Mental Health in the African American Community
The need for reshaping and reinvigorating the public conversation on Black mental health could not come a moment sooner. Despite comprising only 12 percent of the United States population, Black people represent more than 25 percent of the nation’s mental health needs. Over the past 30 years, Black male suicide rates have climbed by more than 200 percent. The depression rate among Black women is 50 percent higher than their white counterparts. Rates of somatization — the emergence of physical illness related to mental health — occur at a rate of 15 percent among both Blacks and women, as opposed to 9 percent among Whites.
The rising mental health needs among Black people are further compounded by the continued lack of mental health service utilization within the community. While only one-third of all Americans receive care for mental illness, Blacks remain statistically less likely to access proper mental health services than other racial groups. These numbers suggest that the Black community is in the midst of a full-fledged mental health crisis.
Social misery of African Americans
Although it is necessary to shake the cultural stigmas that enable the current crisis— the view that mental health maintenance is anti-Black, anti-masculine, and anti-Christian— such work must be accompanied by an equally engaged effort to address the structural issues that compromise Black mental health. We must begin to spotlight the connection between mental health and other social problems plaguing the Black community.
We must understand the collective power of social, cultural and institutional forces in producing, intensifying, and concealing the unique mental health issues confronted by Blacks in the United States.
While all racial and ethnic groups suffer from mental health issues, Blacks are a particularly high-risk population due to their over-representation in contexts of social misery. Currently, Blacks account for 40 percent of the country’s homeless population and nearly 50 percent of the prison population. Black children represent nearly 50 percent of all foster care and adoption cases. Additionally, almost 25 percent of Black youth are exposed to enough violence to meet the diagnostic criteria for post-traumatic stress disorder. These conditions not only play a direct role in producing and exacerbating mental illnesses, they also create new levels of social marginalization and isolation that further distance vulnerable populations from the services that they need.
Poverty’s affect on mental health Black mental health is further compromised by economic inequality.economic inequality. While 16 percent of the nation is uninsured, nearly 1 in 4 Blacks live without health insurance, thereby making it difficult to access appropriate mental health services. Blacks with health insurance still have average employer based coverage rates of only 50 percent, compared to 70 percent for their White counterparts. These conditions, combined with the disproportionate absence of living wages within the Black community, make mental health services financially nonviable for many Blacks.
While economically disadvantaged Blacks have access to government-run mental health resources, individuals often have to navigate an extremely bureaucratic and fragmented maze of mental health services. Those who ultimately receive services often do not obtain them through the actual health care system, but through agencies like public schools, welfare offices, and the court system— none of which have the appropriate resources. As a result, many poor Blacks receive uncoordinated, inconsistent, and ineffective levels of care that ultimately discourage them from utilizing the system.
Many of those in prison suffer from mental illness
In addition to poverty, the impact of the prison industrial complex on the current Black mental health crisis cannot be overstated. Beginning with President Reagan’s aggressive efforts to close mental hospitals and cut off federal aid to community mental health programs in the 1980s, the United States has witnessed a dramatic increase in its homeless population. Concurrent with this neo-liberal assault on the welfare state, neo-conservative lawmakers successfully aimed to criminalize ostensibly anti-social behaviors like panhandling, public drinking, and public urination, all of which are routinely linked to mental illness.
As with nearly all criminal justice matters in the United States, arrests, convictions, and sentencing for these offenses are disproportionately assigned to poor Blacks and Latinos.) As a result, many individuals who would have previously been under medical supervision for their mental illnesses (including drug addiction) are now chattel within the for-profit prison industry.
The Department of Justice reports that nearly 16 percent of all prisoners are mentally ill. Also, many states, such as New York, have literally transformed mental health facilities into prisons, as well as devoted billions of dollars to the construction of criminal psychiatric wings within existing prisons. In addition to being fundamentally immoral, the incarceration of the mentally ill is largely ineffective, as federal and state prisons routinely fail to even identify, much less support or treat its mentally ill patients. As a result, many prisoners fail to comply with prison rules and norms, thereby
subjecting them to further punishment, social isolation, and abuse from both authorities and other prisoners. Many ultimately finish their prison sentences and re-enter the world with intensified illnesses due to prison trauma, making them a greater danger to society and themselves.
Historical context of African American mental health
Further complicating the Black mental health crisis is the deep and troubling relationship between Blacks, mental health institutions, and the State. Since slavery, the American scientific establishment has functioned as an ideological apparatus of White supremacy by advancing and normalizing claims of Black moral, physical, and intellectual inferiority. As a result, the last four centuries have witnessed the production of deeply racist beliefs and practices that justify the abuse, exploitation, and institutionalization of “flawed” and “diseased” Black bodies.
Early American studies of mental illness, which have since been soundly dismissed by thescientific community for their methodological biases, suggested Blacks were more biologically inclined toward severe mental illness than Whites. Pseudoscientific terms like drapetomania were developed to classify runaway slaves as mentally insane for “abandoning service.” Scientific reports even falsified 1840 Census data on lunacy rates in the North to suggest that freedom was literally driving Blacks crazy. In the 1960s, terms like “protest psychosis” were developed by psychologists to categorize civil rights activists as insane.
By using mental illness to justify the denial of full humanity, freedom, and citizenship to Blacks, as well as ascribe mental pathology to those who operate against the interests of the White supremacist capitalist State, the American medical establishment has engendered a healthy and persistent distrust among Black communities.
The relationship between Blacks and mental health institutions is further undermined by contemporary acts of intended and unintended structural racism. In 2010, Blacks continue to be misdiagnosed with schizophrenia— a condition that has become increasingly imbued with violent and dehumanizing connotations since it became a “Black disease” in the middle of the 20th century— more than other affective disorders. In response, Blacks receive anti-depressant medication at a rate of 27 percent as opposed to 44 percent of Whites. When receiving the same medication, Blacks are statistically more likely to receive versions with more dangerous side effects. In addition, American mental health workers (only 4 percent of whom are Black) regularly ignore the role of racism, white supremacy, and the structural effects of poverty on the mental health of Black people.
Over the past four centuries, Blacks have fought to end economic exploitation and access to quality schools, jobs, and housing. As we continue to advance our struggle for full citizenship, we must also recognize the relationship between freedom and mental health. By examining the ways that mental health has been weaponized against Black communities by the State, we are able to develop a more informed and insightful analysis of social injustice. By understanding the social barriers to quality mental health, we are better equipped to effectively fight for justice and equality. Most importantly, by re-imagining mental health as both a human necessity and a right of citizenship, we can begin our journey toward building the type society, communities, and individuals that we desperately needy.
Source: Marc Lamont Hill is Associate Professor of Education at Columbia University.