Advocating for Black Mental Health
- Jonathan Benz
- Feb 28, 2022
- 6 min read
Much of my career has centered in working in communities that are different than my own.
When I entered the counseling field, I soon realized the value of listening to the lived experience of my clients, especially of those who are different than I. These stories of clients’ diverse experiences prompted me to ask questions of my colleagues who were more culturally like my clients, so that I could learn how to better connect relationally and guide my clients on their individual journeys of healing and recovery.
Along the way, I began to realize that the behavioral health field is riddled with mental health inequity and disparities for Black, Indigenous, and People of Color (BIPOC), especially those identifying as Black, African American, Afro-Latinx, or Afro-Caribbean. I began to raise my voice whenever I could to educate myself and my colleagues on how to best support these communities.
People called me “ally” or “advocate” and even “friend” to the Black community. To be honest, I wasn’t seeking affirmation. I just wanted to see some justice and equity in access to mental healthcare and emotional support. However, I now have come to fully embrace these roles both professionally and personally. This work of ally-ship has become a source of great learning, personal discovery, and profound joy for me along the way.
It was in this spirit that last year I had the honor of presenting at a mental health symposium with the University of Arkansas at Pine Bluff, a Historically Black College and University (HBCU). I felt a little awkward being the “white guy” talking to Black and Brown students about their mental health. I mean, my lived experience was very different than these graduating seniors. However, my Black colleagues encouraged me to push through and present some keys on how Black people can better access mental health services in a larger healthcare system that often has a bias towards White communities, especially those who have the financial means for self-pay.
Here is some of what I’ve learned.
Data suggests that communities of color experience mental illness at similar rates to White Americans. However, we must consider that BIPOC oftentimes are underrepresented in research and other clinical trials. Thus, in some cases the lived experience for communities of color may be very different than research conclusions.
Research indicates that BIPOC bear a disproportionately higher burden of receiving a diagnosis, treatment, or access to care. According to data from the American Psychiatric Association in 2017, among adults with mental illness, 48% of White Americans received mental health services, compared to 31% of Black Americans and Latinx/Hispanic Americans and only 22% of Asian American Pacific Islander populations.
Interestingly per current data trends, people who identify as Black experience lower rates of depression than White Americans. This could be due to possessing a greater sense of solidarity with their community as opposed to Whites who often tend to isolate and value individualism over the collective community. But the data also shows that despite their connection to their communities, Black Americans are more likely to have more persistent symptoms of mental health distress and unfortunately remain undiagnosed and untreated.
This is in large part due to a lack of cultural understanding and competency by health care providers. This deficit may contribute to underdiagnoses and/or misdiagnoses of mental illness in people from racially and ethnically diverse populations.
We do know that mental health conditions occur in Black and African American people at about the same or less frequency than in White Americans. However, the historical Black experience in America continues to be characterized by trauma and violence more often than for their White counterparts. This repeated trauma adds additional layers of mental health complexity for Black people.
Just recall the murders of George Floyd, Breonna Taylor, or Ahmaud Arbery. Every time violence against Black bodies is perpetrated and then broadcasted repeatedly, Black Americans are forced to watch privilege paraded—loudly, violently, and aggressively—as they literally fight daily for their fathers, sons, and brothers to simply be alive after any chance police encounter. These scenes of repeated brutality are retraumatizing and impact emotional wellbeing and mental health for both Black and Brown individuals alike.
According to research from Mental Health America, historical dehumanization, oppression, and violence against Black and African American people have evolved into present day racism. All of this cultivates a mistrustful community experience, characterized by a myriad disparities including inadequate access to and delivery of care in the behavioral health system. So, Black people are left processing and dealing with layers of individual trauma on top of new collective traumas from the COVID pandemic, images of police brutality, and an ongoing vitriolic climate of divisive political rhetoric.
One study from the National Institute of Health showed that 63% of Black people believe that a mental health condition is a sign of personal weakness. As a result, people may experience shame about having a mental illness and worry that they may be discriminated against due to their condition. It can be incredibly challenging to discuss the topic of mental health due to these concerns about how they may be perceived by others. This fear could prevent people from seeking mental health care when they really need it.
It is also true that many Black and African Americans choose to seek support from their faith community rather than seeking a medical diagnosis. In Black communities, the church, mosque, or other faith institution can play a central role as a meeting place and source of strength.
Faith and spirituality can help in the process of healing and recovery and be an important part of a treatment plan. For example, spiritual leaders, clergy, and faith communities can provide support and foster connection. However, they should not be the only option for people whose daily functioning is impaired by mental health symptoms.
It's also important to note that Millennials and Gen Z tend to be less connected to faith communities than their parents’ or grandparents’ generations. The result is that some appear to be a little more willing to seek outside help when they need it. This might mean confiding in a friend, attending a mutual aid support group, or seeing a behavioral health professional. For many of them, mental health issues carry less stigma than they do for their community at large.
So, what are the kinds of questions Black people should be asking when they want help or support for their mental health? How does a Black person access culturally competent care?
When searching for a provider—whether a therapist, psychiatrist, or other behavioral health specialist—I recommend doing one’s research. Most mental health settings are structured around the needs of the majority White community and do not always take into consideration the needs unique to Black, African American, Afro-Latinx, or Afro-Caribbean communities. Due to this fact, it is important to ask around and find out who in your community provides culturally competent care.
The National Alliance on Mental Illness (NAMI) recommends interviewing providers to get a sense of their cultural awareness. I recommend asking these questions to behavioral health professionals you may see, regardless of their race or ethnicity.
What is your approach to psychotherapy? For how long do you like to work with clients and with what frequency?
Have you treated other Black people or received training in cultural competence for Black mental health? If not, how do you plan to provide me with culturally sensitive, client-centered care?
How do you see our cultural backgrounds influencing our communication and any diagnosis and treatment I may receive?
Do you use a different approach in your treatment when working with clients from diverse cultural backgrounds?
What is your current understanding of differences in mental health outcomes for Black clients?
If the therapist can’t answer these questions, I recommend you keep looking. However, if your provider is willing to seek out answers to these questions with you, as they provide culturally competent care and treatment options, I would recommend giving them a chance.
Keep in mind that you may have to choose a White therapist. If this is the case, be aware that while they may be aware of their “Whiteness”, they may not get it right every time. However, if they have committed themselves to providing culturally competent care, they will more than likely embody humility and teachability and be able to adapt more quickly when needed.
NAMI also encourages Black clients to contemplate the following when choosing a behavioral health provider:
Does my therapist communicate effectively with me?
Is my therapist willing to integrate my beliefs, practices, identity, and cultural background into my treatment plan?
Do I feel like I am treated with respect, honor, and dignity?
Do I feel like my therapist understands and relates well with me?
Now, a word for behavioral health professionals seeking to provide mental health equity for their clients. Keep in mind that it can be incredibly challenging for some in Black communities to discuss the topic of mental health, oftentimes due to the fear of how they may be perceived by those in their own community.
These apprehensions could prevent people from receiving mental health care when they desperately need it. So, be aware of the way you communicate. Be mindful to not race to judgment. Be sensitive about how you confront, and as well, know when to back off. When in doubt, just ask the client the style of communication and feedback they are most comfortable with. This is all in keeping with best practices of client-centered care.
Finally, speaking for those in the White community, I am acutely aware that we don’t always get it right, myself included. But I understand not all my White counterparts see it this same way. Unfortunately, the White collective just isn’t there yet. However, I think if we remain committed to embodying principles of humility, empathy, and curiosity, we can all get their together. Healing and recovery are possible for everyone.
To find a therapist who is BIPOC and who understands your lived experience, visit:
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