The stigma of mental healthcare within the African-American community has persisted for generations. Due to several reasons, it is a taboo topic. According to the National Alliance of Mental Illness, one in three African American adults get the mental healthcare they need. However, it is time to put an end to negative thoughts about mental health in the Black community and ensure that our loved ones receive the help they need.

Clinical Social Worker Eric Hall decided to give back to his adoptive hometown of Fayetteville, NC, by supplying much-needed mental health services by founding Creative Minds Healthcare PLLC in 2019. Creative Minds supplies counseling services to clients of all ages and demographics. However, as an African-American male, he understands the need for representation in the mental healthcare industry.

Barriers to Mental Health in the Black Community

Even though the mindset about mental healthcare in the African-American community has improved recently, the stigma still exists. Taylor Bryant examined the barriers to black mental and here is what he found:

• High Costs Of Mental Health
• Familial Shame Around Mental Health
• Cultural Stigma Of Mental Illness
• Lack of Diversity In Health Care
• Poor Competency Among Non-Black Clinicians
• Whiteness As A Foundation to Mental Health Care
• Distrust of the Medical Industry
• Difficulty Navigating The Process
• Emotional Hesitation
• Negative Past Experiences

For a more in-depth look at Bryant's findings on the barriers to black mental health, read his 2022 article on PSYCOM's website here.

 

The Stigma of Mental Healthcare in the Black Community Webinar

 

Exploring the Mental Health Stigma in Black Communities

By Amy Morin, LCSW

While Black Americans experience a wide range of attitudes toward mental health treatment, there’s a stigma surrounding mental illness that prevents some people from getting help.

It’s important to consider how the stigma—and the forces that create the stigma—may make it difficult for individuals to reach out to a mental health professional.  

 Beliefs About Mental Illness

Some communities accept the idea that mental illnesses are health problems that require treatment. But in other communities, there’s a serious stigma that implies a mental health problem is a sign of weakness and should be kept hidden from others.

Beliefs about mental illness are formed through experience, cultural traditions, and formal education. Stories from friends and family also play a role.

If family members talk about a “crazy” uncle who had to get hospitalized, younger generations may grow to believe that having a mental illness means you can’t function in society.

Similarly, if someone who commits a crime is said to have a mental illness, it may perpetuate the belief that individuals with mental illness are violent. Anyone that commits a crime or displays some type of undesired “bad” behavior would be stigmatized as having a mental illness or along that spectrum, which isn’t necessarily true.

These types of beliefs reinforce the idea that mental illness is shameful.

Ideas about mental illness that may reinforce the stigma include beliefs about:¹

• Identity: This addresses the symptoms of a mental illness. Does someone believe symptoms of depression are a normal part of life? Do they think symptoms surrounding anxiety are a sign of a physical health issue?
• Cause: Do symptoms stem from a spiritual weakness, personal weakness, or character defect? Or, can anyone develop a mental illness the same way they might develop a physical health issue?  
• Timeline: This refers to beliefs about whether an illness is acute, cyclic, or chronic. So someone might assume depression should resolve within a certain time period or they may believe anxiety lasts a lifetime in all cases.
• Consequences: Do individuals think that untreated mental illness has consequences? Or do they think that mental illness serves a helpful purpose (like depression sparks creativity)?
• Controllability: How much does an individual trust that an illness can be treated? Do they think it can be cured or do they believe that treatment won’t help?

There are many cultural factors, societal pressures, and stereotypes that may influence beliefs about mental health in the Black community.

Additionally, issues like systemic racism and the lack of culturally sensitive treatment by providers may also play a role in the way the Black community views mental illness and treatment. It is not normalized in the way that it should be. People often view it as a personal and/or moral defect. As a result, the mental health field is viewed along the same lines as the other systems that have caused substantial harm to Black people.

Factors That Affect Mental Health

The Health and Human Services Office of Minority Health reports that Black adults in the U.S. are more likely than white adults to report symptoms of emotional distress, such as sadness, hopelessness, and feelings that everything is an effort.²

Individuals in the Black community likely experience distressing events that affect their mental health. Racism, discrimination, and inequity affect a person’s psychological well-being. The stress may increase a person’s risk of mental illness. Some experiences may even be traumatizing.

Financial problems tend to increase the chances of an individual will experience serious psychological distress. Black adults who live below the poverty line are two times more likely to report serious psychological distress than those living above it.

It is also important to remember that these social determinants of health are all layered, with racism adding in another substantial layer.

Mental Health Treatment Disparities

Only 1 in 3 Black Americans who could benefit from mental health treatment receive it. This may be in part due to the disparities in mental health treatment.³

Black individuals often lack access to culturally competent care. As a result, the treatment they receive is often poorer.

Black individuals are less frequently included in research, which means their experiences with symptoms or treatments are less likely to be taken into consideration.

They’re also more likely to go to the emergency room or talk to their primary care physician when they’re experiencing mental health issues, rather than seeing a mental health professional.⁴

Black individuals are also more likely to be misdiagnosed by treatment providers. This can fuel the distrust toward mental health professionals as a misdiagnosis can lead to poor treatment outcomes.⁵

Contributing to the disparities is the fact that Blacks are more likely to have involuntary treatment, whether it is forced inpatient or outpatient treatment. This contributes to the stigma, hostility, and lack of willingness to voluntarily seek care.⁶

Community Stigma

Much of the research has found that the Black community has a high degree of stigma associated with mental illness. In the 1990s, a public opinion poll found that 63% of African Americans believed depression was a personal weakness and only 31% believed it was a health problem.⁷

Other studies have found that the Black community is more inclined to say that mental illness is associated with shame and embarrassment. Individuals and families in the Black community are also more likely to hide the illness.⁸

Individuals in the Black community may be more likely to believe that since they’ve survived so much adversity, they’re strong—and no one has a right to tell them that there is something wrong with them (since they may view a mental health issue as weakness).

Studies that specifically examine the beliefs of Black women are scarce. But, one study found that Black women were more likely to believe that individuals develop depression due to having a “weak mind, poor health, a troubled spirit, and lack of self-love.”¹

But not all studies indicate a high degree of stigma among Black women. One study, conducted in 2009,¹ found that most Black women didn’t have a stigma attached to mental illness. Researchers found that women understood the causes of mental illness, accurately identified many of the symptoms, were aware of the potential consequences, and believed that mental illness could be managed with treatment and personal motivation.

Many of the women in the study identified a variety of positive coping skills. In addition to saying they would seek treatment, they also identified faith, prayer, and support from friends and family as go-to coping strategies.¹

Breaking Down the Stigma

Reducing the stigma could increase the likelihood that individuals with mental health issues will seek treatment. Treatment could help them live happier, more fulfilling lives.

Breaking down the stigma will likely involve a two-pronged approach; increasing the number of culturally competent providers and changing the narrative surrounding mental illness. 

Education surrounding mental illness and normalizing mental health problems may help individuals recognize that treatment for a mental health problem doesn’t have to be any more shameful than treatment for a physical health problem.

It’s also important for mental health treatment providers to be equipped to care for individuals in the Black community. Culturally competent therapists and psychiatrists could help ease mistrust and provide better care.

The publication of some recent books may help reduce the mental health stigma among African Americans. Some titles include: 

• The Unapologetic Guide to Black Mental Health: Navigate an Unequal System, Learn Tools for Emotional Wellness, and Get the Help you Deserve 
• Community Mental Health Engagement with Racially Diverse Populations
• Mind Matters: A Resource Guide to Psychiatry for Black Communities (Volume 1)
• Black Mental Health: Patients, Providers, and Systems

There are also podcasts and influencers on social media who are helping break down the stigma. Rappers have made a number of songs discussing mental health issues, including G Herbo, Polo G, and Quando Rondo. Other celebrities have used their platforms for awareness-raising and tackling some of the issues. 

There are also culturally relevant apps and websites that people can turn to for advice, resources, and even online therapy. All of these things are contributing to reducing stigma among African Americans.

Conclusion

Fayetteville, North Carolina, has a population of over 200,000, with African Americans making up the majority at 42%. Eric Hall and Creative Minds Healthcare PLLC are working to remove the stigma of mental healthcare in the local African-American community. Hall has made it his life's work to help those in need and want to make changes in their mental health.