Although conversations surrounding mental health treatment have shifted in recent years, there is still a necessity to discuss the challenges surrounding accessing quality treatment in Black communities. As painful as it can be to revisit historical cases of inequality and mistreatment, the reality is, our history continues to inform and impact people’s experiences today. The history of treating mental health disorders has been long and complex, particularly for people in the Black community. Inhumane methods of treating mental health disorders largely stemmed from a lack of understanding of the complexities of the human mind, but racism has also significantly contributed to the mistreatment of people of color with mental health disorders.
Despite advancements in the medical field, the history of treatment for mental health disorders, particularly for people of color, has become one of several barriers in providing resources for Black communities. Lack of representation, cultural barriers, generational trauma, and racial disparities come together to form a complex challenge in addressing the mental health needs of people of color. A history of underrepresentation in the field coupled with overrepresentation in high-risk populations has contributed to weariness and feelings of distrust that must be acknowledged and addressed in order to start the process of healing from the erasure of experience we have historically observed.
Underrepresentation versus Overrepresentation
About 13.4% of the United States population identifies as Black or African American, but systematic barriers have contributed to making them overrepresented in high-risk populations. Approximately 40% of the homeless population, 50% of the prison population, and 45% of children in foster care are members of the Black community. High-risk populations are at an increased risk for experiencing traumatic events and violence further increasing the likelihood of mental health challenges developing. Numerous historical, social, economic, and political factors continue to put Black communities at risk for psychological and physical health consequences.
Research shows that these factors contribute to continued disparities in mental health treatment. Rather than receiving quality care and addressing traumatic experiences effectively, it is more common to observe trauma being passed down through generations, further compounding inequalities and making it more difficult to access treatment.
There are a number of factors that contribute to these disparities, some of which include:
- Adult African Americans are more likely to struggle with feelings of sadness and hopelessness as compared to white adults. Research suggests that adult African American people are 20% more likely to experience mental health problems.
- Although less likely to die from suicide, Black teenagers are more likely to attempt suicide than white teenagers.
- Because such a small percentage of the American Psychological Association is made up of people of color, some people report feeling apprehension regarding treatment. Providers may not be able to provide culturally competent care and be able to address specific issues. Furthermore, racism and microaggressions can be communicated by therapists, whether intentional or not.
- Historical abuse of Black people in healthcare has led to feelings of distrust. A lack of cultural responsiveness, experiences of discrimination, and historical abuse in which Black people were subjected to “treatment” under the guise of healthcare has caused many to fear utilizing treatment options. In addition, Black people are statistically less likely to have access to adequate insurance, further impacting their ability to seek treatment.
- Despite conversations shifting perspectives, mental health is still largely stigmatized in many Black communities. It can often be regarded as personal weakness due to negative stereotypes, making it difficult for those in need to express a need for help. Lack of cultural responsiveness and representation in medical fields, particularly in mental health, can further influence negative views and increase stigmas.
All of these factors considered, in general, the following themes are observed. People of color are:
- Less likely to receive care
- Less likely to seek help
- Less likely to have access to mental health treatment
- More likely to receive poor quality of care
- More likely to terminate treatment early
The Link Between Mental Health, Substance Abuse, and Race
Studies show that those with underlying mental health issues are at a higher risk for developing substance abuse problems. Reports published by the Journal of the American Medical Association state that approximately 50% of those affected by severe mental health disorders also struggle with substance abuse. Co-occurring disorders are incredibly common and can develop in any order. In some cases, addiction develops as a result of attempting to self-medicate for symptoms of a mental health disorder. In other instances, substances can lead to the development of mental health problems. Regardless of the order in which these conditions present themselves, co-occurring disorders often exacerbate symptoms of one another and worsen a person’s overall quality of life.
The relationship between mental health, substance abuse, and race is complex. Lack of representation, inability to access resources, criminalization of drug use, and systemic racism all contribute to putting people of color at increased risks. Underlying mental health conditions are often found in those with substance abuse disorders. People of color statistically have less access to quality care and the prevalence of stigmas surrounding mental health can make it difficult to receive professional treatment. In turn, this can put people at greater risk for developing substance abuse disorders as a means of coping with symptoms of mental health issues.
Because drug use is largely criminalized and people of color are overrepresented in high-risk populations, these factors combine to create a system that is difficult to circumvent. In a way, these factors perpetuate systemic racism and subject people of color to disadvantages that are ingrained at a societal level. It is almost as if a system has been designed to keep disenfranchised people further alienated and unable to overcome these hurdles without a significant change being enacted at a political and social level.
Nexus Recovery Services is dedicated to treating people of all races who struggle with mental health and substance abuse issues. If you or a loved one is in need of help, contact us today.