Mental Health in the Black Community
Hi Friends!
Welcome to Issue 18 of this newsletter! I decided to turn this into a series on mental health in BIPOC communities. BIPOC refers to Black, Indigenous or people of color. And while this term does have some controversy around inclusivity and specificity, I think it applies here. This week, we will focus on Mental Health in the Black Community. From generational trauma to coping mechanisms and stigmas, there is a lot to dive in to. Let’s get into it!
Key Terms
Generational Trauma: This is trauma that isn’t just experienced by one person but extends from one generation to the next. In 1966, Canadian psychiatrist Vivian M. Rakoff, MD, and her colleagues recorded high rates of psychological distress among children of Holocaust survivors, and the concept of generational trauma was first recognized. Trauma affects genetic processes, leading to traumatic reactivity being heightened in populations who experience a great deal of trauma.
Sterilization: A process or act that renders an individual incapable of sexual reproduction. Forced sterilization occurs when a person is sterilized after expressly refusing the procedure, without her knowledge or is not given an opportunity to provide consent.
Lobotomy: Lobotomy was an umbrella term for a series of different operations that purposely damaged brain tissue in order to treat mental illness. It is is a neurosurgical operation that involves severing connections in the brain's prefrontal lobe.
Post Traumatic Slave Syndrome: P.T.S.S. is a theory that explains the etiology of many of the adaptive survival behaviors in African American communities throughout the United States and the Diaspora. It is a condition that exists as a consequence of multigenerational oppression of Africans and their descendants resulting from centuries of chattel slavery. A form of slavery which was predicated on the belief that African Americans were inherently/genetically inferior to whites. This was then followed by institutionalized racism which continues to perpetuate injury.
Let’s Get Into It
A Brief History
In 1848 John Galt, a physician and medical director of the Eastern Lunatic Asylum in Williamsburg, Virginia, offered that “blacks are immune to mental illness.” Galt hypothesized that enslaved Africans could not develop mental illness because as enslaved people, they did not own property, engage in commerce, or participate in civic affairs such as voting or holding office. According to Galt and others at that time, the risk of “lunacy” would be highest in those populations who were emotionally exposed to the stress of profit making, principally wealthy white men.
Dr. Benjamin Rush diagnosed Negritude which he described as the irrational desire by Blacks to become white.
Dr. Samuel Cartwright, a pro-slavery physician diagnosed Drapetomania, a disease that caused enslaved blacks to flee their plantations and Dysaethesia Aethiopia, a disease that purportedly caused a state of dullness and lethargy, which would now be considered depression. He argued that severe whipping was the typically the best “treatment” for both conditions.
Most pre-Civil War mental health facilities in the South usually barred the enslaved for treatment. Apparently mental health experts believed that housing Blacks and whites in the same facilities would detrimentally affect the healing of the whites.
In 1895, Dr. T.O. Powell, the superintendent of the Georgia Lunatic Asylum observed an increase in insanity and consumption (tuberculosis) among Black people which he attributed to three decades of freedom. He argued that when the former slaves got their freedom, it caused them to have little or no control over their appetites and passions and thus led to a rise in insanity.
In the 1930s Black Americans diagnosed as insane were the most widely sterilized group. Although sterilization lost some of its appeal when it was discovered Nazi Germany embraced the practice on a wide scale, by the 1970s some states in the South, including notably North Carolina and Alabama. In North Carolina in the 1960s, for example, more than 85% of those legally sterilized were Black women.
Black Americans were victims of lobotomies from the 1930s to the 1960s.Dr. Frank Ervin, a psychiatrist, and two neurosurgeons, Drs. Vernon Mark and William Sweet ignored the systematic oppression, poverty, discrimination, and police brutality of the 1960s and argued that this violence was the result of a surgically-treatable brain disorder and promoted their agenda as a specific contribution to ending the political unrest of the period. While never widely accepted and practiced, some lobotomies were performed on Black children as young as five years old who exhibited aggressive or hyperactive behaviors.
Today, Black Americans have a distrust of the medical system due to historical abuses of Black people in the guise of health care, less access to adequate insurance, culturally responsive mental health providers, financial burden, and past history with discrimination in the mental health system. (Columbia)
Generational Trauma
A growing body of research suggests that traumatic experiences can cause profound biological changes in the person experiencing the traumatic event. Cutting edge researchers are also beginning to understand how these physiological changes are genetically encoded and passed down to future generations. (Columbia)
Watch this 5 minute video for some truly amazing insight to generational trauma and what Dr. Joy DeGruy calls Post Traumatic Slave Syndrome.
Stigma
Instead of seeking mental health care, useful strategies including religious coping and methods such as pastoral guidance and prayer often are the most preferred coping mechanism in the Black community. These ideas often lead people to believe that a mental health condition is a personal weakness due to negative stereotypes of instability and attitudes of rejection. Individuals 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. (Columbia)
Due to a reasonable distrust of the medical system stemming from all of the past history discussed earlier, the church was consistently a place to go when there was nowhere else for Black people to seek refuge. Moreover, given that the Black community exists at the intersection of racism, classism, and health inequity, their mental health needs are often exacerbated and mostly unfulfilled. (Columbia)
The Black community, in particular, is at significantly increased risk of developing a mental health issue due to historical, economic, social, political influences that systemically expose the Black community to factors known to be damaging to psychological and physical health. Research consistently shows that these disparities are not a new phenomenon and have been present for generations. (Columbia)
Facts & Figures
25% of African Americans seek mental health care, compared to 40% of whites. (McLean)
The adult Black community is 20% more likely to experience serious mental health problems, such as Major Depressive Disorder or Generalized Anxiety Disorder than their white counterparts. (McLean)
The Black community comprises approximately 40% of the homeless population, 50% of the prison population, and 45% of children in the foster care system. (McLean)
Only 1 in 3 Black Americans who could benefit from mental health treatment receive it. (McLean)
Black individuals are less frequently included in research, which means their experiences with symptoms or treatments are less likely to be taken into consideration. (McLean)
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. (McLean)
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. (McLean)
Black individuals 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. (McLean)
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. (McLean)
Today suicide rates in African American children aged 5-11 years have increased steadily since the 1980s and are now double those of their Caucasian counterparts.
Action Steps
Bring awareness to the use of stigmatizing language around mental illness
Educate family, friends, and colleagues about the unique challenges of mental illness within the Black community
Become aware of our own attitudes and beliefs to reduce implicit bias and negative assumptions
Rescources
Through their partnerships with Therapy for Black Girls, National Queer & Trans Therapists of Color Network, Talkspace and Open Path Collective, Loveland Therapy Fund recipients have access to a comprehensive list of mental health professionals across the country providing high quality, culturally competent services to Black women and girls.
Next week, we continue to talk about the history, trauma and stigma that plagues people of color when it comes to seeking and being adequately treated for mental health concerns. Personally, I’ve been very transparent about my mental health care, and feel like psychotherapy has been a fundamental part to my processing, healing and growing through both personal and generational trauma. I’ll see you next week to talk about Mental Health in the Indigenous Community.
