Mental health in the Black community
[7 MIN READ]
In this article:
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Stigmas around mental health prevent some Black people from seeking help for conditions including depression and anxiety.
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Fostering a strong community and support system can encourage people to get the help they need to improve and protect their mental health.
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Mental health is just as important as physical health. Culturally competent care can help people on the path to healing.
Mental health in the Black community: Breaking the stigma and finding support
Stigmas and barriers to care often prevent members of the Black community from seeking the mental health care services they need. Experts estimate that just one-third of Black adults will receive care for conditions including depression, anxiety and PTSD.
Because at Providence, we envision a world where every person has the chance to live their healthiest life, we’re committed to creating mental health treatment programs that foster equity for mental health. These programs include mental health services focused on conditions that impact African Americans and other people of color.
“Your mental well-being is just as important as your physical health,” says Sherlyn Frank, LCSW, clinical behavioral health specialist at Providence. “Healing is for everyone. Therapy and self-care are fundamental aspects of your well-being that transcend race, gender, age or socioeconomic status.”
Understanding the stigma around mental health
Specifically in Black communities, hesitation to seek physical or mental health care often stems from a widespread distrust of the medical system. Alex Smith, PsyD, licensed psychologist at Providence, explains that this mistrust began a long time ago. A reluctance to use mental health resources is likely the result of factors including discrimination, inequity in health outcomes and past experimentation focused on the Black community.
Viewing mental health as a weakness
“Therapy is often seen as being for ‘crazy’ people in Black communities,” says Dr. Smith. “As a result, there can be a lot of shame and embarrassment related to seeking out mental health care services.”
He adds that needing therapy is sometimes viewed as a weakness. In addition, African American communities have historically faced higher rates of medical misdiagnosis when compared to white patients.
Discrimination and mental health
The history of racism and discrimination within the mental health field can discourage Black Americans to get involved, even when mental health support is necessary to prevent severe mental health crises. Along with a lack of access to care, Black people might not be referred for appropriate treatment.
According to Dr. Smith, Black children are much more likely to receive a behavioral diagnosis such as oppositional defiant disorder (ODD) or conduct disorder, versus the anxiety or depression diagnosis white children are more likely to receive. Black children are also less likely to receive assessments for learning disabilities or ADHD.
“Among Black adults, the likelihood of being diagnosed with psychosis or personality disorder is higher than that of a white adult,” says Dr. Smith. “These examples continue the cycle of mistrust the community has with the health care community.”
“Black people advocating for civil rights were often misdiagnosed with mental health conditions, especially by white medical professionals,” says Frank. “One notable example is the diagnosis of ‘drapetomania’ in the 19th century, which was a fabricated condition used to describe enslaved Black people who tried to escape or resist enslavement. It was considered a mental illness by physicians of the time.”
Additionally, during the civil rights movement, many Black activists and leaders were assigned conditions like paranoia or schizophrenia simply for challenging the status quo and fighting for racial equality. Frank says this practice reflected the broader systemic racism within the medical and psychological fields, where Black resistance was often labeled as mental illness rather than a legitimate desire for justice and equality.
While it’s easy to assume that negative health care experiences affecting African Americans happened a long time ago, Dr. Smith says there are plenty of examples that continue today. This includes higher maternal death rates for women of color, as well as a lack of pain management for people of color.
Discrimination in both the past and present has created hesitancy among the Black community to engage in the health care system, and an overall mistrust in the system and people providing care – including mental health services.
Lack of representation
Dr. Smith points out that Black people are also often not adequately represented in health and mental health research. This means that assessments, measures, treatment protocols and interventions are not designed with Black people in mind. The result is limited effort to improve care, outcomes and the patient experience for the Black community.
The representation of Black professionals in various mental health fields remains disproportionately low when compared to the general population. A lack of mental health professionals who understand the unique experiences of Black individuals can make it harder to trust or relate to providers.
“Efforts to increase diversity within the mental health workforce are essential to address these disparities and improve mental health outcomes for underrepresented populations,” says Frank. “Therapists without cultural competency may unintentionally dismiss or misunderstand the impact of racism, microaggressions and systemic oppression.”
Other barriers to seeking help
Beyond an overall mistrust of the health care system, Frank explains that many African Americans favor faith over therapy. As a result, individuals often seek support from spiritual or religious communities rather than turning to professional mental health services.
“Discussing mental health struggles is discouraged within some faith-based communities,” says Frank. “This perpetuates silence and is compounded by the belief that mental health issues reflect a lack of faith.”
Other barriers to care include access and affordability, as well as a lack of awareness and education. Economic disparities and limited access to affordable, high-quality mental health care can make seeking care seem impractical or unattainable. Frank adds that limited knowledge about mental health conditions and their treatments can perpetuate myths and misconceptions.
Common mental health challenges
Despite the stigmas, Black people still face many of the same mental health challenges as white people, including depression and anxiety. In addition to those conditions, Dr. Smith says that Black people often deal with generational trauma, which occurs when the experience of a person’s parents, grandparents or other ancestors impacts someone’s current culture and experience.
According to Frank, Black people deal with a wide range of mental health conditions that result from racial trauma, microaggressions, systemic racism and oppression. This is in addition to repeated exposure to systemic racism and discrimination which can lead to chronic stress that manifests as anxiety, depression or PTSD.
“Significant stress and anxiety can result from the discrimination and biases Black people face regularly from media, movies and the people they interact with,” says Dr. Smith. “There is a constant struggle to fend off both explicit and implicit racism through aggressions and micro-aggressions. All this is while trying to disprove the image of Black people that the media often portrays.”
Encouraging conversations and seeking help
There are several ways to help overcome the mental health stigmas and challenges that Black people experience today. Frank suggests that people who need mental health care start by recognizing that seeking therapy is an act of self-care and empowerment, not weakness.
“Knowing you’re in a judgment-free zone allows for open conversations about struggles and triumphs,” says Frank. “It can be helpful to share your interest in therapy with trusted friends, family or mentors with similar experiences or resources.”
Tips for finding the right therapist
Dr. Smith says that finding a therapist can be difficult. With such a wide variety of different treatment methods, theoretical backgrounds and personalities that need to mesh, it’s important to find the right fit to get the most out of therapy.
“One thing I notice is that people will often quit therapy rather than advocating for themselves or finding a new therapist,” says Dr. Smith. “People need to speak up for what they want and need from the therapeutic relationship. Don’t be afraid to talk to your therapist about your concerns or switch if it isn’t a good fit.”
He says it’s also important to remember that your therapist is legally and ethically obligated to keep confidential what you share and discuss during your therapy sessions.
Dr. Smith says that it would be ideal for someone to find a therapist who is of the same culture. But with so few Black therapists that isn’t always possible. However, he says many therapists are very good at providing culturally competent care regardless of their background. Sharing what is important to you can help to foster a good relationship and make therapy productive.
“People should have a conversation with a potential therapist to gauge whether they can meet their needs with regard to culturally competent care,” says Dr. Smith. “No therapist, regardless of race, is going to know everything about you and your cultural background. Knowing everything about you is not necessary for therapy to be successful.”
Building a supportive community
Building and being part of a supportive community is important to positive mental health. Research shows that being a part of a community can increase longevity and overall mental health.
“It would be great if everyone received mental health checkups each year, just like getting a physical,” says Dr. Smith. “For now, it is beneficial to be a part of a community that allows for mental health to be discussed openly and without stigma.”
Frank agrees that a strong community can provide emotional, social and practical support, which is invaluable for mental health. This includes a shared understanding and access to resources, as well as encouragement and motivation.
“Feeling connected to others helps combat loneliness and fosters a sense of belonging,” says Frank. “Communities can also offer tangible support, like help with childcare, transportation or other needs, which reduces stress.”
National organizations and local support
Finding the right mental health support is crucial. Frank says there are several organizations that provide culturally competent mental health care, resources and advocacy for Black communities.
- Therapy for Black Girls
- Therapy for Black Men
- Therapy for QPOC
- Melanin Therapy
- Liberatory Wellness Network
- Therapy for Black Kids
- Psychology Today
In addition, Dr. Smith recommends The Well Being Trust for resources that support Black mental health. The BEAM Black Emotional and Mental Health Collective is another organization dedicated to removing barriers Black people experience getting access to mental health care. Black Mental Wellness provides evidence-based information from a Black perspective and works to reduce stigma in the Black community.
Contributing caregivers
Alex Smith, PsyD, is a licensed psychologist at Providence Medical Group.
Sherlyn Frank, LCSW, is a clinical behavioral specialist at Providence Behavioral Health Concierge.
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Related resources
Fostering equity for mental health
The future of mental health with Arpan Waghray, M.D.
This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
