During the Civil Rights Movement, white psychologists invented a so-called mental illness. Dubbing it “protest psychosis,” these psychologists used the racially-motivated “syndrome” to explain away the reasonable rage of black Americans demanding an end to segregation.
Sixty years later, racial disparities in the mental health care system remain, including lack of access to mental health services for communities of color, inadequate addressal of the real psychological trauma caused by racism, and racially-motivated diagnoses like the now-scrapped “protest psychosis.”
But that doesn’t have to be the case. Increasingly, anti-racist advocates in the mental health community are encouraging us all to recognize mental health as a racial justice issue.
Racism Is a Mental Health Issue
As a consequence of systemic racism, people of color in the United States, and particularly black people, suffer higher rates of mental illness than white Americans.
Trauma due to racism causes a near-constant sense of insecurity for many people of color, which leads to physical stress and increased risk of depression and anxiety. People of color as a whole are also 10% more likely, and black people are 20% more likely, than white people to report serious psychological distress. The very anticipation of racism can have deleterious physical and emotional health effects, and this stress builds up over time.
Witnessing or being a victim of racial trauma can cause post-traumatic stress disorder, particularly prevalent in the current political climate. Following the shooting of Michael Brown, one study found that 34% percent of the Ferguson, Missouri, community, and 14% of police officers, demonstrated symptoms fitting the definition of PTSD.
Racism further compounds with poverty to put people of color, disproportionately low-income, at added risk.
But Racism Is Also a Part of the Mental Healthcare System
While mental healthcare should be a right for everyone, it’s difficult to access for most Americans — and systemic racism makes this even more challenging for people of color.
Two-thirds of Americans of all races with depression don’t get treatment, and black people are even less likely to receive appropriate care. As a result of this structural inequality, many people of color suffering from mental illness, and particularly black Americans, are more likely to be sent to jail than to access adequate care.
More than half of all counties in the United States lack a certified mental health worker to begin with, and even those communities that do have therapy services often lack options for low-income residents. Many low-income people and especially people of color lack health insurance, but even if they do have it, many therapists don’t accept insurance at all — and people of color are disproportionately unable to pay steep out-of-pocket costs.
And finding a therapist who accepts insurance is no guarantee of receiving quality care. In one study, researchers found that therapists discriminated against potential clients presenting as low-income and black, even if they had insurance.
Finally, as the story of “protest psychosis” demonstrates, psychology has a racist history of treating people of color as illogical or disordered, rather than understanding that experiences of racism are a form of trauma. Anger at a racist system makes sense. For example, racially discriminatory judgements cause providers to diagnose black men with schizophrenia four to five times more often than the general population.
These systemic problems lead many people of color to be understandably reluctant to seek mental healthcare and deprive people of color of their right to treatment.
Activists Are Taking Action
From community-level campaigns to provider training, mental health advocates are confronting racism. Their efforts are vital reading whether you’re a person of color seeking care, a provider, or an ally.
From campaigns to destigmatize mental illness in communities of color, like Dior Vargas’s “POC and Mental Illness Photo Project” to resources like the “Brother, You’re on My Mind” toolkit for leading conversations about depression among black men, community advocates are sparking dialogue on mental health. Numerous organizations also offer actionable tips for people of color seeking mental healthcare and resources for accessing culturally-sensitive care.
Training Medical Providers
In 2001, the American Psychological Association released a statement against racism. This stance reflects a broader shift in the field, with professional associations and providers increasingly emphasizing culturally competent care, meaning that mental healthcare providers should be sensitive to clients’ cultural backgrounds, gender and sexualities, and experiences of oppression. At a governmental level, the federal Office of Behavioral Health Equity has begun to address the lack of people of color in the mental health field through campaigns and fellowships to train psychologists of color.
Achieving truly equitable, anti-racist mental healthcare is a long-term process since it means fighting racism and poverty on a society-wide level. But technological interventions can help increase access within the current healthcare system. Therapy apps and online therapy, for example, can both provide more affordable care and can cut down on therapists’ rejection of clients for racially discriminatory reasons.
Everyone Has a Right to Mental Health
The mental health system shares our society’s wider history of racism, with an ugly legacy of treating people of color as disordered rather than acknowledging their real experiences of trauma and oppression. But alongside the tireless efforts of advocates, we can work toward a mental healthcare system that delivers on the promise of health and healing from systemic racism.