Mental health and mental illness is not a topic easily broached in communities of color, and from my experience, in Black families. Black women are expected to be strong, Black men are supposed to be hyper-masculine and tough. Struggling with mental illness is treated as a form of weakness that does not fit these expectations; a source of shame and secrecy rather than a real issue of health that needs to be addressed. Furthermore, mental illness, when experienced by POC, is systemically criminalized rather than treated. Just these two factors alone makes mental health and living with mental illness a particularly isolating and dangerous experience for POC in the USA. The fact is being a person of color in the USA is not good for one’s mental health.
When you are a person of color, when you are poor (separate factors, but both present barriers and intersect disproportionately) you do not have the kind of access to sensitive and adequate mental health care services available to those with white or socioeconomic privilege. Counseling, and for POC in particular, counseling by someone who looks like, can relate to you and does not hold implicit biases and assume stereotypes about you, is difficult to find and, if it does exist, it’s something many cannot afford. Just the fact of not being able to find someone of a similar race or culture to approach regarding mental health means POC are more likely to have a greater empathy gap to overcome when dealing with counselors.
Many POC with mental health issues that can benefit from counseling, whether it’s a diagnosable illness or coping with particularly difficult life circumstances or some combination of these, generally have to do without mental health services. People of color dealing with depression, PTSD, generalized anxiety, chronic stress, problems with regulating their moods or psychological state, regularly remain undiagnosed and without the services that can improve their quality of life because of a combination of societal stigma and structural racism.
This leaves too many people dealing with serious mental health situations alone and without necessary support. People find ways to deal with it on their own. Spirituality, music and art with their cathartic qualities, tobacco, alcohol and other types of drug use are all ways people deal with their psychological distress. Sometimes these are enough, but some other times they don’t quite cut it and people need something more if their lives and wellness are not to spiral out of control trying to cope with these very real mental health issues.
The criminalization of POC, the disproportionate incarceration of Black people and POC for drug use and drug related crime despite no evidence of any difference in drug use by Black people compared to white people exacerbates the problem. It has been clear for years that drug use is a public health issue and should be treated as such. People with white privilege and money get “treatment” and “rehab” and get to “recover” – all health terminology. When it comes to people of color and poor people, drug use stops being a health issue and is treated instead as a crime. This systemic double standard ignores the well understood facts that drugs are often used as self-medication for mental illness or as a coping mechanism for people dealing with stressful personal and social conditions (like structural racism).
The double standards related to drug abuse is just a blatant example of the structural racism that makes mental health for POC a particular challenge. There needs to be both structural and cultural changes in how mental illness, with or without drug use, and mental health for POC are treated. One structural change of course would require changing the outlook on substance use (which includes tobacco and alcohol, as well as controlled drugs) as a public health issue (for POC as well as anyone else) rather than a criminal offense. The wider society also needs to recognize the importance of mental health and the necessity of providing affordable, diverse, widely available and culturally sensitive mental health services. Other structural changes will include the overhaul which would be required in all systems to eliminate the effects of structural racism because all of it affects mental health directly and indirectly.
In addition to the structural overhaul, there needs to be a cultural overhaul. We need to start thinking in terms of mental health as opposed to mental illness. How can we make the environment healthier, how can we make a nurturing environment that alleviates and not worsens mental illness? No one starts with a clean slate – how can we create an environment for people with all their psychological differences, diagnoses or reactions to have a positive quality of life? I can’t answer this question. One one thing that is important, though, is that POC (and everyone else) need to remove the stigma and start acknowledging mental health as a real and tangible aspect of Health. The same seriousness and understanding (or at least attempts of understanding) provided for someone experiencing Diabetes or Hypertension or Kidney disease needs to be provided for those with mental health concerns. The mind and body are not separate. The physical and mental interact. Many people with diabetes also deal with depression. Both the physical and psychological disruptions need to be addressed in order for the person to have a healthy quality of life.
Mental health does not just affect the individual, it affects families, relationships, society. This is why we as a society need to do more to safeguard the mental health of the most vulnerable. Health justice is an important part of social justice. There are many ways POC can, and need to, do self-care to protect our own mental health, but it is a constant uphill battle in a society that actively transgresses against the mental health of its members. Many people are taking up healthier lifestyles, learning more about healthy foods, trying to live longer, but being healthier does not occur in isolation. If we want to be healthier, we need to take an active part in working toward social justice. It is all connected and there is a lot of healing that needs to take place before society, of which you are a member (so by extension – you), can truly be healthy.
© 2015 Kelene Blake, All Rights Reserved