During an episode of the hit Fox series Empire, one of the main characters, Andre, found himself in a facility for treatment of his bipolar disorder. Despite him struggling with his condition, Andre’s parents shrugged off the illness, one of them even decrying it as a “white person’s” problem. And his music therapist, portrayed by Jennifer Hudson, asked her patient to join her in prayer.
The episode touched on the range of attitudes among black Americans about mental health and illness, as well as broader issues regarding stereotypes of mental health in America. For one thing, mental illness is not a luxury concern that’s simply for white people. What’s more, these ideas — that mental illness isn’t real and that religion is cure-all — are two of the most prevalent misconceptions about mental health in the black community.
When held alongside actual facts about the issue, however, it becomes clear that mental health is a serious issue for black people too. Here’s why:
1. Black Americans are as likely to suffer from mental illness as whites.
The American Psychiatric Association reports that as many as 1 in 4 adults in the U.S. will suffer from some kind of mental disorder each year. And, as the association notes, African-Americans are at least as likely to suffer from a mental health issue as their white counterparts.
That’s why the myth that black people shouldn’t worry about seeking professional mental health services — evidenced through statements such as “if black people could get through slavery, they can get through anything” and even the “strong black woman” trope, Mental Health America notes — are so damaging.
But these beliefs aren’t just tied to religion or cultural attitudes. It’s one that’s also been perpetuated by some within fields of psychiatry. For example, in a 2012 interview with NPR, psychiatrist William Lawson said he was told by a faculty member during medical school that black people are “lucky” they don’t deal with mental health issues in the same way that white people do.
2. Relatively high rates of poverty increase likelihood for mental health issues.
African-Americans are 20% more likely to report having serious psychological distress than non-Hispanic whites, according to the Department of Health and Human Services. And within the black community, the department notes, those who live below poverty level are three times more likely to experience psychological distress than those who are comfortably above the poverty line.
The resulting challenges, including hunger, difficulty finding jobs, homelessness and lack of other vital needs, can be destabilizing. These arduous living conditions, as the World Health Organization highlights, can create a vicious cycle: Poverty increases the risk for mental health issues, which may then render an individual unable to work and afford basic needs, including treatment.
3. Racism in care still exists.
Some may worry that mental health care practitioners are not culturally competent enough to treat their specific issues. As Monnica T. Williams noted in Psychology Today, studies have shown that African-Americans view the typical psychologist as an “older, white male, who would be insensitive to the social and economic realities of their lives.”
Many of those fears are based in truth, as some black patients, as well as other patients of color, have reported experiencing racism and microaggressions from therapists, such as dismissing complaints of racial insensitivity in work settings.
This is compounded by the fact that African-Americans make up less than 2% of American Psychological Association members, according to a 2014 survey.
4. Barriers in access to adequate health care make it harder to get help.
Anticipation of encountering racism coupled with the challenges of paying for care may make the prospect of getting help daunting for black Americans.
Racial disparities persist in health care access. In 2012, for example, 40.6% of African-Americans relied on Medicaid or public health insurance, in comparison to 29.3% of non-Hispanic whites, according to the Office of Minority Health. That same year, 17.2% of African-Americans were uninsured, in comparison to 10.4% of non-Hispanic whites.
Even if African-Americans can afford a basic checkup, the APA notes, many primary care specialists lack training in the diagnosis and treatment of mental and behavioral health issues. Thus those suffering need access to specialized care.
5. Black Americans heavily use prayer to cope with stress or mental illness.
One study cited by the American Psychiatry Association said that 85% of African-Americans would describe themselves as “fairly religious” or “religious,” and that their most common way to handle stress is through prayer. For people who come from religious backgrounds, especially those without adequate access to adequate medical care, prayer may be a primary method of dealing with mental illness as well.
Attitudes may be shifting, and some faith communities are partnering with care providers to help their congregants, according to the Washington Post.
6. Stigma in the community may make it that much tougher to seek help.
A 2008 study found that more than one-third of African-Americans actively seeking treatment believe talking about their anxiety would lead to them being called “crazy” by their peers, Williams noted at Psychology Today. A quarter of those surveyed reported that they didn’t feel they could talk about their mental health with family members.
First lady Michelle Obama addressed the need to reduce the stigma of getting professional help when needed. “There should be absolutely no stigma around mental health,” she said at a recent mental health summit. “None. Zero. … It’s time to tell everyone who’s dealing with a mental health issue that they’re not alone, and that getting support and treatment isn’t a sign of weakness, it’s a sign of strength.”
Cultural shifts take time, but it’s important to foster a climate in which friends and loved ones can seek non-judgmental support for a mental health condition. Doing so could make all the difference in helping others feel empowered to get the help they may need.