Why We Need to Talk Openly about Stigma & Minority Mental Health

July is Minority Mental Health Month, and this year brings into sharp focus the challenges America’s minority communities face regarding mental health. The good news is the conversation around minority mental health is moving to the forefront; the bad news is that it’s because mental health inequality is growing.

This trend is particularly prevalent in African-American communities. According to the Urban League’s most recent State of Black America report, a long-standing gap in health equality between African-Americans and whites has widened, with some of the biggest disparities occurring in the areas of mental health and suicide among teens and young adults. A U.S. News & World Report story about the report attributed the changes to   “societal conflicts about behavioral health.”

Stigma of Mental Illness Adds to the Problem

The reasons for these trends are complex, but experts point to poor mental health screening, lack of access to mental health services, and cultural resistance among people of color to admit they have a problem and to seek care.

According to Maya Allen at Byrdie magazine: “To evolve in a culture that perpetuates the myth that prioritizing mental health is a sign of weakness is not easy … but the epidemic of mental health in minority communities is a serious problem we cannot continue to ignore.”

Dr. Dion Metzger, a board-certified psychiatrist and professor, echoed Ms. Allen’s comments:

“From my experience, I would say cultural resistance (stigma) is the biggest reason for the disparity.  When dealing with mental health symptoms, it is more culturally accepted to wait for it to pass and/or pray about it. Seeking professional help is considered something ‘crazy people’ do rather than being an integral part of our overall health.”

I do believe it’s a cascade effect: as fewer African Americans seek mental health treatment, providers are less likely to practice in a predominantly black area due to having a smaller patient population. This leads to less [access to] mental health resources [in these communities].

As for poor mental health screening, I believe that’s an issue for patients of all races. As the primary care visits get shortened to 10 to 15 minute checks, the screening for mental health symptoms has become even more brief.

The shortage of psychiatrists worsens the problems. The worst thing is when a person of color decides they’re ready to seek treatment but they can’t find a provider. This leads to them changing their mind and choosing to suffer with the symptoms. We need more psychiatrists and that starts with the medical students. We have to continue to talk with medical students not only about the need for psychiatrists but also the spectrum of different sectors they can practice in with a healthy work/life balance.”

Additionally, health insurance and the lack of mental health coverage has a huge impact on African-Americans seeking quality care.

“Lack of insurance is a huge barrier especially for those seeking therapy. As most insurance doesn’t fully cover therapy visits, patients often must pay out of pocket,” said Dr. Metzger. “That creates an instant disparity where only those who can afford it can get the necessary amount of sessions to see benefit.”

Openness and Education Are Necessary

In an article marking Mental Health Month in May, Louisiana Weekly noted that it helps to reduce stigma when black celebrities and public figures talk openly about their challenges with mental illness, pointing to:

“Serena Williams, Oprah Winfrey, Dwayne “The Rock” Johnson, and Former U.S. Congressman Jesse Jackson, Jr. suffered from depression; Michael Jackson was said to have a condition which caused a negative pre-occupation with body image; Nina Simone suffered from bipolar disorder, as do Chris Brown, DMX, and Mike Tyson; Don Cornelius committed suicide; even Dr. Martin Luther King, Jr. suffered from depression and was suicidal.”

To learn more about minority mental health, check out these resources:

• Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General
• National Institute of Minority Health and Health Disparities
• National Alliance of Mental Illness — Minority Mental Health Awareness Month

Interested in this topic? Check out this article: https://genesight.com/blog/patient/mental-illness-knows-no-race/