During challenging times, the topic of mental health and wellness moves to the forefront of many people’s minds. However, this does not always mean that people who need mental health care will have access to it. In fact, some of the communities that are currently being hit hardest by events like the pandemic and the Black Lives Matter movement are statistically the least likely to receive quality mental health services.
Here’s a brief explanation of Black, Indigenous, and People of Color (BIPOC) mental health, the factors that make it difficult for underserved communities to receive care, and what mental health care providers can do to overcome accessibility disparities.
In June of 2008, Bebe Moore Campbell National Minority Mental Health Awareness Month was created to shine a light on the unique struggles underrepresented groups face when it comes to mental health and behavioral healthcare in the United States. Named after American author, journalist, teacher, and mental health advocate, Bebe Moore Campbell, who championed mental health accessibility for the Black community, July has come to be a month for reflecting on the needs of underserved groups.
Up until this year, many organizations recognized July as “Minority Mental Health Month,” but some organizations have turned toward a different title. With recent social and cultural movements unfolding, the term ‘minority’ has come into question as a way to describe underserved communities because it highlights the difference in power between a majority and a minority — or in other terms, more and less. Additionally, the term ‘minority’ only takes into context the quantity of a group and various projections have indicated that the majority of the United States population will be non-White within the next 30 years. So, what is the appropriate alternative?
In the field of mental health care, studies have shown the significance of using person-first language, which aims to prioritize the personhood of an individual before their diagnosis. For example, instead of describing someone as “bipolar,” you would describe them as “a person with bipolar disorder.” The reasoning behind this is that language has a significant impact on the way we think about groups of people, which is why Black, Indigenous, and People of Color (BIPOC) was created to replace the term ‘minority.’
The BIPOC acronym highlights the differences between the lived experiences of each group instead of lumping them all together under a nondescript umbrella word. This year’s BIPOC Mental Health Month comes at a unique time in our country’s history and provides us with an opportunity to examine the relationship between the mental health care field and the communities that often face the most adversity when it comes to seeking treatment.
Mental illness does not discriminate. Studies have shown that nearly 1 in 5 Americans will experience a mental illness in a given year and mental illness is the leading cause of disability in the United States. While non-White people experience relatively similar rates of mental illness as White people, they face glaring disparities when it comes to accessing mental health help.
According to Mental Health America, 17% of Black people and 23% of Native Americans live with a mental illness and people who identify as belonging to two or more races are most likely to report any mental illness within the past year than any other racial or ethnic group. Research has shown that BIPOC groups are:
Some of these barriers can be attributed to a variety of factors such as cultural stigma around mental illness, systemic racism and discrimination, language barriers, a lack of health insurance, mistrust of mental health care providers, and a lack of cultural competency on the part of mental health care providers.
Systemic racism and discrimination practices have had a long and profound history within our country and the mental health care industry is not exempt. While mental health conditions can appear regardless of race, ethnicity, gender, or identity, these factors can make it significantly more difficult for someone to receive mental health treatment.
Some populations are more likely to be exposed to risk factors that increase the chances of developing a mental health condition, such as homelessness and exposure to violence as a result of other forms of systemic racism. In fact, Black Americans are 20% more likely to experience serious mental health problems than the general population and Black youth who are exposed to violence are at a greater risk for developing post-traumatic stress disorder by over 25
Strides have been made in recent years to destigmatize the subject of mental illness and treatment but many people in marginalized communities face internal stigma when it comes to getting help. Victor Armstrong, a member of the National Council for Behavioral Health’s Board of Directors spoke to the social stigma in Black communities:
“For many in the African American community, our story is one of perseverance and resilience. After all, we survived slavery; surely, we can survive “sadness” or “anxiety.” In this mindset, anything less would be considered a spiritual or moral weakness. The problem, in part, is that we often fail to recognize that mental illness is much more than feeling melancholy or anxious, it is not a sign of weakness, and it does not discriminate based on skin color. We fail to recognize mental illness as an “illness,” as we would cancer, diabetes, or high blood pressure.”
In short, some communities view mental illness as a personal failing or weakness rather than a real, diagnosable, and treatable condition.
A lack of insurance or access to funds specifically set aside for mental wellness is a huge barrier for many people in the BIPOC community, despite the obvious need for care. According to the American Psychiatric Association, only one-third of Black adults who need mental health treatment actually receive it, despite being more likely to report symptoms of emotional distress like hopelessness than White Americans.
Alongside this, language barriers and differences in communication can also make it incredibly challenging for BIPOC people to get the care they need. Higher proportions of BIPOC people speak a language other than English, which can make finding a local provider a difficult task.
Although mental illness appears to affect various racial groups at similar rates, the vast majority of mental health treatment providers in the United States are White. In 2015, approximately 86% of psychologists were White while by contrast, only 2% of American Psychological Association members were Black. The lack of diversity can create a significant gap in experiences and understanding between providers and those seeking treatment. Additionally, without similar, relevant lived-experiences, providers who are not part of the BIPOC community might underestimate the effects that racism and discrimination play on a person’s mental health, potentially leading to a diminished quality of treatment.
Diversity and inclusivity are at the heart of many solutions proposed to close the gap between mental health care providers and the marginalized communities they serve. One step that many mental health care providers have taken is to implement some type of cultural competency training, which aims to helps providers understanding the importance of culture, cultural identity, and intersectionality to provide the best level of care possible. Some areas of exploration might include intersectionality, power dynamics, stereotypes, biases, and microaggressions.
Cultural competency is also a core component of the “whole person” approach to behavioral health care, meaning providers take a number of factors into consideration when treating someone beyond just race and diagnosis.
Alongside this and breaking down the stigma that surrounds mental health, it’s important for providers to help steer the conversation toward the idea of mental wellness and the fact that everyone has mental health. Current attitudes toward mental health tend to only highlight the negative or difficult elements, but mental health includes positive experiences and feelings just as much as it does stress, anxiety, and depression.
Bringing awareness to the fact that BIPOC communities face different types of barriers to receiving quality mental health treatment is only the first step in the path toward mental health care equity. BIPOC Mental Health Month is a great way to bring these issues to the forefront of our minds, but it’s important to work toward improved accessibility and care all year long. To learn how you can become a mental health advocate for local BIPOC communities, join the Jefferson Center Policy Action Network. Together, we can break the silence, dismantle stigma, and create a space where quality mental health care is accessible to everyone.
If you are in a crisis, please call us at 720-791-2735 or by calling the crisis line at 844-493-8255. The 24/7 crisis walk-in center and withdrawal management program is open at 4643 Wadsworth Blvd, Wheat Ridge, CO 80033.
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