African American Mental Health
Mental health conditions do not discriminate based on race, color, gender or identity. Anyone can experience the challenges of mental illness regardless of their background. However, your concerns or experiences and how you understand and cope with these conditions may be different.
Although anyone can develop a mental health problem, African Americans sometimes experience more severe forms of mental health conditions due to unmet needs and other barriers. According to the Health and Human Services Office of Minority Health, African Americans are 10% more likely to experience serious psychological distress.
African Americans, like many minority communities, are also more likely to experience socioeconomic disparities such as exclusion from health, educational, social and economic resources. These disparities may contribute to worse mental health outcomes.
Issues to Consider
Different reasons prevent African Americans from seeking treatment and receiving quality care.
Lack of Information and Misunderstanding about Mental Health
In the African American community, many people misunderstand what a mental health condition is and don’t talk about this topic. This lack of knowledge leads many to believe that a mental health condition is a personal weakness or some sort of punishment from God. African Americans may be reluctant to discuss mental health issues and seek treatment because of the shame and stigma associated with such conditions.
Many African Americans also have trouble recognizing the signs and symptoms of mental health conditions, leading to underestimating the effects and impact of mental health conditions. Some may think of depression as “the blues” or something to snap out of.
Because of the lack of information about mental health issues, it’s not always clear where to find help when you may need it. Fortunately, you came to the right place to learn about what mental health conditions are and how to access treatments and supports.
Faith, Spirituality and Community
In the African American community, family, community and spiritual beliefs tend to be great sources of strength and support. However, research has found that many African Americans rely on faith, family and social communities for emotional support rather than turning to health care professionals, even though medical or therapeutic treatment may be necessary.
Faith and spirituality can help in the recovery process but should not be the only option you pursue. If spirituality is an important part of your life, your spiritual practices can be a strong part of your treatment plan. Your spiritual leaders and faith community can provide support and reduce isolation. Be aware that sometimes faith communities can be a source of distress and stigma if they are misinformed about mental health or do not know how to support families dealing with these conditions.
Do rely on your family, community and faith for support, but you might also need to seek professional help.
Reluctance and Inability to Access Mental Health Services
Approximately 30% of African American adults with mental illness receive treatment each year, compared to the U.S. average of 43%. Here are some reasons why.
- Distrust and misdiagnosis. Historically, African Americans have been and continue to be negatively affected by prejudice and discrimination in the health care system. Misdiagnoses, inadequate treatment and lack of cultural competence by health professionals cause distrust and prevent many African Americans from seeking or staying in treatment.
- Socio-economic factors play a part too and can make treatment options less available. In 2017, 11% of African Americans had no form of health insurance.
Provider Bias and Inequality of Care
Conscious or unconscious bias from providers and lack of cultural competence result in misdiagnosis and poorer quality of care for African Americans.
African Americans, especially women, are more likely to experience and mention physical symptoms related to mental health problems. For example, you may describe bodily aches and pains when talking about depression. A health care provider who is not culturally competent might not recognize these as symptoms of a mental health condition. Additionally, men are more likely to receive a misdiagnosis of schizophrenia when expressing symptoms related to mood disorders or PTSD.
Members of minority communities often experience bias and mistrust in health care settings. This often leads to delays in seeking care. The section below gives ideas on how to find the right provider for you.
Finding the Right Provider
Cultural Competence in Service Delivery
Culture—a person’s beliefs, norms, values and language—plays a key role in every aspect of our lives, including our mental health. Cultural competence is a doctor’s ability to recognize and understand the role culture (yours and the doctor's) plays in treatment and to adapt to this reality to meet your needs. Unfortunately, research has shown lack of cultural competence in mental health care. This results in misdiagnosis and inadequate treatment. African Americans and other multicultural communities tend to receive poorer quality of care.
However, you can improve your odds of getting culturally sensitive care.
While we recommend you go directly to a mental health professional because this is their area of expertise, if you do not feel comfortable right away, a primary care doctor is a great place to start. The primary care doctor might be able to start the assessment to determine if you have a mental health condition or help refer you to a mental health professional.
When meeting with your provider, ask questions to get a sense of their level of cultural sensitivity. Do not feel bad about asking questions. Providers expect and welcome questions from their patients since this helps them better understand you and what is important to you. Your questions give your doctor and health care team important information about you, such as your main health care concerns. Here are some questions you could ask:
- Have you treated other African Americans?
- Have you received training in cultural competence or on African American mental health?
- How do you see our cultural backgrounds influencing our communication and my treatment?
- How do you plan to integrate my beliefs and practices in my treatment?
Your mental health provider will play an important role in your treatment, so make sure you can work with this person and that you communicate well together. Mention your beliefs, values and cultural characteristics. Make sure that she understands them so that they can be considered in the course of your treatment. For example, mention whether you would like your family to be part of your treatment.
If finances are preventing you from finding help, contact a local health or mental health clinic or your local government to see what services you qualify for. You can find contact information online at findtreatment.samhsa.gov or by calling the National Treatment Referral Helpline at 800-662-HELP (4357).
NAMI’s Sharing Hope Program
Sharing Hope is an hour-long program to increase mental health awareness in African American communities by sharing the presenters’ journeys to recovery and exploring signs and symptoms of mental health conditions. The program also highlights how and where to find help.
"Sharing Hope: An African American Guide to Mental Health" provides mental health information in a sensitive manner through personal stories. Recovery is possible, and this booklet tells you where to find more information, seek help and be supportive. You can buy hard copies through the NAMI Bookstore.