Why historical and current racism perpetuates mental illness in the Black community.
Seeking help for mental illness is challenging. Not only does a person have to admit they need help, but they must go and seek this help. However, what if there is a bias in the mental health industry towards the clientele?
Claims have been made that Black people, and notably, Black women, are at a higher risk of being turned away for health concerns:
"It has also been asserted that when young Black women ‘…do seek healthcare services for their health and mental health, they are often not taken seriously or their complaints are ignored.’"
What could be the cause of this?
Historical Racism in Mental Health
The mental health industry is not exempt from the systemization of racism. In fact, it has been due to “science”, rather, fake science or scientific racism — “the spread of bogus theories of supposed black inferiority in an attempt to rationalize slavery and centuries of social and economic domination and plunder” — which has an underlying agenda, that initiated a false understanding of Black people in the practice of psychiatry.
The history of racism and mental health is something to research to understand why dismantling racism in the mental health industry is a challenge. I suggest this article by The Washington Post: A brief history of the enduring phony science that perpetuates white supremacy, to gain a better understanding of how racism has shaped the Black experience in regards to mental health.
Another article to gain insight is by the National Alliance on Mental Illness (NAMI): Discrimination and Racism in the History of Mental Health Care. These articles discuss how racism has infiltrated the past mental health industry and why there are still issues today.
Due to racism, and notably, historical racism in the mental health field, is it understandably harder for Blacks to trust that they will receive fair treatment. Thomas A. Vance, PhD in his article, “Addressing Mental Health in the Black Community” writes,
"Lack of trust in the medical system due to historical abuses of Black people in the guise of health care, less access to adequate insurance, culturally responsive mental health providers, financial burden, and past history with discrimination in the mental health system. Also, a fear that these experiences will be repeated is all suggested by research as factors in explaining lower utilization of mental health care among the Black community."
Without addressing mental health as a historically and presently racist system, BIPOC will continue to be unable to be treated properly like their white counterparts. Since the Black community was physically oppressed and claimed “medically” to be inferior in order to justify this, even over a century after slavery has been abolished, racism continues to oppress them psychologically.
The following information garnered from a NAMI article explains how the mistakes of the past are still being represented and exploited today:
"Recent work by historian and psychiatrist Jonathan Metzl shows that the ideas that underpinned these past practices merely shifted terrain in the 1970s. For example, psychiatrists added the word 'aggressive' to the definition of schizophrenia, and marketed pharmaceuticals directly at Black patients who they felt were more 'out of control.'
The long-term effect of this shift has been a disparity in diagnostic rates. Black men are more likely to diagnosed [sic] with schizophrenia than white, with no scientific basis. Black patients continue not to seek mental health services. And the criminal justice system continues to push Black people with mental illness into prisons."
If the mental health industry still holds the prejudices of decades ago, how will racism be excavated from our society and how can the Black community find the same amount of care and safety in seeking treatment?
The answer is they can’t.
By perpetuating the idea that Black people are different from White, there will fail to be fair diagnostics or treatment. NAMI states that, “In 2003, the Human Genome Project found that human genetics are 99% the same,” proving that BIPOC are not as different from Whites as we are led to believe through media and history.
Therefore, the symptoms for diagnosis that are deemed appropriately “white” are not justifiably altered in order to suppress and maintain Blacks who are stereotyped to be seen as “out of control.”
The human race is almost biologically identical, making the importance of fair analysis and treatment even more advantageous to helping decrease mental illness at large. However, even with science alerting us to the fact that there is one race with various skin tones, the subject of mental health is heavily referenced around the White experience.
White Centering in Mental Health
It’s a white person’s world. (And even more notably, a white man’s world.)
Due to colonization, white people have taken control of the world, and thus, the power rests in the hands of the dominant culture. Even though the US Census Bureau says that whites will become the minority in the US between 2055 and 2060, for now the focus is, and has been, on the white experience.
In Robin DiAngelo’s White Fragility, she lists statistics of the racial breakdown of those in control of main institutions in 2016–2017, and you’ll see the majority of them are white, and glaringly so:
- US Congress: 90 percent white
- US governors: 96 percent white
- Top military advisers: 100 percent white
- People who decide which TV shows we see: 93 percent white
- People who decide which books we read: 90 percent white
- People who decide which news is covered: 85 percent white
- Teachers: 82 percent white
The majority of the people in power in the US is white. Therefore, by nature, the American culture is painted with the white experience. A walk down any beauty aisle will show that the BIPOC experience is not considered in a lot of decisions and marketing although they make up a high population in the US.
While the implications of this may not initially be seen as detrimental or life-or-death for many groups of people, if you look closer, you will understand that by centering white people as the standard, the industries of mental health and health, in general, do an injustice to the Black community:
"[T]he White experience is the standard against which Black people are measured, often to the point of exclusion. For example, most mental health research has been conducted with White subjects, limiting its generalizability to racialized populations."
By trying to compare one group’s experience to another, especially when one of those groups is systematically oppressed (which comes with it’s own unique experience, most likely including anxiety, fear, and depression), you are bound to fail to fully see and appreciate the differences and be able to address and treat appropriately.
It’s hard enough to ask for help, but when the system is racist against you, refusing to see your perspective as truth, but rather judging you based on what they think should be your experience, it is hard to find a safe space to seek treatment.
White centering in mental health causes the invalidation of the Black experience. By allowing racist practices such as this to proliferate in an institution that is meant to help people, the system is not only discrediting Black people, but actually hurting them and preventing them from receiving the help they need.
Furthermore, while white centering takes away the Black experience by trying to fit it into a different sized box, the additional racist stereotypes of Black people cause a disadvantage from receiving proper and effective treatment, making it harder than normal to live a healthy and happy life.
Stereotypes in Mental Health
Prejudice is defined as “an unfavorable opinion or feeling formed beforehand or without knowledge, thought, or reason.” To pre-judge someone without first knowing them or fully understanding them is unfair, and when it comes to prejudging someone as a medical practitioner, it is unethical and malpractice.
Due to the prevalence of media and the popularity of mass-marketed film and TV, socialized stereotypes are rampant throughout our society. This causes the perception of less familiar groups of people to be seen only through the lens of what has been seen before. With white-centric neighborhoods and school, there is a high probability for misinformation about the BIPOC communities through the main “interactions” being solely through stereotypes seen on TV.
The children who are led to believe the stereotypes that they absorb through media will then grow up to be the doctors, lawyers, politicians, and authority figures who will generalize populations of people due to their skin color and what they have been subjected to via film and television.
One of the common dangerous stereotypes — while it may seem like a positive one — is that Black women are strong and resilient. Holding this as an overarching belief is troublesome because it limits individual experience, which will no doubt be different from someone who has mental health problems. Therefore, when a Black woman seeks treatment she may not be perceived as having a serious problem, and consequently, unable to receive a proper diagnosis and treatment:
"Instead of asking for help, considering personal needs, or speaking out against injustice, the expectation that they will overcome renders Black women silent about emotional distress, which leads to the damage of their self-esteem, personal and intimate relationships, and physical and mental health. Black women are also expected to overcome hardship because ancestors who were enslaved endured worse."
While it is natural for the brain to create patterns, without the proper anti-racism work, these associations could end up causing harm, especially if you’re in the medical field. By attributing stereotypes to a whole group of people, mental health personnel are discrediting the individual’s experience and disempowering them from living a healthy life.
Stereotypes, when in conjunction with the stigma of mental illness that also exists, prevent people from getting the proper treatment they need. Due to the fact that there is already pressure applied to Black women to be strong figures, oftentimes heads of household, mental illness is seen as a weakness and less likely to be addressed. This prejudice permeates our culture and the media system, further oppressing and preventing Blacks from getting the help they need:
"The stigma and oppression caused by the negative perception of mental illness does not bode well for Black families, especially for many Black women who are the backbones of their families. Thus, it is not surprising that there is a disproportionate number of Black youth at the intersection of race and gender who suffer in silence with mental illness and the associated stigma."
By not addressing racism in the mental health field, these harmful stereotypes will continue to disempower large groups of people. Therefore, anti-racism work must be done to ensure that all people are being treated equally regardless of the color of their skin.
The Need for Anti-racism in Mental Health
While racism is incredibly intricate in the web of complexities in which is infiltrates our everyday experiences, one place that it cannot stand to exist any longer is in an industry that is designed to help people — or at least it was designed to help White people, and now we need to redesign it to help all people.
Therefore, it is not enough to claim that we are not racist, the work to become anti-racist is required, especially by people who hold our well-being in their hands. It is the responsibility of those with power to become clear vessels of truth and knowledge, rather than clouded one-way tunnels, clogged with socialized dogma.
The history of psychology and how scientific racism has been used to not only negate Black people’s experience, but to actually harm them is a disgrace to science and a supposedly humanitarian field. Humanity should always come first and foremost, before any preconceived and biased viewpoint. If we fail to put anti-racists in positions of authority, we will fail the soon-to-be majority of a country that is touted to be the land of the free.
Brittany Noelle Roa is an interdisciplinary artist with an MFA in Physical Theatre who uses her art and creativity to heal herself and others. She loves learning about health and wellness so she can optimize her human potential to live a full and happy life.
Anti-Racism Resources: Educate Yourself. (2020, June 23). Retrieved September 26, 2020, from https://www.projecthome.org/anti-racism-resources
Browne, A. (2000, September 03). Non-whites will be majority in US and Europe by 2050. Retrieved September 24, 2020, from https://www.theguardian.com/uk/2000/sep/03/race.world
DiAngelo, R. J. (2018). White fragility: Why it’s so hard for White people to talk about racism. Boston, MA: Beacon Press.
Prejudice. (n.d.). Retrieved September 26, 2020, from https://www.dictionary.com/browse/prejudice?s=t
Ruane, M. (2019, April 30). A brief history of the enduring phony science that perpetuates white supremacy. Retrieved September 25, 2020, from https://www.washingtonpost.com/local/a-brief-history-of-the-enduring-phony-science-that-perpetuates-white-supremacy/ 2019/04/29/20e6aef0–5aeb-11e9-a00e-050dc7b82693_story.html
Smith, K. M., Ph.D. (2020, July 06). Discrimination and Racism in the History of Mental Health Care. Retrieved September 25, 2020, from https://www.nami.org/Blogs/NAMI-Blog/July-2020/Discrimination-and-Racism-in-the-History-of-Mental-Health-Care
Taylor, D., & Richards, D. (2019, April 24). Triple Jeopardy: Complexities of Racism, Sexism, and Ageism on the Experiences of Mental Health Stigma Among Young Canadian Black Women of Caribbean Descent. Retrieved September 25, 2020, from https://www.frontiersin.org/articles/10.3389/fsoc.2019.00043/full
Vance, T. A., PhD. (2019, February 08). Addressing Mental Health in the Black Community. Retrieved September 26, 2020, from https://www.columbiapsychiatry.org/news/addressing-mental-health-black-community