Mental illnesses affect people of all races and present a significant medical issue. However, the Black community representatives are, on average, 10% more likely to suffer from severe mental health problems (Hannor-Walker et al., 2020). Moreover, the number of suicide cases among black children is almost twice as high as among the white population (Hannor-Walker et al., 2020). The main mental illnesses which affect the Black community are disorder and anxiety. Flowers and Wan (2020) report that during the COVID-19 pandemic in the U.S. a record number of cases of mental health problems was indicated. In particular, African Americans are more susceptible to depression and anxiety than other racial and ethnic minorities. More than 40% of the surveyed representatives of the Black community were diagnosed with signs of mental illnesses (Fowers & Wan, 2020). To a greater extent, the situation is associated with discrimination and socioeconomic conditions. African Americans are often unable to receive adequate help, so a number of measures need to be implemented to expand access to mental disorders treatment and promote a cultural shift.
Anxiety among Black Community
Anxiety is the leading cause of suicide among the Black community members. The reasons for the development of the condition can consist of a variety of behavioral, environmental, and family factors. However, representatives of the Black community have additional risks for the development of this mental health problem, including racism, inequality of opportunities, and exposure to traumatic experiences (Villines, 2020). Anxiety can be related to other diagnoses such as “obsessive-compulsive disorder (OCD), posttraumatic stress disorder, phobias, and generalized anxiety disorder” (Villines, 2020). The condition has a variety of symptoms, including physical manifestations, feelings of fear or extreme irritation, traumatic memories, problems with concentration, chronic headaches, muscle tension, and others.
Socioeconomic conditions, racism, and a high risk of violence against them can be the reasons for the spread of anxiety among the Black community representatives. It is reported that many African Americans are converting to the faith and the church instead of receiving qualified help, aggravating the situation (Villines, 2020). However, a link between reducing the risk of suicide and visiting religious organizations has also been established (Celestine, 2019). It is noteworthy that African Americans suffer more from the manifestations of posttraumatic stress disorder (PTSD), which leads to the development of severe forms of the illness. In 2005, it was reported that symptoms of anxiety were on average more common among the White population (Simons, 2018). However, in 2010 there was an increase in the number of cases of PTSD manifestations among representatives of the Black community (Simons, 2018). This trend has been observed for a long time, having a negative impact on the mental health of African Americans.
PTSD symptoms are not only more common among the Black community but are also more severe. The reason for the worsening of the situation for African Americans is “socioeconomic factors that may limit their resources to cope with traumatic stressors” (Sibrava et al., 2019, p. 102). It is also noted that PTSD is most often caused by experiences of episodes of discrimination and does not lead to other anxiety disorders (Sibrava et al., 2019). Thus, this type of mental illness is the most common and severe among the Black community.
Depression among Black Community
Depression is the other most common medical condition among African Americans. According to the data, in the U.S. in total, about 18 million people have symptoms of the mental disorder, 10 million of whom suffer from clinical or major depression (Bailey et al., 2019). One of the risk factors for the development of the condition is “adversity due to trauma and psychosocial stressors such as low socioeconomic position” (Bailey et al., 2019, p. 603). Although African Americans have less risk of suffering from the disorder than other ethnic minorities, their condition is chronic in more than half of cases. Moreover, they are much less willing to seek help, despite severe symptoms which have a negative impact on their lives.
As with anxiety and PTSD, discrimination is one of the main causes for the development of depression. However, ethnic identity and connection with the community, in particular with religious organizations, acts as a protective factor against the occurrence of the mental illness (Bailey, 2019). Moreover, there is a strong link between income levels, employment status, housing conditions, and the educational level of the Black community members and their mental health.
Black adolescents are at a higher risk of developing mental illness than adults or White peers. They often experience “cultural dysthymia and mental health symptoms such as low-grade depression; feelings of sadness, hopelessness, and anger; aggression; and self-destructive behaviors” (Hannor-Walker et al., 2020, p. 286). The illness develops mostly due to oppression and racial discrimination; therefore, it remains undiagnosed and unrecognizable. Moreover, the study conducted by Assari et al. (2018) found a correlation between the high income of Black families living in predominantly White areas and the prevalence of depression symptoms among young people. The situation may be motivated by the increased structural and social racism which children and adolescents have to face in this environment.
As noted in the description of the situation with anxiety and depression, one of the main causes of mental illness among the Black community is racism. The inequality and discrimination faced by African Americans can result in “racial trauma” (Jaye, 2020). Later, the associated feelings of anxiety, anger, fatigue, or sadness can lead to the development of mental disorders. The indirect impact is manifested in the form of microaggression, which is “verbal or nonverbal expressions, can be unintentional or intentional, and appear vague or specific” (Williams et al., 2017). This type of discrimination is often difficult to describe for both the community member and the therapist, which makes it challenging to identify the causes of symptoms.
Another issue is associated with the described problem, leading to a worsening of already existing signs of deterioration in mental health and development of chronic illness. Often members of the Black community are misdiagnosed, which prevents them from receiving adequate treatment. In many cases, identical symptoms are interpreted differently depending on the patient’s race (Oladipo, 2019). The reason for this situation is the lack of cultural competence of therapists, as well as the lack of accurate statistics. Many of the mental illnesses are considered exclusive to Whites, leading healthcare providers to ignore their symptoms in members of ethnic and racial minorities.
Another major issue related to the mental health of the Black community is stigmatization. Perceived stigma refers to a situation where a person thinks that society has a negative attitude towards mental illnesses, and an individual stigma implies a personal vision of such disorders (DeFreitas et al., 2018). Because of both types, African Americans often do not seek help from therapists due to the shame or the fear of being judged by others (Celestine, 2019). Moreover, there is “a longstanding belief in these communities that such concerns are taboo” (Armstrong, 2019). Thus, more severe symptoms of mental illness and a high percentage of chronic forms are due to widespread perceived and individual stigma.
The issue associated with the socioeconomic situation is increased exposure to violence and other traumatic experiences. Despite the limited number of representatives of the Black community, it “comprises approximately 40% of the homeless population, 50% of the prison population, and 45% of children in the foster care system” (“Addressing mental health,” 2019). Thus, social, historical, economic, and political conditions continually contribute to the development of mental illness among African Americans. In particular, police killing is considered an example of structural racism, which increases the level of anxiety and stress in the Black population (Bor et al., 2018). The Black community has experienced oppression and segregation for centuries, which also stimulates the development of genetic predisposition (“Addressing mental health,” 2019). Thus, trauma can cause irreversible biological changes among African Americans.
Based on the identified existing issues related to the mental health of the representatives of the Black community, several measures can be identified which are necessary to improve the current situation. First of all, the development of a culturally sensitive healthcare system plays a significant role. As noted, the therapist can often misinterpret the causes of the mental disorder as an inability to fully understand the traumatic experience of the patient who is the representative of the Black community. Therefore, it is crucial to take into account the culture, values , and beliefs of people of color when interacting with them in the framework of treatment. Lack of fear of stigma and judgment will allow them to speak more openly about their mental problems and receive timely help.
The church can play a significant role in promoting awareness of the importance of treating mental disorders. Among the representatives of the Black community, “87 percent reporting a formal religious affiliation” (“Why mental health care,” 2019). Thus, faith is often considered a way to treat mental illness, which prevents the visit to specialists and aggravating pre-existing symptoms. Religious organizations need to do extensive community education about depression and anxiety by encouraging professional help.
Due to the socioeconomic nature of the community, it is also necessary to provide them with more open access to the healthcare system. African Americans have the lowest percentage of health insurance coverage of all racial and ethnic communities (“Why mental health care,” 2019). Thus, they are often unable to receive adequate and timely help for the treatment of depression or anxiety. Moreover, in the judicial system, their mental conditions are often ignored, which also makes it impossible for them to seek treatment. Structural changes and specific policies are needed to increase access for the Black community to diagnose and treat these illnesses.
African Americans often suffer from depression and anxiety, in particular PTSD, as a result of racial trauma or socioeconomic conditions. Despite the prevalence of mental disorders symptoms among representatives of the Black community, in most cases, it is difficult for them to get qualified treatment. The stigma and the cultural insensitivity of therapists make people of color refuse medical help or lead to misdiagnosis. Thus, the community experiences more severe symptoms and a higher number of chronic cases of illness. A number of measures need to be implemented in order to develop cultural competence among therapists, eliminate stigma, and expand access to healthcare for African Americans with mental disorders.
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