African Americans are disproportionately more likely to suffer from mental health issues than white Americans. According the US Department of Health and Human Services, in 2015 African Americans were 20 percent more likely to report serious psychological distress than white Americans, and African Americans are almost twice as likely to be diagnosed with schizophrenia as white Americans. Despite these statistics, African Americans are less likely to receive behavioral treatment. In 2011, 73 percent of white American received treatment for major depressive episodes, while less than 55 percent of African Americans received treatment.There are many different factors for why African Americans with mental health issues are not receiving the care they need.
Institutionalized racism in America has greatly influenced socioeconomic disparities faced by communities of color, and poverty is a high risk factor in behavioral health issues. According to the US Department of Health and Human Services’ Office of Minority Health, African Americans are three times more likely to report psychological distress if they are living below the poverty line.
Moreover, despite the implementation of the Affordable Care Act, during 2014 around 6 percent more of African Americans were uninsured than white Americans. Without insurance, many cannot afford to treat their mental illness. Poverty is therefore both a risk factor in developing mental health issues, and a barrier to receiving treatment.
Another factor in addressing mental health in the African American community is a significant stigma against receiving treatment for mental illness. A study conducted in 2008 revealed that even among African Americans who were already mental health consumers, more than a third felt that discussing their mild depression or anxiety would have them considered “crazy,” and that they consider discussion of mental illness to be inappropriate even with their family.
A third factor is the lack of representation of African Americans and lack of understanding of race issues’ effects on mental health among physicians. Only around 2 percent of the American Psychological Association members and associates identify as African American. There is a concern that because African Americans are so underrepresented in behavioral health specialists, that these specialists may lack the cultural competence to understand the needs of the community. That concern has unfortunately not proven baseless.
Evidence of a lack of cultural competence has appeared in counseling sessions. White therapists have shown discomfort and dismissiveness to their clients of color, particularly when discussing how the social factors around their clients’ race could be affecting their mental health. Some of these comments have included allusions to the stereotype that African Americans are lazy. Other counselors have tried to take a “colorblind” approach, which dismisses the link between social factors around race and mental health. These types of comment show a lack of ability or willingness to comprehend that what an African American patient might be facing could be different from that of a white patient.
During this Black History Month, we should recognize that equality means making a conscious effort to create, affirm, and protect the rights of people whom society has marginalized, and part of this effort will be to create better access to mental health care and resources for African Americans.