Race shouldn’t be an issue when it comes to mental health, but unfortunately, it is. I’m not talking about genetic susceptibilities to certain illnesses that can vary by ethnic group; rather, the issue is the impact of socially imposed ideas about race, and the lack of equality that results. To achieve social justice, more than just the mental health system needs to change. Change is required on a much broader scale to ensure that everyone has an equal opportunity to live healthy lives.
An article in Psychology Today says that the processes connecting race and poor health are “strongly tied to ethnic-racial biases and stigma, operate at multiple stages, namely at the intra-individual, interpersonal, and intergroup levels, and these different levels interact with structural-based resources that are frequently less available to stigmatized individuals.” If bias is occurring at each of these stages, that means that potential solutions can’t simply target a single stage.
A factsheet from the American Psychiatric Association (APA) outlines some of the mental health disparities observed among racial groups. Racial minorities tend to have a higher burden of disability as a result of mental illness. Depression rates in Black and Hispanic people are the same as in other ethnic groups; however, their depression tends to persist longer. Indigenous populations have higher rates of PTSD and alcoholism.
The APA also notes that about 50-75% of youth offenders have a mental illness, and racial minority groups are over-represented in the criminal justice system. Youth from racial minorities are more likely to be diverted to the criminal justice system rather than the mental health system compared to white youth.
Disparities in health care
There are also disparities when it comes to receiving care. Figures from 2015 show that 48% of white adults with mental illness received mental health services. For Black and Hispanic adults, that figure was only 31%, and for Asians 22%. Barriers included lack of insurance, high levels of stigma, lack of culturally competent mental health care practitioners, and distrust of the health care system.
Where to focus research
An article from the British Journal of Psychiatry argues the research into racial discrimination and mental health shouldn’t necessarily focus on those who are discriminated against. Doing so may medicalize “appropriate social struggle and distress” and reduce their struggles to simply a response to racism. It may also demonstrate institutional power over stigmatized groups. The article suggested that academic research should focus on those who discriminate rather than those who are discriminated against.
It’s an interesting perspective that I’m not sure I entirely agree with, as it would depend on the research method used. For example, participatory action research is driven by the participants and their identified needs on a community level, and that type of research could have great value in identifying specific areas for improvement regarding mental health.
The cumulative effects of oppression
It’s also important to recognize the effects that colonialization, slavery, and segregation have on an enduring basis through intergenerational trauma and deeply entrenched systemic racism. In Canada, the findings were recently released from the National Inquiry into Murdered and Missing Indigenous Woman and Girls, calling it a genocide. The majority of society has treated this group as if they have no value, and that’s bound to have an effect on the mental health of their families as well as broader communities.
Somehow, far too many people have not gotten the message that we are all created equal. There is no health with mental health, and there is no justice without justice and equitable treatment for all.
You may also be interested in my review of Rheeda Walker’s book The Unapologetic Guide to Black Mental Health.