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Additional barriers to accessing mental healthcare exists for Black Americans, but experts propose three ways those barriers can be broken down. Getty Images
  • Black American adults are 10 percent more likely to report serious psychological distress than white American adults.
  • Barriers to mental healthcare for Black Americans exist.
  • Due to unmet needs and other barriers, those living with serious mental health conditions likely aren’t aware of or able to access the treatment they need.

According to the National Institute of Mental Health, approximately 30 percent of Black American adults with mental health conditions receive treatment each year, compared to the U.S. average of 43 percent.

“African Americans have historically faced stigma related to mental health… Events centered around racial injustices and even the COVID-19 pandemic continue to bring conversations around mental health access for African Americans to the forefront of national dialogue. This need is further perpetuated as African Americans continue to experience racism, discrimination, and inequity — all of which can significantly affect a person’s mental health,” Julie Smithwick, director of the Center for Community Health Alignment, told Healthline.

Serious mental health conditions, such as schizophrenia and bipolar disorder, may also affect Black Americans more greatly.

According to the Department of Health and Human Services Office of Minority Health, Black American adults are 10 percent more likely to report serious psychological distress than white American adults.

Due to unmet needs and other barriers, those living with serious mental health conditions likely aren’t aware of or able to access the treatment for their conditions.

Experts break down three main reasons there is such a gap in access to mental healthcare for Black Americans.

Socioeconomic disparities stemming from historical adversity, including slavery, sharecropping, and segregation as well as race-based exclusion from health, educational, social, and economic resources, continue to affect minority communities, according to the American Psychiatric Association.

“These disparities may contribute to [worsen] mental health outcomes,” said Rose Brown, MSW, senior director of program services at the Mental Health Association of Essex and Morris Counties in New Jersey.

Smithwick agrees, noting that until the healthcare system is transformed, Black Americans will continue to face barriers to mental healthcare.

Under the umbrella of socioeconomic disparities, Smithwick says barriers include provider bias, inequity in care, and discrimination in the healthcare system.

“Conscious or unconscious bias from providers and lack of cultural competence can result in misdiagnosis, inadequate treatment, and mistrust of mental health professionals. These disparities can create a distrust in mental health professionals, which can prevent many from seeking or continuing treatment,” she said.

Pernessa Seele, PhD, CEO and founder of The Balm in Gilead and host of the podcast “Dr. P on the Pod,” says the stigma of being perceived as “weak” is associated with mental health in the African American community, and keeps many from seeking professional help.

“Growing up, African Americans are taught to mask their true feelings since showcasing emotions are often politically categorized as violent, aggressive, or angry. Moreover, most public health providers do not understand the myriad of mental health stress that we face as African Americans.

“Over time, beginning in childhood, we learn to compartmentalize our mental health issues because of the culturally inflicted shame associated with speaking openly about symptoms to a loved one, community member, or healthcare professional,” Brown said.

Brown adds that mental health discussions among family are considered inappropriate.

However, Black Americans often turn to their religion and religious leaders to cope with psychological issues.

According to a study out of the University of Wisconsin-Madison, both African American men and women reported being somewhat open to seeking mental health services but prefer religious coping.

According to the U.S. Census Bureau, in 2015 86 percent of psychologists in the U.S. workforce were white while 5 percent were Asian, 5 percent were Hispanic, 4 percent were Black/African American, and 1 percent were multiracial or from other racial or ethnic groups.

Cultural competency is essential when addressing mental health issues, Seele says.

“The severity of traumas, cultural bias, and stigma — both present and intergenerational — when discussing mental health within African American populations requires that the mental health industry becomes intentional on increasing the number of trained African American mental health professionals,” she said.

To successfully engage African Americans through the spectrums of education, diagnosis, and treatment adherence, Seele says, it’s necessary to have mental health professionals who reflect the ethnicity and cultural alignments of their patient or client.

While some efforts have been made to normalize conversations around mental health and access to care for Black Americans, more needs to be done.

“There has been an emergence of tools and resources that are both culturally informed and timely, and even an uptick in the presence of social media where you commonly see hashtags like #BlackMentalHealthMatters.

“These resources and platforms not only bring awareness to the issue, but also help to normalize the conversation. We also cannot forget the efforts of community health workers, who support these conversations day-to-day in their very own communities,” Smithwick said.

However, the following may help influence more change.

1. Address systemic racism

Having open discourse about systemic racism, recognizing historic wrongs and the mistrust that has developed because of them, as well as training, supporting, and hiring more Black and minority mental health providers is needed, Smithwick says.

“It is not enough to simply acknowledge historic wrongs. We must also acknowledge that systemic racism continues to impact our present-day systems, institutions, and infrastructure. However, acknowledgment must also come with actionable change to truly address the disparities faced by African Americans and Hispanic Americans,” she said.

Seele agrees, noting that systemic racism clearly exists in healthcare.

“African Americans connect more so with practitioners of color because of their shared experiences. We need to narrow the communications gap and increase cultural training, which should consider environmental differences that induce a traumatic experience,” she said.

2. Tailor treatment to Black Americans

Seele points out the need to incorporate the cultural and spiritual experiences of African Americans into treatment plans.

“African Americans want to be heard and accepted as respected individuals seeking treatment of a medical condition. Studies have shown that within America’s healthcare system, there is not enough emphasis on cultural competence in dealing with communities of color in reference to healthcare,” she said.

By increasing the cultural competency of healthcare professionals, Black Americans will be more likely to seek help.

“Due to lack of empathy given to the multitude of traumas among African Americans, we often don’t seek professional help, since we don’t trust those in a position to help us,” Seele said.

Mistrust makes it hard for a Black American to seek mental health treatment from someone who doesn’t look like them.

“Access to culturally competent healthcare providers is key so that people with mental health conditions are supported when they may need to seek help beyond clergy and the church,” Brown said.

3. Increase mental health awareness

Increasing mental health awareness and education among Black Americans is essential to identifying mental health conditions and the appropriate support resources, Seele says.

“With increased awareness, African Americans must work to stop behaviors that support stigmatizing mental health in our communities,” she said.

Part of this approach involves including communities of faith.

“I’ve made it my life’s mission through The Balm in Gilead to build and strengthen the capacity of faith communities throughout the United States to deliver programs and services that contribute to the elimination of health disparities in the African American community.

“Faith-based organizations and healthcare professionals must work together to increase and improve access to mental healthcare for African Americans,” Seele said.

Whether promoting awareness in communities or congregations, Brown says there needs to be a reconditioning of the mind regarding how mental health is perceived.

“Seeking mental health treatment is not a sign of weakness or inferiority,” she said.


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