Anti-Black racism affects various aspects of society, including the health care system. In mental health care, this form of discrimination can significantly affect the quality of care that Black people receive.
This article explores anti-Black racism and mental health care, its effects on mental health, and strategies to promote more equity and inclusivity in mental health services.
Anti-Black racism refers to a system of racial prejudice, discrimination, and inequity that specifically disadvantages Black people.
This type of racism is rooted in a history of slavery, colonialism, pseudoscience, and segregation that continues to promote injustice in modern society.
Anti-Black racism
Interpersonal racism
This refers to racist behavior that occurs between individuals. Microaggressions are common examples.
Microaggressions are smaller acts of discrimination that, cumulatively, can have a significant impact. They often occur in the form of offhand comments or behaviors that reinforce negative stereotypes about Black people.
Examples of microaggressions include:
- touching a Black person’s body or hair without asking
- talking to a Black person as though they are less intelligent
- assuming Black people have less money than others
Institutional racism
This refers to policies and practices established in institutions that exclude or disadvantage certain racial groups.
Institutional racism may affect various areas such as education, employment, healthcare, and criminal justice, leading to disparities in opportunities and outcomes for Black people.
Structural racism
Due to the segregation and underfunding of diverse neighborhoods, people living in these areas are
This does not occur by choice. These are examples of structural racism, where the structures of a society disadvantage one group while advantaging another.
Anti-Black racism can affect the mental health of Black people in many ways, including:
Chronic stress
A
Black people often anticipate and cope with racism in various aspects of life, such as employment, education, and daily interactions.
This ongoing stress can alter physiological processes and has associations with higher rates of other conditions, such as hypertension and cardiovascular disease.
Low self-esteem
Experiencing racism, whether through direct discrimination or societal bias, can significantly affect self-esteem.
Black people may internalize negative stereotypes,
This internalization of negative messages can limit personal and professional growth. Low self-esteem is also associated with mental health conditions, such as depression.
Depression
A
Exposure to discrimination, social exclusion, or economic disparities may lead to a pervasive sense of hopelessness and despair. The effects may compound when a person belongs to more than one oppressed group.
Anxiety
The fear of facing racism in daily interactions can increase anxiety.
According to a
Anxiety may affect daily functioning, including work performance and social relationships.
Post-traumatic stress disorder (PTSD)
According to Mental Health America (MHA), experiencing trauma directly or having traumatic feelings because of others experiencing racist trauma can lead to symptoms similar to PTSD. People refer to this as racial trauma.
These symptoms may include:
- anxiety
- anger
- low self-esteem
- intrusive thoughts about the traumatic events
- hypervigilance
A
This can not only increase fear, vigilance, and prior trauma reactivation but also decrease trust in social institutions.
Unhelpful coping mechanisms
Persistent racism can undermine a person’s ability to cope with their emotions, potentially leading them to rely on
A 2023 study linked systemic racism to higher rates of alcohol and drug use, limiting the ability to seek and receive appropriate management.
Read more about the link between racism and mental health.
Anti-Black racism reduces the quality of mental health care in many ways.
Misdiagnosis
Discrimination and stereotyping can lead to Black people receiving the wrong diagnosis. If healthcare professionals perceive Black people as more aggressive, more dangerous, or less rational than white people, this may lead them to misinterpret their symptoms.
A
Lack of cultural competence
Cultural competence is the ability to understand and communicate effectively with people of different cultural backgrounds and beliefs. It is an important skill for mental health professionals, who may treat a diverse group of people.
However, a shortage of culturally competent professionals can result in ineffective mental health care for Black people. Professionals who are not culturally aware may misinterpret symptoms or fail to understand the context of a person’s experiences.
This lack of understanding may lead to inappropriate treatment that does not address the specific needs of Black clients.
Limited access to care
A
- economic disparities
- lack of health insurance
- limited mental health care services in their area
These barriers can make it difficult for many Black people to afford therapy or out-of-pocket expenses for mental health services.
Stigma and mistrust
Historical and ongoing mistreatment has contributed to many Black people having a profound mistrust of the healthcare system.
This includes the legacy of unethical medical practices, such as the Tuskegee Syphilis Study, that has left a lasting negative impact on Black people, their communities, and their perception of the healthcare system.
This mistrust, along with the mental health stigma, often prevents Black people from seeking mental health care, according to the American Psychiatric Association (APA).
Therapists can take several steps to make their practice actively anti-racist. Steps
- Learning: Engaging in continuous education to understand and address the unique needs of Black people. This could include becoming more culturally competent, learning about the social determinants of health, and learning the different ways racism can manifest.
- Self-examination: Reflecting on implicit biases and how they may affect therapeutic relationships and outcomes can help in developing an objective approach to discussions and treatment plans.
- Inclusive practice: Ensuring the practice environment is welcoming and affirming for Black people. Taking time to learn about each client’s unique background, culture, and religious beliefs is important.
- Open discussion: Learning about and discussing the effects of racism on mental health if or when it is relevant and how to cope with these effects provides mental health professionals with tools and resources to support their clients.
- Advocacy: Advocating for systemic changes within their institutions and professional organizations helps promote equity and inclusion.
Finding anti-racist mental health care can be challenging, but resources are available to help. Examples include:
- Directories and databases: Consider using directories such as Therapy for Black Girls and the National Queer and Trans Therapists of Color Network to find culturally competent therapists. These platforms offer listings of therapists committed to providing inclusive care. Other helpful directories include Therapy for Black Men and Inclusive Therapists.
- Organizations: Organizations like the Black Mental Health Alliance provide resources and support for finding appropriate mental health care services. They also offer educational materials, community programs, and referrals to trusted mental health professionals. The Black Emotional and Mental Health Collective is another valuable resource for support and information.
- Community recommendations: Seeking recommendations from community groups, social networks, and trusted friends or family members can also help identify therapists known for their anti-racist practices.
Systemic changes are necessary to make mental health care more equitable. These changes may include:
Increasing diversity among therapists
Encourage and support more Black people to enter the mental health profession. Scholarships, mentorship programs, and supportive educational environments are several ways to provide support.
Policy changes
Advocate for policies that address socioeconomic barriers and promote equitable access to mental health care services.
Policies should focus on reducing healthcare costs, expanding health insurance coverage, and increasing funding for mental health services in underserved communities.
Cultural competence training
Implement cultural competence training for all mental health professionals to improve the quality of care for Black patients.
This training should be part of professional licensing requirements and continuing education programs.
Community engagement
Engage with Black people to understand their needs and build trust. This may involve partnering with community leaders, holding meetings, and creating forums for open dialogue to help ensure mental health services are responsive, inclusive, and accessible.
Data collection and research
Improve data collection on mental health disparities to inform policy and practice. Conducting research that focuses on the mental health needs of Black people and using this data is vital in developing targeted interventions and tracking progress in reducing disparities.
Anti-Black racism in mental health care leads to disparities in treatment and outcomes for Black people. Biases and lack of cultural competence can lead to misdiagnosis and ineffective treatments, while economic barriers limit access to care.
Therapists can improve support through cultural competence training and creating safe spaces, while systemic changes are necessary for overall equitable mental health care.