tasks and chores. The Black community especially suffers from depression but most of the cases go unnoticed or even if they seek treatment, they don’t get it due to cultural taboos against the discussion of mental health [2]. 

The signs of depression include but are not limited to persistent low mood, lack of interest in activities one used to enjoy, and thoughts of worthlessness among others. Black people and mental health conversations cannot leave out depression so that people receive the help they require. If left untreated, depression can cause some serious ramifications in most spheres of life such as interpersonal relationships, employment, and overall well-being.

Anxiety Disorders

Black people also experience anxiety disorders with a greater propensity. These disorders include generalized anxiety disorder, panic disorder, and social anxiety disorder. Symptoms of anxiety include; Worrying too much, feeling restless, tiredness, and trouble with concentration. Among Black individuals, anxiety could be a result of racism, poor economy, or violence within the Black community. 

The pressure of handling such problems becomes a chronic source of anxiety, which interferes with normal living and health. Anxiety disorders that affect Blacks, as well as other mental illnesses that affect this population, should be addressed to guarantee that people can live normal and healthy lives.

Post-Traumatic Stress Disorder (PTSD)

Another mental health disorder that affects the Black community is PTSD. It can occur after a person or a witness of a violent act, abuse, or a severe accident has undergone it. Blacks are more vulnerable to trauma because of issues such as community violence and racism. 

The symptoms of PTSD include reliving the event, having frightening dreams, being scared easily, and staying away from anything that has to do with the event. PTSD can cause a lot of disability and thus it is important to address when discussing black people and mental health.

Substance Use Disorders

A common mental health problem among Blacks is substance use disorders. This condition is characterized by the abuse of drugs or alcohol or the use of drugs or alcohol in a way that is dangerous or unhealthy, possibly as a way of dealing with stress, trauma, or other mental health problems. Illicit substance use may cause addiction, and this is a vice that has impacts not only on the specific persons but also on their families and society at large. 

It is crucial to know the relationship between Black people’s mental health issues and substance use disorders since both are interconnected. If left untreated, substance use disorders are likely to cause other mental and physical illnesses, legal troubles, and social detachment.

Bipolar Disorder

Bipolar disorder is a mental disorder that influences a person’s mood by making them go through episodes of both mania or hypomania and depression. Black people with bipolar disorder may have periods of high energy and apparent happiness, then become severely depressed. 

Bipolar disorder in the black community is not easy to diagnose and manage, and this is due to the following reasons; Firstly, some of the symptoms may be similar to those of other diseases, and this makes the management of the illness difficult. Early diagnosis and treatment of Bipolar disorder are critical to prevent disruption of productive function in society.

The black community faces extended challenges in acquiring mental health services. This is due to internal intra-community and external factors. We will briefly have a look at them in this section.

Cultural Stigma

Cultural stigma is one of the most significant challenges to mental health care in the Black community. Blacks are also likely to stigmatize mental health since this is a result of a long-standing belief that mental health issues are a sign of weakness or something that should be hidden. Many Black people feel the need to ‘tough it out’, and not seek help for mental health problems. This cultural expectation can deter any person from seeking the help he or she needs. This is because society has placed a taboo on mental health hence those who require help fail to accept that they need help.

Distrust of the Medical System

Another major hindrance to mental health care in the Black population is the lack of trust in the medical fraternity. This mistrust has a historical and present-day basis because of discrimination, unfair treatment, and exploitation experienced by people of color in healthcare facilities. 

Black people may feel that their complaints will not be listened to or they may feel that they will be abused or given a wrong diagnosis. This mistrust can make it difficult for black people to come out for mental health care services since they do not trust the system. It is therefore imperative that this mistrust is addressed to enhance the utilization of mental health services within the Black population.

Lack of Representation In Mental Healthcare

Another challenge faced by Black people in accessing mental health care is a shortage of mental health care providers. Some Black people may prefer to share their mental health concerns with a specialist of African descent because of the personal experiences that he or she has. 

However, black professionals are scarce in the mental health sector, and this makes it even more challenging for black people to get therapists with whom they can easily connect. This absence can result in a barrier in the doctor-patient relationship which is crucial in developing trust and rapport for the management of the patient’s illness. Hiring more Black therapists is an important step in better representation of the black community in the mental health field [1].

Financial Barriers

Other factors that have been cited as major hurdles to the uptake of mental health services in the Black community include financial constraints. Therapy, medication, and other mental health services can be expensive, and people with no insurance or inadequate insurance may have no access to these services. Blacks are more predisposed to have economic challenges, which may make it a challenge to seek mental health services. 

However, when care is available, the cost deters people from accessing it regularly, and this results in untreated or poorly managed mental health disorders. Mitigating these financial factors is important so that everyone, irrespective of their socio-economic status, can get the mental health treatment they require.

Lack of Mental Health Services

Lack of access to mental health care is another challenge faced by the Black community. For instance, there are limited mental health providers and services in many of the regions, especially those with a high proportion of Black people. Such a situation can hinder people from accessing the services they require even if they are willing to go for the services [1].  

Besides, Black people may lack adequate knowledge about mental health and the available services, which poses a challenge in getting the required care. Availability and utilization of mental health services in the Black community require improvement and should extend to the areas with little to no access to mental health services.

To sum up, the Black community faces several challenges related to mental health care: cultural stigma, mistrust in the medical system, lack of diversity among healthcare professionals, financial issues, and restricted access to resources. These issues make it difficult for Blacks to access and be treated hence the continued mental health issues that affect the Black community. It is therefore important to reduce these barriers to enhance the mental health of Black people.

The provision of adequate mental healthcare is the right of all individuals. Black community significantly lags behind other ethnicities in getting mental healthcare due to a variety of reasons. 

Access To Quality Care

African American people suffer from inequalities in terms of mental health care service delivery. Sometimes, services are available, but they do not address the needs of the Black people in the way that they should. Factors contributing to these disparities include:

  • Lack of qualified and sensitive health care practitioners who can address the concerns of Black people.
  • Racism, where there are limited mental health centers in Black communities.
  • A lower probability of receiving adequate subsequent care after the first appointment with a mental health practitioner.

Treatment Outcomes

There are also disparities with Black people and treatment outcomes for mental health. There is evidence that black people get less and worse treatment for their mental health problems. This can lead to:

  • Greater prevalence of mental disorders without treatment, which would worsen with time.
  • The patients seek care in the emergency departments instead of seeking preventive or regular checkups.
  • Higher chances of being misdiagnosed, which leads to the wrong treatment being administered.

Cultural Competence In Treatment

Lack of cultural competence among mental health providers is one of the reasons for disparities in care. Black individuals may encounter providers who do not understand their cultural background or specific challenges, leading to:

  • Lack of effective communication and conflict in treatment.
  • Sensations of uneasiness or of being out of place may deter further care.
  • Generic treatment since health care professionals may not take time to understand cultural differences.

Effects On The Black Individuals

The disparities in mental health care have significant effects on the Black community, including:

  • A higher prevalence of mental disorders is not well managed.
  • Reducing overall health status because of the comorbidity between mental and physical health.
  • The continuation of mental health stigma in the Black community as the inequalities in the provision of care contribute to the development of prejudice towards seeking help.

1. National Alliance On Mental Illness. Black/African American. https://www.nami.org/your-journey/identity-and-cultural-dimensions/black-african-american/

2. School Of Public Health: University Of Michigan. Bridging the gap to address Black mental health disparities. https://sph.umich.edu/pursuit/2024posts/black-mental-health-disparities-2024.html

3. Healthline. Why It’s Time to Shift the Focus to Mental Health in the Black Community. Mental https://www.healthline.com/health/mental-health/mental-health-in-the-black-community

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