February is Black History Month. Anyone can struggle with mental illness, regardless of age, gender, race, or other demographic features, so mental illness is not unique to people of color. Unfortunately, there are a lot of barriers that still exist, for black people who are struggling with mental health concerns. At Cottonwood, in Tucson, Arizona, we offer creative, nuanced, and comprehensive behavioral health care that focuses on mental, emotional, physical social, and spiritual dimensions of well-being, tailored to meet the needs of each individual we serve, and honoring the various pieces of their identity.
Recognizing the Strengths of the Black Community
It is important to recognize that African American communities in the United States are often thriving and resilient, providing:
- Strong family connections
- Solid moral values
- Connection to music as a coping skill and creative tool
- Spiritual support with strong religious networks
- Community networks
Barriers to Care
Although African Americans report slightly lower rates of mental illness than their white counterparts, they are more likely to experience persistent emotional distress, more likely to feel shame when diagnosed with a mental illness, and are significantly less likely to receive treatment when they do have a mental illness. Young, black people are also at increased risk of suicide attempts than white young people.
Several reasons have been identified for this disparity in treatment:
- Poor cultural competency among providers, resulting in an inability to meet cultural, social, and linguistic needs
- Experiences with trauma, dehumanization, discrimination, and bias related to historical, structural, and systemic racism, such as slavery, oppression, colonialism, and segregation
- Stigma attached to seeking out mental health treatment, which may encourage black people to instead utilize clergy and prayer in lieu of psychiatric treatment, rather than seeing them as two components of a strong mental health strategy
- Mistrust of the healthcare system because of barriers to access and unpleasant encounters with healthcare professionals
- Lack of insurance coverage – more than 10 percent of black adults do not have any health insurance
- Shortage of non-white providers making it more difficult for patients of color to find providers with first-hand knowledge of life as a minority in America
- Despite only making up around 12 percent of the United States population, African Americans are at increased risk for being part of high-risk populations that can also increase their risk of developing a mental health disorder, including:
- 40 percent of the homeless community
- 50 percent of the prison population
- 45 percent of children in foster care
Solutions and Supports
Practitioners can take steps to make mental health more accessible for African Americans, such as:
- Recognizing that black people may prefer counseling from their spiritual leaders or through a faith-based approach. They may also be more willing to seek out mental health treatment if their spiritual leaders encourage them to do so.
- Understanding that black practitioners, with lived experience, may be better able to build rapport with African American patients.
- Being mindful of biases that could exist and impede progress
- Understanding that black patients may describe mental health struggles in terms of physical ailments that result from distress and making referrals for mental health treatment when appropriate
- Helping patients to utilize resources developed specifically for the needs of Black individuals
Questions to Ask Mental Health Providers
If you are black and want to ensure that you are selecting a mental health provider who knows how to help you, it may be helpful to ask them questions about their experience in treating African American patients, such as:
- Have you treated black people in the past?
- Have you received training in cultural competency specific to black mental health?
- How do you foresee our cultural backgrounds influencing my treatment and our communication?
- How is your approach different when you work with black patients, versus white ones?
- What do you see as the differences in health outcomes for black patients?
After You Receive Treatment
After you have worked with a culturally competent provider, you should feel:
- Your provider communicated effectively
- Your provider was willing to integrate your beliefs, practices, culture, etc. into your care plan
- Respected and understood
- Like your provider relates well with you
At Cottonwood, we believe in providing evidence-based, holistic behavioral health treatment. We want our patients to feel safe and respected, whether we are treating them for a mental health disorder, substance misuse, or process addiction.
