By: Vivian Zhi
In 2008, July was officially established as BIPOC (Black, Indigenous, and People of Colour) Mental Health Awareness Month, a month dedicated to raising awareness and shattering the stigma surrounding mental health issues in people of colour. Although they experience mental health issues, they are less likely to seek help for it. There are many factors preventing them from accessing mental health services, including:
Poverty and financial barriers: People of colour are more likely to live under the poverty line, and thus are less likely to have adequate insurance or are able to afford proper mental health treatment.
Cultural and racial underrepresentation in the mental health field: People of colour make up only 16% of the psychology workforce, so those seeking treatment are less likely to have a provider who understands their cultural background, language and values.
Racism: People of colour may fear facing racism or cultural insensitivity from health care providers.
Stigma: Many cultures view mental illness as humiliating, unimportant or a sign of weakness. These views can lead to the decision not to seek help from a mental health professional.
Criminal justice over treatment: Young people of colour are more likely to be referred to the juvenile justice system than their white peers.
Unique Challenges Faced By BIPOC Groups in the Field of Mental Health
The Black Community
The Black community has experienced racism in the mental health field for a long time. In the early 1800s, physicians and psychiatrists argued that Black Americans were biologically “inferior” and slavery was their natural state because they were incapable of looking after themselves outside the system. The most vocal supporter of this belief, Samuel Cartwright, claimed that enslaved people demonstrated child-like simplicity and lack of complex emotional processes. Hospital superintendents used these ideas to justify a lack of any real treatments for Black patients.
These conditions were not seriously challenged until the 1960s. Inspired by new Civil Rights legislation, lawyers and activists fought for an end to racial segregation in all the country’s hospitals, including its psychiatric ones. Sadly, racism in psychiatry did not end there. 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.” This caused a shift in diagnostic rates. Today, Black men are more likely to be diagnosed with schizophrenia than their white counterparts with no scientific basis, and the criminal justice system continues to push Black people with mental illness into prisons.
In addition to the discrimination psychiatry has allowed to foster within its system, racism has had a profound impact on mental health. People who have experienced traumatic events due to discrimination may be more likely to suffer from mental health problems. One study revealed that racial discrimination can continue to affect a person’s mental health long after the initial exposure, and another study concluded that videos depicting the killing of unarmed Black Americans have adverse mental health impacts on the Black Americans who watched them. These effects lasted for up to three months for many who participated in the study.
The Indigenous Community
Indigenous populations all over the world have experienced some sort of trauma and discrimination, whether it was in the form of residential schools, human rights violations, or political killings. Indigenous people in America report experiencing serious psychological distress 2.5 times more than the general population over the span of a month, and they tend to start using and abusing alcohol and other drugs at younger ages, and at higher rates, than all other ethnic groups.
The concept of mental illness and beliefs about why and how it develops have many different meanings and interpretations among the Indigenous population. Physical complaints and psychological concerns are not distinguished, and they may express emotional distress in ways that are not consistent with standard diagnostic categories. Those who meet the criteria for depression, anxiety, or substance abuse disorders are much more likely to seek help from a spiritual and/or traditional healer than from mental health specialists, and due to high levels of poverty, many Indigenous people in America face economic barriers that prevent them from receiving treatment. Additionally, lack of awareness about mental health issues and services that are available and limited access to mental health services in rural locations prevents them from seeking the help that they need.
The Asian American/Pacific Islander (AAPI) Community
The stigma surrounding mental health has a profound impact on AAPIs. Many AAPI parents and elders may not believe in mental illness and its potential impact on their community. If they admit they need help for their mental health, parents and other family members might experience fear and shame, and assume that the condition is a result of their poor parenting or a hereditary flaw. Seeking help from those outside the immediate family also conflicts with the Asian- and Pacific Islander-specific cultural value of interdependence. After all, why would you pay to tell a stranger about your problems when you should be relying on the strength of your community?
There is a belief among younger generations that their elders experienced far more challenging hardships. For example, many Southeast Asians, who may be refugees or asylum seekers, may have experienced trauma due to oppressive regimes or economic instability back home. AAPI teens and young adults might feel guilty sharing their mental health struggles knowing their relatives faced something “more” stressful just to survive.
The Latinx/Hispanic Community
Similar to the AAPI community, many people in the Latinx/Hispanic community tend to be very private and often do not want to talk in public about challenges at home. They are familiar with the phrase el dicho "la ropa sucia se lava en casa” (similar to “don’t air your dirty laundry in public”). Unfortunately, this stigma can lead to a lack of information within the community about mental health as talking about it can be viewed as taboo.
Cultural differences may lead doctors to misdiagnose those from the Latinx/Hispanic community. For instance, they may describe their symptoms of depression as “nervios” (nervousness), tiredness or as a physical ailment. These symptoms are consistent with depression, but doctors who are not trained in how culture influences a person’s interpretation of their symptoms may assume it’s a different issue.
The LGBTQ+ Community
Being LGBTQ+ puts a person at a higher risk for suicide attempts, and lesbian, gay and bisexual (LGB) adults are also more than twice as likely as heterosexual adults to experience a mental health condition. In addition, research shows that 44% of LGB adults are likely to have problems with alcoholism. There are many reasons for this, including the discrimination, prejudice, violence and family rejection that people in the LGBTQ+ community experience.
Health needs of the LGBTQ+ community often are grouped together despite that each sub-community represents a distinct population with their own unique mental health challenges, rates of mental illness, experiences and coping strategies.
What Do We Make of This?
While raising awareness is definitely a great first step to ensuring equality in the mental health care system, there is more to be done. We need to find a way to make mental health services more accessible to those who may not have the financial means to pay for it. We need to promote diversity within the psychology workforce, which means hiring people of colour and people of different genders, sexual orientations and backgrounds. We need to destigmatize the conversations around mental health; so this July, take the time to educate yourself about the mental health of BIPOC and start having those uncomfortable conversations with your families and friends. Because stigmatization and change can happen, one conversation at a time.
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