Did you know Martin Luther King suffered bouts of severe depression throughout his life? Probably not. That’s because King didn’t speak out about his mental illness, and even refused to seek treatment. Back then, there was much more stigma around mental illness than there is today. But even now, over fifty years after King’s death, many African Americans still don’t get the mental health care they need. In fact, only a third of African Americans who need treatment actually get it.
So while we celebrate Martin Luther King’s civil rights legacy today, it’s important to remember that we’ve got a long way to go before his dream of equality is really achieved. And mental health care is one of many places where African Americans are still losing out.
Mental Health in African American Communities
Mental illness affects African Americans at roughly the same rate as every other population in the US. However, the lasting legacy of slavery and systemic discrimination leads to African Americans experiencing more risk factors for mental illness than white communities. African Americans are at greater risk of poverty, homelessness, incarceration, violent crime, and substance abuse – all of which are linked to poorer mental health.
In honor of Martin Luther King Day, we dug into four key reasons why so few black people are getting the mental health care they need – and what can be done to change things.
1. Lack of understanding of mental illness
In lots of African American communities, mental illness still isn’t well-understood or talked about. This means people often don’t recognize symptoms of depression, anxiety, PTSD, or other mental illnesses in themselves or their friends and family. People use common phrases like “having the blues,” and feeling “down” or “stressed” – phrases that can hide how much they’re really struggling with mental illness.
Cultural norms lead people to keep quiet about their struggles to protect their reputation and their families’ reputation. Talking openly about mental health problems just isn’t as common in African American communities. And that lack of conversation means a poorer understanding of symptoms, treatment options, and the reality that anyone can experience mental illness.
2. The stigma around mental illness
There’s still a lot of stigma around mental health in African American communities. Like in many communities, having a mental illness can be seen as being “weak” or “unable to cope.” People – especially young black men – are often encouraged to “man up” and tough it out, rather than sharing how they feel and asking for help.
But the truth is that mental illness affects African Americans at the same rate as other groups. And breaking down the stigma around mental health is vital for black communities to get the healthcare they deserve. Luckily, things are starting to change. Jay-Z has spoken out about how therapy changed his life for the better and called out the “ridiculous” stigma around mental illness in black communities
3. Unequal access to healthcare
Despite the links between poverty, oppression, and mental health issues, entrenched injustices in the US healthcare system mean that many African Americans don’t have access to adequate healthcare, full stop. Lack of infrastructure, funding, and staff means that some communities lack the facilities needed to assess and treat mental health conditions.
And because of historical bias, many African American’s don’t trust the (majority-white) healthcare system to have their best interests in mind. Their experience of prejudice, discrimination, and inadequate care means they are less likely to seek medical treatment, including for mental health issues.
On top of everything, it’s estimated that about 16% of African Americans don’t have health insurance – which means even if they can access mental health treatment, they have no way to pay for it.
4. Lack of cultural competence in healthcare
Only about 2% of mental health providers in the US are black. And only some others are trained in cultural competence for treating African American patients. There are lots of cultural differences that affect how we experience mental illness and how we approach treatment. For example, African Americans tend to focus on physical symptoms of depression than white patients don’t mention as often.
For a doctor to provide adequate treatment to everyone, regardless of race, gender, or class, they need the cultural competence to understand these differences. Unfortunately, that often isn’t the case. And that lack of cultural competence can lead to misdiagnoses, insufficient treatment, and more negative experiences with healthcare. In fact, African Americans are less likely to be offered medication or therapy than white patients with the same illness.
Continuing the fight for equality in mental health
Overcoming entrenched bias in the healthcare system and changing cultural norms around mental health will take time. But changes are coming, thanks to recognition within both African American communities, and the healthcare system, that more needs to be done. Young black men and women are speaking out about their experiences of mental illness. And mental healthcare providers are offering more cultural competency training to tackle inadequate care.
On Martin Luther King Day, let’s remember how far we’ve come. But let’s recognize how far we have to go to redress the systemic injustices that African Americans still experience to this day – especially when it comes to their mental health.