Where race and mental health collide

Handcuffed racism word cloud

Image by John Hain from Pixabay

Like so many other things in this world, race shouldn’t be an issue when it comes to mental health, but it is.  I’m not talking about biological effects associated with race like genetic susceptibilities to certain illnesses, but rather 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 all racial and ethnic groups have equal opportunities 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, but 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.

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, while for blacks and Hispanics 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.

An article from the British Journal of Psychiatry argues the research into racial discrimination and mental health should not 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, and may serve to demonstrate institutional power over stigmatized groups.  The author of this article suggested that academic research should focus on those who discriminate rather than those who are the victims of discrimination.  It’s an interesting perspective that I’m not sure that I entirely agree with, as I think it would depend greatly 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 good have great value in identifying areas for improvement regarding mental health.

It’s also important to recognize the effects colonialization, slavery, and segregation have on an enduring basis through intergenerational trauma and deeply entrenched systemic racism. In Canada the findings were recently released of the 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.

Have you checked out my book Psych Meds Made Simple?  It’s available on Amazon as an ebook or paperback

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24 thoughts on “Where race and mental health collide

  1. Meg says:

    Very informative! And sad!! I saw an episode of a sitcom years ago about a Hispanic family. I hated the program. I think it was called the George Lopez show. In this episode, his mother was lying on the sofa staring at the wall for hours on end because her house had burned down and she’d lost everything. His wife said, “I think she’s depressed. Shouldn’t we get her some help?” And George said, rather patronizingly, “Nah. Depression’s a rich white person’s disease. She’ll snap out of it.” And my eyebrows shot up. Like, are you kidding me? Get your mother to a doctor!

    • mentalwealth2019 says:

      Let me explain that, being a person who works in the mental health sector as a therapist and who is also of Caribbean heritage, most commonly referred to as black. We can not afford to deal with out mental health issues due to social, financial hindrances, we just don’t have the resources for it. Not to mention the fear that comes with it. Maybe you aren’t aware but the mental health sector did a lot of experimentation on drugs and experiments on people from minority ethic groups. The savage treatment of slavery has yet to be fully disclosed, there were also a lot of experimentation which took place and due to the severity of the results it will never be disclosed. Yes we hide it and it is not healthy by no means, we just never had the privilege to be dealt with as human beings. It is getting better but there is still a stigma, maybe more articles explain the inequality is necessary for readers to register that this is s huge problem. The last thing we want is to be patronised and see as poor minority group as we have enough of that to last another 500 years. What we need is access to therapy with people we feel we can trust. hopefully more people read the article and learn something.

  2. Barb says:

    Yes, there is a HUGE stigma in the Asian-American community. When I was first hospitalized my dad told me that Filipinos don’t have depression (????). Fortunately, he is more knowledgable now and, in fact, his girlfriend, who is Filipino, is studying to be a mental health nurse.

  3. kbr0632 says:

    Great write up. I have a friend..who is African American..who told me that you are basically told to brush things off..as far as mental health goes. Therapy is not discussed. I guess it is looked at as a weakness. I did talk her in to taking steps to seek out a counselor for herself. She did. She is now in therapy (although she is not sure if it’s really helping). However, we broke that cycle in her family. It’s a shame. There is so much that bothers me with the way mental health is treated. We have therapists and psychiatrists that do not have to take insurance. Therefore, if you want to see a specialist, you may have to pay hundreds of dollars to do so. With that, the person is not getting the right help. They are going to a therapist that has no specialty (i.e. in OCD) which can hinder any progress or make it worse for the patient. I understand the logic behind it (lots of continuing education)…however, our insurance companies should be willing to pay the same for mental health as they would for physical health. The insurance should pay enough that the therapists will accept it. Thanks for your article. It’s a shame that people have to hold off on therapy…when they really need it.

      • kbr0632 says:

        Agreed. I wish there was something that could be done. I have written our congressman. I had one respond to me..but it didn’t go anywhere. I am not sure if he was even re-elected. Need to keep pushing.

  4. Brendan Birth says:

    This was a very informative post, and for me brought up the seldom discussed but important topic of the intersection of race and mental health.

    How would you feel about my sharing this post on my blog at some point? The intersection of race and mental health is an important topic to bring up and spread awareness about, so I thought that I would ask!

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