Black people less likely to treat mental health issues due to cultural stigma
Senior psychology major Jedaun Carter said she has been in therapy since she was 6 or 7 years old, but never saw the benefit from it until high school.
“I wasn’t allowed to talk to them; my family believed in having a therapist for show,” Carter said.
Growing up in the foster system, every child is required to go to therapy sessions, but Carter’s family thought it was so taboo that they would not even allow her to yield the benefits. Sometimes her parents would go into the sessions with her or even by themselves without her.
No one is immune to mental health issues. Although some are genetically predisposed to serious mental illness, everyone goes through situations in life that affect their mental health. A lack of resources or complete understanding from family, friends and professionals allows these conditions to fester and can create larger, lifelong problems for the person suffering.
In the black community, stigma stemming from institutional and social pressures surrounding mental illness prevents many from seeking the treatment they may need.
According to a 2016 study by the National Institute of Mental Health, white people were 5.4 percent more likely to indicate having mental health issues than black people, but were 19.4 percent more likely to receive treatment.
Black Americans are more likely to experience factors such as homelessness and exposure to violence due to living in concentrated areas, which increases their risk for developing mental health issues, according to the National Alliance of Mental Health.
Lack of affordable medical insurance is another factor that keeps many black people from considering therapy. According to the U.S. Census Bureau, 19 percent of black people had no form of health insurance as of 2012.
Stigma played into Carter’s early experience with therapy, when her foster parents told her not to open up to the therapists she was assigned to see.
Carter added that psychiatrists would prescribe almost any medication just to get paid. The government-issued system of psychiatric assistance, she added, takes advantage of people who are forced into those situations and do not know how to help themselves or recognize when a toxic situation is disguised as help.
No one would pay to sit and tell a stranger things they cannot readily tell someone they are close to, Carter said. Mental health directly affects our physical health as stress and anxiety are the cause of many physical problems.
Still, the lack of resources makes many black people deem therapy unnecessary. Carter emphasized the need for self care. Prescribed medication only further suppresses the problems that create feelings of depression and anxiety. She also wants to dispel fears in her community.
“We act and think the way we do because it’s systematic and historic that we think we’ll get punished and lose our family and everything if we tell people our business,” Genesis Hampton, junior community health major and former Black Student Union president, said.
Carter said that the fear that one’s freedom and sense of normalcy could be taken away prevents many from sharing thoughts and feelings. She added that in her experience, she has been hospitalized before being offered treatment, which perpetuates that fear. This stems from the trauma slavery and the constant fear that a family member or any possession could be taken from them at any time, Hampton added.
Carter said she had an amazing therapist from the Counseling and Psychological Services center at La Verne her freshman year who helped her get where she is today in college.
A history of oppression in black America continues to play a huge role in the lives of its people every day. Black Americans have a longer history of mental illness than blacks in other countries because slavery stripped them of their culture.
Hampton said that in her family and most black families she knows, children are raised to not speak about “family issues” at school out of fear that the faculty would think badly of them or try to take away the child.
It has become such a cultural norm to suppress pain and cope alone that some black people categorize those in their own community as “crazy” and neglect them when they share their problems. It weakens the community when someone is afraid to confide in someone else because of how they will be judged.
“Growing up, black kids are told to mind their business,” Hampton said. “I keep mine to myself because I know how I look at other people when they put their business in the streets,” “I’ve seen people share their stories and it backfires.”
Hampton grew up in Covina, in a predominantly white neighborhood, but in an apartment on the side of town that most of her peers did not live in since she went to school in a more affluent neighborhood. She did not find anyone she felt she could open up to so she didn’t.
“I knew no one would understand, so I didn’t want to tell them my woes just to hear them say what I’m going through must be hard,” Hampton said.
Senior psychology major Michael Hill, who is also black, said he believes he should be in therapy since he wants to be a psychologist himself. But so far he has not seen one because of the stigma and the fact that he has not experienced anything that he considers serious enough to warrant the investment.
“Going to therapy isn’t going to make something better the next day,” Hill said. “I’m not going to pay someone to try to fix my long-term problems.”
White people probably do not expect their problems to be fixed by one conversation with a therapist, but the normalcy of therapy in white culture creates more positive responses to long term issues.
Hill said a general distrust of white people may be the deeper historical reason black people keep their problems “in-house.”
“I would never go to a white therapist because there’s no representation,” Hill said. “A black psychologist would know what you’re going through is normal, but a white one would say ‘wow there’s a lot going on,’ but it’s just life. White people have different problems.”
According to the National Health Interview Survey, 2010-2013, black and Hispanic men aged 18 to 44 were 2.4 percent less likely to report daily feelings of anxiety or depression than white men. Also according to this report, black and Hispanic men who have daily feelings of anxiety or depression, were 9 percent less likely than white men to have used mental health treatments, such as talking to a mental health professional. This racial and ethnic disparity in use of treatment is associated with lack of health insurance coverage, according to the NIMH.
Sophomore business major Tyresha Willis said that she has never heard her family members say, “you need help.” It is always “you can figure it out yourself.”
Being in a family or group setting makes it easier to succumb to the ways of everyone else, so people learn from what their families practice – whether it be a mental health conversation or not.
“Parents can be contradictory and tell their kids ‘you can tell me anything.’ But when they do, the parents don’t believe them, let alone help,” Willis said, adding that families do not realize how damaging the statement “what happens in this house stays in this house” can be.
Ethel Gardner lost her son in a car accident when he was 17.
“When a black mother loses one child to death, she mentally checks out and loses the rest of them to the system,” Gardner said. “She may be present in the house, but her focus is on the one she lost, not the ones still there.”
The governmental “system,” is built to subconsciously break down black people and their communities, Gardner said.
“Black mothers put all their energy into their children after experiencing their fathers and husbands leave,” she said.
Most of the time no one ever asks how the siblings of the children who passed away are. It is important to remember that they lost someone too, Gardner said.
“Everyone returns to their normal life after the casseroles are gone,” she added.
She said that she and other black mothers are usually “the fixers.” “So who do I go to?” she said. Pride will hold you back from asking for help, Gardner said. “‘I’m fine’ is killing us.”
Three years after her son’s death, she founded the Kennedy Austin Foundation in Pomona to turn her grief into tools to help others. She said that through the Foundation she wants to lend the kind of help to others that she did not have during her time of grief. She wants to assure them they are not alone and can find the power within themselves to quell mental health issues that stem from those situations.
Gardner said she internalized her emotions for a long time before she began journaling, something she found to be a beneficial coping mechanism, and wanted to share it with others.
The Foundation hosts a weekly journaling workshop called “Write the Wrong,” where community members discuss and write about their grief and mental health journeys.
“I thought if I went to therapy I’d self-medicate,” Gardner said. “I was afraid of my own emotions. I didn’t want to face my truth and have someone tell me what I was really feeling.”
Substances commonly used by black people to self-medicate are alcohol and marijuana, as the communities they live in are crafted for easy access to liquor stores and drugs.
She said that if one seeks therapy, they may feel like they have to go frequently in order to feel complete in whatever they are battling. The white community sees seeking mental health treatment as a more of a norm while a black person doing so would be looked at as or unable to handle their life for using professional treatment.
However, she does agree that everyone needs help and does not recommend anyone try to get through hardship totally alone.
“If we don’t reach out for help that hole doesn’t go anywhere,” Gardner said.
“First, come to absolute truth with yourself. When you discover (the issue) in your own soul, then reach out to friends. You learn through your physical body that there are indicators saying: ‘I can’t do this on my own. You have to break those barriers to seek help.”
She compared coping with loss to a time capsule.
“You have to release a little at a time because if it all comes out at once. I can honestly tell people now after 25 years, ‘hang on, it too shall pass,’” she said.
Some black people are afraid to go to a therapist, particularly a white therapist, because they fear they may be assessed more critically. Lack of cultural competency leaves room for discrimination between white therapists and black patients.
According to the U.S. Department of Health and Human Services’ Office of Minority Health, cultural competency influences most therapist-patient relationships and interactions. “Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations,” according to the Office’s website. The organization has also found that cultural competency is a main ingredient in leveling racial disparities, which would close the health care gap. Practitioners should provide service that is respectful of the patients’ beliefs regarding physical and mental health and their treatment.
Mia Smith, graduate student in marriage and family therapy at Mount Saint Mary’s University, said she thinks the dynamic between therapists and clients of different races can breed awkwardness in their interactions.
“That person (the client) is the expert on their life,” Smith said. “A therapist is there to guide the person in developing coping skills they have never had.”
Smith, a La Verne alumna, said a method to avoid giving clients personal advice is to ask them what they have done in the past to cope, and then allow them to pick their own ways that best help them.
She said next semester, as part of her graduate training, she has to meet with a therapist regularly. She plans to choose a black woman therapist, who she feels would understand her best.
A difference that may cause conflict are wellness belief systems. Different cultures have varied perceptions of disease and illness and their causes, which creates an awkward barrier between the patient and health care provider.
Historically, because of slavery, most black people are Christians, which gives them views on healing that do not always incorporate physical treatment. Most black people have heard, “just pray about it” from an elder at least once in their life. This phrase has hurt so many black people over the years because of the fear to talk to their own families about their feelings.
“We didn’t address mental health because we really didn’t have a good understanding,” said Jeffrey Lewis, superintendent and pastor of New Antioch Church of God in Christ in South Los Angeles. “We had a lack of resources. Many times, the church is guilty of this, when we don’t understand something (we) attack it.”
He added that people tend to villainize whatever seems abnormal instead of facing it.
“Historically, black people have called mental health issues ‘demons’,” he said.
“In the ‘20s, ‘30s and ‘40s, when other nationalities (or races) were graduating from high school and going to college, and were getting a better understanding of the physical side of an individual, we (black people) as a race of people didn’t have that advantage,” Lewis said.
“While others were about to spot mental health (issues) and call it what it is and get help, we just prayed about it, called it a demon and in many cases we just overlooked it. We would know that our children were struggling but we didn’t have the resources and didn’t know what it was or what to do, so all we relied on was prayer.”
He said there was a shift that started in the 1960s and 1970s when black people became more educated and started calling mental illness what it truly is.
“It was a stigma until recently for a Christian to even go to a psychologist,” Lewis said. “I remember the day when preachers would get up on Sunday mornings and say, ‘Ain’t no saint got no business going to a psychologist’.”
He said many churches, like West Angeles Church of God in Christ, have mental health centers for their members. He added that pastors can be sued for stepping out of their lane and giving members counsel beyond biblical principles.
“They cannot act as a professional, offering solutions that they are not trained to suggest (and) are (not) viable for every person,” Lewis said.
White people forced this religion onto black people many years ago, and now they use it to reinforce black people’s fear of admitting to and coping through pain. Our slave mentality has never left. Ingrained so closely in our history, the trauma follows us every day and grows into long-term mental illnesses such as depression and anxiety.
Black students like Smith and Carter who study psychology are the future of breaking this stigma. They can educate their communities and create a better platform for black people to acknowledge, understand and address their mental health.
Tyler Evains can be reached at firstname.lastname@example.org.