Black people deal with mental health issues the same as anyone else, but the roots of their psychological challenges run deeper than those of other communities.

Despite the progress that’s been made and the positive direction society is going in, systemic racism is still a deep-seated problem that all Black individuals have to live with. As a result, their needs and required approaches to mental health care are unique. 

At a Glance

Black mental wealth is about helping Black people center their mental health journey and prioritize their emotional needs, which can’t be overlooked when it comes to overall health and well-being in the Black community. 

On Black Mental Wealth

But what exactly is Black mental wealth, and how does it differ from Black mental health more broadly? 

“One of the biggest things, I would say, is humanizing blackness and allowing individuals to be present in the space in the way that they choose to be present. I feel like the opposite of Black mental wealth is rooted in white supremacy and dehumanization, so I think anything that has to do with Black mental wealth goes to counteract that,” says Raquel Martin, PhD, Licensed Clinical Psychologist.  

Black mental wealth is anything that humanizes the Black experience and allows us to be present without needing to shrink.

Martin explains that mental health is under the broader umbrella of well-being, and in terms of mental wealth, it expands to services, community care, holistic care, therapy, and even being comfortable and confident about wearing your hair however you want to.

"Black mental wealth is anything that humanizes the Black experience and allows us to be present without needing to shrink," says Martin.

"I am a licensed clinical psychologist, but I identify as a liberation psychologist, and that means that it's not only my job to talk about the intricacies of what's happening to you internally, it's also my job to work with you to be an agent of change within your community."

On the Unique Issues Surrounding Black Mental Health

There may be a unified consensus within the psychological community about most mental health conditions and how patients or age groups experience them, but when it comes to people of color, we have to think about it differently.

“Black mental health is not the same as mental health for any other culture or ethnicity because our mental health, our well-being, our existence is inextricably linked to society and the way that we are treated,” says Martin.

Black people are one of the most oppressed, dehumanized, and adultified groups in history. This systemic racism and prejudice is embedded in the experience of being a Black person, and mental health care providers need to understand this. 

“Then we can't in any way think that depression, as a result of racial battle fatigue for a Black woman is gonna be the same as depression as a result of European American gender norms, right? There's no way to think that it would be the same because we don't get treated the same,” says Martin. 

Martin shares an anecdote about being pregnant at the same time as a colleague and sharing not only the excitement but also the fear of having a Black child that only a Black parent can understand. "She had never thought of anything other than joy because she's a European American woman…she automatically understands that the world is meant to center and protect her child and she was having a boy. So, that child's voice will always matter," Martin says.

On Navigating Discomfort Around Issues of Race and Injustice

These conversations really matter, but they also make people uncomfortable. But critically put, “people have to realize that being uncomfortable is not the same as being unsafe," says Minaa B., a licensed social worker, mental health educator, and author of Owning Our Struggles.

"I think feeling unsafe is why a lot of people have these knee-jerk reactions, specifically White people, that they don't even realize is rooted in them now being able to weaponize their race to bring harm to the Black body because you simply feel uncomfortable and don't know how to regulate your own uncomfortable emotions," she says.

If you’re a non-Black person, it’s well worth educating yourself and letting yourself be uncomfortable so you can learn to regulate your internal responses to these complicated issues. 

“Discomfort has always been a part of the Black experience, and the more awareness there is of this discomfort and lack of safety for Black people, the more the burden might be eased,” says Martin.

Black mental wealth is all about decentering the white mental health narrative. Martin emphasizes that even when White people say they can relate to her teachings, she reminds them that the conversation isn’t about them. The point is to cause a little discomfort by bringing awareness to their privilege.

People have to realize that being uncomfortable is not the same as being unsafe.

“If you want the Black culture, if you wanna talk about something that is embodied in every single Black person, I want you to think of fear," says Martin. "Don't think about our music, don't think about our hair, don't think about the effortless drip that is, you know, just amazing. I want you to think about fear.”

On Why Community Care Matters

Naturally, as one of the central themes of this season of the podcast, Minaa delves into the subject of community care and how it pertains to the overall subject of Black mental wealth.

Martin discusses the significance of chosen family and the importance of finding and surrounding yourself with people you feel safe and at home with.

“When I think of community care, I always talk about the aspect that family of origin and family of choice are the same thing in my mind, and there are a lot of people that I work with that were not blessed with the family that they deserve,” says Martin. 

“So I always say, 'Build the family that you deserve. Family of origin and family of choice are the same thing.' My mom has one sister. I call about 10 people auntie…that's the community that she also built around herself. Therapy is helpful. But I feel as though community care is actually more integral and it doesn't only have to be communities that you're around.”

Online Communities Count, Too

Digital communities are also super helpful and truly have their place in the context of community care. “Facebook, you know, back in the day, before there was TikTok, Instagram, Snapchat? Facebook was actually the community-building app,” says Martin.

She goes on to share that many of her patients who move to an area where there doesn’t seem to be a lot of people who look like them have had luck finding Black Facebook groups in that city, and it’s really helped them settle into their new community.

Martin explains that being around people who look like you, normalizing your experience, and not making you feel like it's in your head is incredibly helpful. “It's so isolating when you hear something racist and you wanna look at the person next to you, to a Black person next to you and be like, 'Yo, was that racist?' But there's no one next to you, so you just think you done lost your mind.”

Your Environment and Your Mental Health

As their conversation goes on, Martin expands on the discussion of community and talks about the impact that one’s environment in general can have on mental health.

“Irritability is a very common sign of depression or when something is wrong…One of my students in particular, she mentioned that being irritable is her personality and I said, oh, that's not true..when you feel as though you're irritated all the time, when you feel as though you're angry all the time, something is wrong and the reason why you may think this is your personality is because the thing that is wrong may be environmental."

You need community. We're not supposed to be in isolation. There was a reason why that was one of the main tools of the oppressors to separate us.

Martin notes that it can be "your parents or your cousins who you live with who disparage and invalidate you every single day…. It’s why most of my students can not stand Christmas and Thanksgiving break. They have to go back to that space that is awful for them, and they don't really have a choice.”

She encourages her patients to notice what places give them energy and don’t drain them. What places don’t exhaust them? Those are the places they should be and seek community within.

"Pay attention to the people where you feel like you get to be more genuine around yourself. Can you increase the likelihood of being around those people? You need community. We're not supposed to be in isolation. There was a reason why that was one of the main tools of the oppressors to separate us.”

You've likely heard the phrase "strong Black woman." It's often been used as an ode to the power and resiliency of Black women. But how did they gain this title? As a Black woman, I'd say that perhaps it's because we've historically had to face unprecedented hurdles and burdens, and on the surface, we've done it with poise and grace, leaving others marveling at our abilities to "do it all." 

Despite appearing to keep it all together, playing this role as an immobile pillar of strength — coupled with the difficulties that continue to plague the Black community today — has a very real impact on our mental health.  And while it may feel intuitive to maintain an appearance of strength in the face of so much hardship as a means of survival, embracing the "strong Black woman" schema can lead to increased levels of depression, anxiety symptoms and loneliness. 

Words to Know

Cultural competence: the ability to understand, appreciate and interact with people from cultures or belief systems different from one's own.

Epigenetics: the study of how behaviors and environment can cause changes that affect the way genes are expressed in an individual as well as potentially their offspring.

Intersectionality: the interconnected nature of social categories such as race, class and gender as they apply to a given individual or group; often used as a lens for seeing the way in which forms of inequality can operate together and exacerbate one another.

Microaggression: originally used to describe the insults and dismissals of Black Americans; now refers to the daily, casual and often unintentionally harmful and hurtful comments that all marginalized people experience from people in positions of privilege. 

Privilege: certain societal advantages possessed by an individual by virtue of their race, gender, class, sexuality, ability, education, body size, among other factors.

Somatization: when psychological concerns (e.g. depression or anxiety) manifest as physical symptoms (e.g. stomach pains, nausea).

Black women have always been advocating for themselves and for others. From slavery to the wage gap to attempting to measure up to Eurocentric standards of beauty, there's still so much intergenerational trauma that has yet to be explored. In many ways, this trauma has left Black women feeling like we are the lowest class of citizens in the United States. Malcolm X spoke of this in a 1962 speech delivered in L.A., stating, "the most disrespected person in America is the Black woman. The most unprotected person in America is the Black woman. The most neglected person in America is the Black woman."

In our workplaces, we're often faced with the "angry Black woman" trope, and the plight of daily microaggressions, from subtle comments such as "you're so articulate" to more serious offenses such as having coworkers touch our hair or being passed up for promotion or mentorship opportunities. And yet, we're often forced to put these jabs aside and, in doing so, swallow our pride to continue advancing our careers. In addition to doing our jobs well, we have to downplay our feelings and be careful not to display any outrage or discontent for fear of how our actions may be misconstrued. This, all while making 63 cents to the dollar compared to our white male counterparts, and 78 cents to the dollar compared to our white female colleagues.

In 2017, the Center for American Progress reported that more than 84 percent of Black mothers were the primary, sole or co-breadwinners for their families, compared to 62 percent for white mothers and 60 percent for Latina mothers. Black women have a major impact on the financial health of their families, as well as the Black community in general. Thus, during the height of COVID-19, when Black women had some of the highest unemployment rates in the country at nearly 10 percent, not only was our physical health at risk but also our economic health.

All of these realities have the potential to negatively affect our mental health. But reaching out for help can frequently feel incredibly challenging and intimidating due in part to the continued stigmas around mental health within the Black community. While anyone can struggle with mental health regardless of race and gender, women are at least twice as likely to experience an episode of major depression as men, and compared to white women, Black women are only half as likely to seek help. When we consider that only about 2 percent of practicing psychiatrists and 4 percent of psychologists are Black, finding a culturally competent therapist can be yet another barrier to access and receiving adequate care. At the intersection of both racism and sexism, Black women face a unique set of circumstances. It's time to take a look at the heavy load that Black women are carrying and how they're coping (or struggling to) with their circumstances, along with the beauty  — the joy, the resilience, and the pride — that they've managed to craft and nurture along the way.

While Black Americans experience a wide range of attitudes toward mental health treatment, there’s a stigma surrounding mental illness that prevents some people from getting help.

It’s important to consider how the stigma—and the forces that create the stigma—may make it difficult for individuals to reach out to a mental health professional.  

Beliefs About Mental Illness

Some communities accept the idea that mental illnesses are health problems that require treatment. But in other communities, there’s a serious stigma that implies a mental health problem is a sign of weakness and should be kept hidden from others.

Beliefs about mental illness are formed through experience, cultural traditions, and formal education. Stories from friends and family also play a role.

If family members talk about a “crazy” uncle who had to get hospitalized, younger generations may grow to believe that having a mental illness means you can’t function in society.

Similarly, if someone who commits a crime is said to have a mental illness, it may perpetuate the belief that individuals with mental illness are violent. Anyone who commits a crime or displays some type of undesired “bad” behavior would be stigmatized as having a mental illness or along that spectrum, which isn’t necessarily true.

These types of beliefs reinforce the idea that mental illness is shameful.

Ideas about mental illness that may reinforce the stigma include beliefs about:¹

• Identity: This addresses the symptoms of a mental illness. Does someone believe symptoms of depression are a normal part of life? Do they think symptoms surrounding anxiety are a sign of a physical health issue?
• Cause: Do symptoms stem from a spiritual weakness, personal weakness, or character defect? Or, can anyone develop a mental illness the same way they might develop a physical health issue?  
• Timeline: This refers to beliefs about whether an illness is acute, cyclic, or chronic. So someone might assume depression should resolve within a certain time period, or they may believe anxiety lasts a lifetime in all cases.
• Consequences: Do individuals think that untreated mental illness has consequences? Or do they think that mental illness serves a helpful purpose (like depression sparks creativity)?
• Controllability: How much does an individual trust that an illness can be treated? Do they think it can be cured, or do they believe that treatment won’t help?

There are many cultural factors, societal pressures, and stereotypes that may influence beliefs about mental health in the Black community.

Additionally, issues like systemic racism and the lack of culturally sensitive treatment by providers may also play a role in the way the Black community views mental illness and treatment. It is not normalized in the way that it should be. People often view it as a personal and/or moral defect. As a result, the mental health field is viewed along the same lines as the other systems that have caused substantial harm to Black people.

Factors That Affect Mental Health

The Health and Human Services Office of Minority Health reports that Black adults in the U.S. are more likely than white adults to report symptoms of emotional distress, such as sadness, hopelessness, and feelings that everything is an effort.²

Individuals in the Black community likely experience distressing events that affect their mental health. Racism, discrimination, and inequity affect a person’s psychological well-being. The stress may increase a person’s risk of mental illness. Some experiences may even be traumatizing.

Financial problems tend to increase the chances that an individual will experience serious psychological distress. Black adults who live below the poverty line are two times more likely to report serious psychological distress than those living above it.

It is also important to remember that these social determinants of health are all layered, with racism adding another substantial layer.

Mental Health Treatment Disparities

Only 1 in 3 Black Americans who could benefit from mental health treatment receive it. This may be in part due to the disparities in mental health treatment.³

Black individuals often lack access to culturally competent care. As a result, the treatment they receive is often poorer.

Black individuals are less frequently included in research, which means their experiences with symptoms or treatments are less likely to be taken into consideration.

They’re also more likely to go to the emergency room or talk to their primary care physician when they’re experiencing mental health issues, rather than seeing a mental health professional.⁴

Black individuals are also more likely to be misdiagnosed by treatment providers. This can fuel the distrust toward mental health professionals, as a misdiagnosis can lead to poor treatment outcomes.⁵

Contributing to the disparities is the fact that Blacks are more likely to have involuntary treatment, whether it is forced inpatient or outpatient treatment. This contributes to the stigma, hostility, and lack of willingness to voluntarily seek care.⁶

Community Stigma

Much of the research has found that the Black community has a high degree of stigma associated with mental illness. In the 1990s, a public opinion poll found that 63% of African Americans believed depression was a personal weakness and only 31% believed it was a health problem.⁷

Other studies have found that the Black community is more inclined to say that mental illness is associated with shame and embarrassment. Individuals and families in the Black community are also more likely to hide the illness.⁸

Individuals in the Black community may be more likely to believe that since they’ve survived so much adversity, they’re strong, and no one has a right to tell them that there is something wrong with them (since they may view a mental health issue as weakness).

Studies that specifically examine the beliefs of Black women are scarce. But, one study found that Black women were more likely to believe that individuals develop depression due to having a “weak mind, poor health, a troubled spirit, and lack of self-love.”¹

But not all studies indicate a high degree of stigma among Black women. One study¹ found that most Black women didn’t have a stigma attached to mental illness. Researchers found that women understood the causes of mental illness, accurately identified many of the symptoms, were aware of the potential consequences, and believed that mental illness could be managed with treatment and personal motivation.

Many of the women in the study identified a variety of positive coping skills. In addition to saying they would seek treatment, they also identified faith, prayer, and support from friends and family as go-to coping strategies.¹

Breaking Down the Stigma

Reducing the stigma could increase the likelihood that individuals with mental health issues will seek treatment. Treatment could help them live happier, more fulfilling lives.

Breaking down the stigma will likely involve a two-pronged approach: increasing the number of culturally competent providers and changing the narrative surrounding mental illness. 

Education surrounding mental illness and normalizing mental health problems may help individuals recognize that treatment for a mental health problem doesn’t have to be any more shameful than treatment for a physical health problem.

It’s also important for mental health treatment providers to be equipped to care for individuals in the Black community. Culturally competent therapists and psychiatrists could help ease mistrust and provide better care.

The publication of some recent books may help reduce the mental health stigma among African Americans. Some titles include: 

• The Unapologetic Guide to Black Mental Health: Navigate an Unequal System, Learn Tools for Emotional Wellness, and Get the Help You Deserve 
• Community Mental Health Engagement with Racially Diverse Populations
• Mind Matters: A Resource Guide to Psychiatry for Black Communities (Volume 1)
• Black Mental Health: Patients, Providers, and Systems

There are also podcasts and influencers on social media who are helping break down the stigma. Rappers have made a number of songs discussing mental health issues, including G Herbo, Polo G, and Quando Rondo. Other celebrities have used their platforms for awareness-raising and tackling some of the issues. 

There are also culturally relevant apps and websites that people can turn to for advice, resources, and even online therapy. All of these things are contributing to reducing stigma among African Americans.

A Word From Verywell

If you are experiencing a decline in your mental health or you suspect you may have symptoms of a mental illness, reach out to someone. You might start by talking to your doctor about treatment options.

If you suspect a loved one is experiencing a mental health issue, talk to them. Open conversations about mental health can help break down the stigma and encourage more people to seek help. 

SOURCES

1. Ward EC, Heidrich SM. African American women's beliefs about mental illness, stigma, and preferred coping behaviors. Res Nurs Health. 2009;32(5):480-492. doi:10.1002/nur.20344
2. Mental Health and Behavioral Health - African Americans. U.S. Department of Health & Human Services Office of Minority Health.
3. 2018 NSDUH Detailed Tables. SAMHSA.
4. Diversity and Health Equity Education. American Psychiatric Association.
5. Bell CC, Jackson WM, Bell BH. Misdiagnosis of African-Americans with Psychiatric Issues - Part II. J Natl Med Assoc. 2015;107(3):35-41. doi:10.1016/S0027-9684(15)30049-3
6. Lynch HT. Involuntary hospitalization and bias against marginalized groups. SURJ: The Standford Undergraduate Research Journal. 2019;18(1).
7. Thompson-Sanders VL, Bazile A, Akbar M. African Americans' perceptions of psychotherapy and psychotherapists. Professional Psychology: Research and Practice. 2004;35(1):19–26.
8. Ward EC, Heidrich SM. African American women's beliefs about mental illness, stigma, and preferred coping behaviors. Res Nurs Health. 2009;32(5):480-492. doi:10.1002/nur.20344