The Stigma of Mental Illness in the Black/African American Community

“My mom and dad ‘beat’ me whenever I did something wrong and I came out just fine!”.

“I lost many of my childhood friends to some act of violence, that I witnessed, but I made it out and I’m just fine!”.
“This is just the way life is how it has always been, and I’m used to it. I’m fine.”.

“You always have to stay on the lookout because people around here will try to catch you slippin’.”

These are just a few of the hundreds of statements I hear every day as I go into predominately African American communities to complete mental health crisis assessments. Some do not realize that there is a
problem until they are presented with a description of their thoughts and feelings encoded into a mental health diagnosis. Some are aware that there is a problem and refuse to acknowledge it due to guilt or
fear of judgment from family or peers. Some do not see a problem at all and assume that life is supposed to operate as such. If you possess any familiarity with the cultural interactions of the African American
family, then you may be able to recollect when you heard a statement, witnessed or experienced an act similar to one of the quoted statements above.

Let’s take a look at researched areas that mental illness can stem from within the African American Community:

· Societal Issues – This includes historical adversity such as slavery and the era of fighting for civil rights. Racism, negative stereotypes and exclusion. Socioeconomic status.

African Americans are still dealing with transgenerational trauma as it relates to historical adversity. African American men are still faced with the fear of authority figures such as police officers, based on the
history that the law has with African American males in the 1950’s up until today. Negative stereotypes can cause anxiety because you are not sure if you are being targeted because of stereotypes that you may not even be aware of, as it relates to your race. Socioeconomic status can be linked to mental illness as it relates to engaging in illegal activities that lead to incarceration or growing up in impoverished, violence ridden neighborhoods.

Are you starting to consider the possibility of mental illness when reflecting back on your encounters with family members and friends and their thought process or odd/bizarre behaviors in certain areas of
their lives, if you come from an African American family or community? Good! This is called awareness.

Is mental illness and lack of seeking professional help acknowledged in the African American community or do we see our own coping strategies and reactions to life’s adversities as normal?

Recent studies have shown that African Americans would prefer to seek help from their trusted religious institutions rather than a mental health professional. But this is also a known fact, because in my personal experience with providing mental health services to African Americans, I find that they are extremely hesitant to open up because they believe that they will be considered “crazy”. Even after I explain that engaging in therapy is not negative and there does not always have to be a mental health crisis occurring for a person to attend therapy, they are still hesitant. Many individuals will deny that there is an issue because they do not want to accept that something like depression, anxiety, schizophrenia, bipolar or posttraumatic stress disorder can affect them. Seeking comfort within your religious beliefs is acceptable if it helps and your symptomology is mild. However, not all ministers are mental health professionals and there are individuals who may be suffering with severe symptomatology that may require intensive mental health services, which could include intense therapy coupled with medication.

Take these examples into consideration regarding ACKNOWLEDGMENT:

1. A black male is pulled over by the police and his internal physical reactions to the siren, blue and red lights and seeing a police uniform may include a racing heart, heavy breathing, nervousness, racing thoughts, sweating, and feeling that their body is preparing for the “fight or flight” reaction. Posttraumatic Stress Disorder! These are all signs of Posttraumatic Stress Disorder (PTSD). Believe it or not, it could be this black male’s first encounter with a police officer. But, because he may have heard stories or seen news reports and recorded videos of violent encounters with police officers, it would be enough to cause him to experience PTSD symptoms. You can almost relate this to a disorder called Vicarious Traumatic Stress Disorder, that occurs with mental health professionals experience symptoms parallel to PTSD after sitting through numerous sessions with a client speaking in detail of their own trauma history.
2. A black woman is expected to remain strong and resilient to life’s adversities. This can be taken back to the time during slavery, up to the civil rights movement, and into today. Due to black men being systematically removed from the household, black women were forced to provide for their families financially, emotionally, and physically on their own. They really had no time show any vulnerability for the fear that they would be viewed as unfit, or they may be taken advantage of. The amount of pressure put on black women, today, to remain strong and mask their insecurities and vulnerability causes issues in their workplace, family, friendships and relationships.

Depression! Depression is a mental illness most prevalent amongst African American women. Depressive symptoms can present differently in African American women when considering cultural backgrounds when being compared to others. However, it will always come back around to symptoms such as physical illnesses, sadness, irritability, guilt or hopelessness, feelings of wanting to isolate yourself, decrease in energy or difficulty focusing and remembering, and sometimes thoughts of completing giving up.

How do we effectively confront the stigma of mental illness in the Black/African American community?

I hope that so far you have gone deep into your mind to try and formulate ideas on how we can encourage African Americans to educate themselves on mental illness and seek professional help without the fear of judgment or backlash from their peers.

Being in the mental health care field, you are always trying to find the best ways to help your client’s. You are researching, reading, and consulting with others regarding what your next steps should be in “fixing” a client. My supervisor asked me, “What do you think can be done to encourage clients to show up to their appointments and to engage?”. It did not take me long to give her a list of reason why the African American clients were more difficult to engage.

1. They are not as trusting of the system.
2. The people that recommended that a therapist reach out to them were their Caucasian teachers,
   managers, or group home staff.
3. They do not see enough African American mental health professionals that could likely be able to
   relate and understand them on a certain level.
4. They may attend therapy and come into contact with a therapist that is not as culturally competent as they should be for the population that they serve. And this could deter a client from returning.
5. African Americans feel that they are considered crazy when they have to be given some type of
   diagnosis in order to be seen by a therapist.