Black History Month: Barriers to Mental Healthcare for African Americans

February is an annual observance of African American history, and has been labeled as Black History Month here in America. According to Mental Health America, mental health conditions are as prevalent in Black and African American communities as they are in white ones. However, the Black and African American experience in America continues to be characterized by trauma, violence, and discrimination, impacting the emotional and mental health of every age group.

The historical oppression, terrorism, and dehumanization of African Americans and Black people have evolved into systemic racism, leading to a myriad of disparities, including inadequate access to America's health system. Racial concerns, including overt racism, were written into the United States' mental health system in ways that are still being unearthed and unlearned today. Addressing the disparities in mental health treatment is the first step in overcoming barriers to Black mental health care and bridging the gap in mental health access.

Understanding African American mental health

Even though Black people develop mental health disorders at similar rates as white people, they experience traumatic stressors at significantly higher rates. Although African Americans and Black people comprise approximately 12 percent of the United States population, they are overrepresented in high-risk populations. Racism, discrimination, and inequity further exacerbate the mental health issues among African Americans. Research tells us that repeated trauma and stress can take a significant toll on your wellness, both physical and mental.

What's more, social injustice, racial inequality, and the COVID-19 pandemic have had a profound and unprecedented impact on Black communities. Social distancing, job loss, and death are all significant changes that can bring incredible stress and anxiety into anyone's life. These stressors have tangentially contributed to the increase in mental health problems and substance abuse issues that we've seen throughout the pandemic. Although studies have suggested that mental health resiliency within the Black community is high, there's still a great need for accessible mental health services.

According to the U.S. Department of Health and Human Services Office of Minority Health, Black adults in the United States are more likely than white adults to report symptoms of emotional distress, such as hopelessness, mood swings, and depression. Black adults living below the poverty line are twice as likely to report serious mental health issues compared to those with financial security.

Barriers to accessing mental health treatment

Despite the disparities in Black mental health, only one in three Black adults who need mental health treatment receive appropriate treatment for mental health problems, including antipsychotic medications, talk therapy, and counseling. For comparison, approximately 25 percent of Black people seek mental health services compared to 40 percent of white people.

According to the American Psychiatric Association, Black people are also:

• Less likely to receive mental health treatment consistent with practicing guidelines
• Less frequently included in mental health research
• More likely to use hospitals or a primary care provider than mental health professionals
  

There are several barriers that make it harder for African Americans to access mental health treatment, including:

Mental health stigma

Even though the dialogue surrounding mental health is evolving, it's often considered a taboo subject in the Black community. Navigating the intersection of mental health and one's identity has always been complex, and negative beliefs toward people living with mental health conditions are pervasive within the U.S. and Black communities specifically. According to a 2014 study, 63 percent of Black people believe that a mental health disorder is a sign of personal weakness. As a result, people with mental health concerns may feel ashamed of seeking treatment.

Socioeconomic barriers

Therapy sessions can be costly without health insurance, and socioeconomic disparities can make treatment options even more inaccessible. In 2018, 11.5 percent of Black adults in the United States had no form of health insurance. Like other communities of color, the Black community is more likely to experience socioeconomic disparities, including exclusion from health care, economic, and educational resources. These disparities can further contribute to worsened mental health outcomes.

Inequity of mental health care

African Americans and Black people have been historically impacted by racism and discrimination in the U.S. healthcare system. Unfortunately, many people still have negative experiences when they seek mental health treatment. Provider bias, a lack of cultural competency, and a lack of Black representation in mental health care can lead to diagnostic errors and inadequate treatment. According to the American Psychological Association, 83.6 percent of psychologists are white, while only 14.6 percent are Black, Asian, or Latinx. These misrepresentations and inequities in care can lead to mistrust in mental health professionals, creating a barrier for many to seek mental health services.

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How to find a culturally-competent mental health provider

If you're experiencing mental health challenges, it's essential to receive quality mental health treatment as soon as your symptoms are recognized. It's equally important to receive care from a culturally competent and compassionate mental health provider.

If you're seeking psychotherapy for the first time, a primary care provider is a great starting point. A trusted health care provider might be able to provide an initial mental health assessment, along with a physical exam to rule out any underlying medical conditions. In addition, your primary care provider can provide a referral to a mental health professional. Local community and faith organizations may also provide referrals in your area.

If you're feeling overwhelmed, online therapy can also serve as a valuable support system. While some online therapy providers offer traditional once-a-week therapy sessions, intensive outpatient programs like Charlie Health offer mental health treatment with more comprehensive support. Online therapy is also a convenient, easy-to-access treatment option for clients living in rural areas, those seeking specialist care for a specific mental health condition, and those with hectic schedules.

When meeting with a mental health provider, it can be helpful to ask questions to learn more about their cultural awareness. Your therapist should expect and welcome questions since this helps them better understand what is important during your mental health treatment. Some questions to ask include:

• Have you received cultural competency training for Black and African American mental health?
• Do you have experience working with Black or POC clients?
• Do you have experience treating Black clients with [panic disorder/mood disorders/substance use disorder/etc.]?
• In your opinion, how do cultural backgrounds influence mental health treatment?
• Do you use a different treatment approach when working with clients from different cultural backgrounds?
  

Mental health resources for African Americans

No matter where you are in your mental health journey, help is available. If left unchecked, mental health disorders can disrupt your daily life, making it harder to maintain relationships, take care of yourself, and perform at work or school.

Online mental health programs, advocacy organizations, and support groups can help you find inclusive, culturally competent mental health support—whether you're experiencing ADHD symptoms, living with post traumatic stress disorder (PTSD) after a traumatic event, or just looking to improve your mental wellness.

Some helpful resources for Black people include:

• Ethel’s Club provides a safe space for Black Americans and other non-white individuals in the New York area. If you're not in New York, the organization also offers a virtual support group to help People of Color connect.
• The National Alliance on Mental Illness (NAMI) offers various support group resources and educational resources for individuals with mental health conditions and their family members. NAMI's Sharing Hope program is a one-hour educational program to increase mental health awareness in Black Communities by identifying common symptoms of mental health conditions.
• Charlie Health provides comprehensive, insurance agnostic virtual mental health treatment for adolescents, young adults, and their family members. Clients are assigned to compassionate, licensed therapists who specialize in their individual mental health needs and leverage evidence-based approaches to allow healing from the comfort of home.
  

If you're experiencing a mental health crisis or need immediate support, call the National Suicide Prevention Lifeline at 988 or the NAMI Helpline at 1-800-950-NAMI (6264).

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Contact Us

Whether you've been diagnosed with a mental health condition or you're struggling with mental health challenges, it's important to remember that you're not alone.

Everyone's mental health needs are different, and finding the right treatment team can make all the difference in your recovery process. Therapy should always be a safe, comfortable experience with someone who understands you. That means how your experiences uniquely influence the mental health concerns that you bring to therapy.

At Charlie Health, our comprehensive intensive outpatient treatment programs include a combination of treatments, including individual talk therapy, family therapy, and supported groups based on your specific mental health needs and goals.

Our mental health professionals will help you gain insights into your mental health, learn healthy ways to cope, and develop a personalized treatment plan so you can begin your journey toward sustainable healing. Find your group today.