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We should stop blaming stigma for our shortcomings in Black mental health access

February 16, 2022, 12:12 PM UTC
By incorporating celebration, Black joy, and liberation psychology–which focuses on empowerment, hope, strength, and resistance to oppression–we can shift the narrative away from stigma.
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My mother worked for the U.S. Postal Service when she was pregnant with me. She sued for racial and gender discrimination after her requests for light duty were denied. 

For years, as the case went back and forth on appeal before ultimately being overturned, my mother suffered in silence, as she went head to head with the federal government. I was in the third or fourth grade when she finally lost her case, but she never spoke about it and I didn’t learn many of the details until I was in graduate school. 

My mother never showed the emotional or psychological toll of this nine-year legal battle because she didn’t want it to affect me and my four siblings. Many may hear this and immediately blame stigma around mental health within the Black community, especially considering studies like this, which found 63% of Black Americans believe that a mental health condition is a sign of personal weakness. 

However, in my mother’s case and many others, stigma is an oversimplification of the mental health barriers facing people of color.

The stigma stereotype

The American Psychiatric Association defines public stigma as negative or discriminatory attitudes that others have about mental illness. It has become the go-to, catchall explanation for the Black communities’ low engagement with mental health services. 

However, many of the barriers are more closely related to a lack of resources and access. Historically, therapy, mental health, and wellness have not been part of the conversation in Black households and if it’s not discussed openly, then seeking treatment isn’t a normal, accessible course of action. It’s one of the reasons why some of my Black patients will still ask if they should lie down on a couch or if we need to discuss their childhood during therapy. 

These stereotypes, which likely came from portrayals of therapy in movies or television shows, reflect a lack of familiarity that contributes to the disparities in access to care for Black communities. In 2018, the CDC found 58% of Black and African American young adults 18-25 and 50% of adults 26-49 with serious mental illness did not receive treatment. 

Attributing everything to stigma is a disservice to those untreated Black patients because it implies an internal voice drove them away from treatment when it’s just as likely that the option was never available.

Meeting people where they are

We shouldn’t discount the innovation that’s been happening on the ground. Churches, faith-based groups, and barbershops have become unofficial mental health havens, where Black individuals often feel more comfortable speaking openly about their struggles. To optimize the experience, we should be arming these groups with resources, training, and access to mental health professionals, so we can provide support in the spaces they already feel safe. 

For many people to feel truly comfortable with their therapist, they need to feel a shared sense of community values and belonging. For the Black community, that often means a preference for a Black provider, but there aren’t nearly enough to meet the need. According to recent statistics from the American Psychological Association, only about four percent of its members are Black or African American. 

There’s no magical way to increase that number, but something we can do is require all providers to be trained in cultural humility. Right now, only 11 states in the U.S. require psychologists to have continuing education credits in diversity, but it’s clear that all providers should be trained so they can properly treat patients from different backgrounds. 

Even if a patient has the same social identity as their therapist or psychologist, they may not be the right person to treat them. For example, I’m a Black psychologist, but I don’t specialize in Obsessive Compulsive Disorder, so if I’m treating a Black patient with that particular issue, another provider may be better equipped to help–but only if they have a real understanding of the unique cultural experiences and/or racial trauma that many in the community face. 

A focus on joy

While an understanding of racial trauma is crucial for every mental health provider, it shouldn’t be the sole focus of treatment. Don’t get me wrong: Racial trauma is still happening daily in Black communities, but with BLM and other advocacy groups raising awareness, mental health doesn’t always need to be discussed from this point of view. 

By also incorporating celebration, Black joy, and liberation psychology–which focuses on empowerment, hope, strength, and resistance to oppression–we can shift the narrative away from stigma and help Black patients realize there’s much more to their story than the color of their skin.

Now that I’m a psychologist, my family talks about mental health all of the time. And when I talk to my mother now about the trauma she faced taking on the federal government, she often says, “I wish I knew then what I know now.” 

She didn’t avoid the topic or suffer silently because of stigma. She simply didn’t have the resources or understanding to know that mental health treatment was a potential solution for the negative feelings she faced.

More than three decades later, the Black community deserves more.

Dr. Jessica Jackson is a licensed psychologist and global DEIB Care Lead for Modern Health, a leading workplace mental health platform supporting 300+ enterprises globally.

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