What happens at the intersection of mental health and one’s experience as a member of the Black community? While the experience of being Black in America varies tremendously, there are shared cultural factors that play a role in helping define mental health and supporting well-being, resiliency and healing.
Part of this shared cultural experience — family connections, values, expression through spirituality or music, reliance on community and religious networks — are enriching and can be great sources of strength and support.
However, another part of this shared experience is facing racism, discrimination and inequity that can significantly affect a person’s mental health. Being treated or perceived as “less than” because of the color of your skin can be stressful and even traumatizing. Additionally, members of the Black community face structural challenges accessing the care and treatment they need.
According to the Health and Human Services Office of Minority Health, Black adults in the U.S. are more likely than white adults to report persistent symptoms of emotional distress, such as sadness, hopelessness and feeling like everything is an effort. Black adults living below the poverty line are more than twice as likely to report serious psychological distress than those with more financial security.
Despite the needs, only one in three Black adults who need mental health care receive it. According to the American Psychiatric Association’s Mental Health Facts for African Americans guide, they are also:
- Less likely to receive guideline-consistent care
- Less frequently included in research
- More likely to use emergency rooms or primary care (rather than mental health specialists)
Socioeconomic factors can make treatment options less available. In 2018, 11.5% of Black adults in the U.S. had no form of health insurance.
The Black community, like other communities of color, are 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.
Negative attitudes and beliefs towards people who live with mental health conditions is pervasive within the U.S. and can be particularly strong within the Black community. One study showed that 63% of Black people believe that a mental health condition is a sign of personal weakness. As a result, people may experience shame about having a mental illness and worry that they may be discriminated against due to their condition.
For many in the Black community, it can be incredibly challenging to discuss the topic of mental health due to this concern about how they may be perceived by others. This fear could prevent people from seeking mental health care when they really need it.
Additionally, many people choose to seek support from their faith community rather than seeking a medical diagnosis. In many Black communities in the U.S., the church, mosque or other faith institution can play a central role as a meeting place and source of strength.
Faith and spirituality can help in the recovery process and be an important part of a treatment plan. For example, spiritual leaders and faith communities can provide support and reduce isolation. However, they should not be the only option for people whose daily functioning is impaired by mental health symptoms.
In one of NAMI California’s recent reports on diverse communities, we surveyed community members and asked them to weigh in on this statement: “I feel comfortable talking with close friends, family, and community members about mine/my loved one’s health.” 67 percent of those who identified as white answered with “strongly agree” or “agree,” compared with 12.5% of those who identified as African American/Black. These disparate responses indicate serious differences in current experiences of stigma.
Read more about our report on diverse communities.
Provider Bias and Inequality of Care
Black people have historically been negatively affected by prejudice and discrimination in the health care system in the US. And, unfortunately, many Black people still have these negative experiences when they attempt to seek treatment. Provider bias, both conscious and unconscious, and a lack of cultural competency can result in misdiagnosis and inadequate treatment. This ultimately can lead to mistrust of mental health professionals and create a barrier for many to engage in treatment.
Black people may also be more likely to identify and describe physical symptoms related to mental health problems. For example, they 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, Black men are more likely to receive a misdiagnosis of schizophrenia when expressing symptoms related to mood disorders or PTSD.
Support and Treatment
Finding the Right Provider
NAMI suggestions on finding a culturally competent provider:
When a person is experiencing challenges with their mental health, it is essential for them to receive quality care as soon as the symptoms are recognized. It is equally important that the care they receive is provided by culturally competent health care professionals.
While we recommend seeking help from a mental health professional, a primary care professional is also a great place to start. A primary care professional might be able to provide an initial mental health assessment and referral to a mental health professional if needed. Community and faith organizations may also have a list of available mental health providers in your area.
When meeting with a provider, it can be helpful to ask questions to get a sense of their level of cultural awareness. Providers expect and welcome questions from their patients or clients, since this helps them better understand what is important in their treatment. Here are some sample questions:
- Have you treated other Black people or received training in cultural competence for Black mental health? If not, how do you plan to provide me with culturally sensitive, patient-centered care?
- How do you see our cultural backgrounds influencing our communication and my treatment?
- Do you use a different approach in your treatment when working with patients from different cultural backgrounds?
- What is your current understanding of differences in health outcomes for Black patients?
Whether you seek help from a primary care professional or a mental health professional, you should finish your sessions with the health care professional feeling heard and respected. You may want to ask yourself:
- Did my provider communicate effectively with me?
- Is my provider willing to integrate my beliefs, practices, identity and cultural background into my treatment plan?
- Did I feel like I was treated with respect and dignity?
- Do I feel like my provider understands and relates well with me?
The relationship and communication between a person and their mental health provider is a key aspect of treatment. It’s very important for a person to feel that their identity is understood by their provider in order to receive the best possible support and care.
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).
Below, resources from NAMI (Note from NAMI: The resources included here are not endorsed by NAMI, and NAMI is not responsible for the content of or service provided by any of these resources.)
Black Emotional and Mental Health Collective (BEAM)
Group aimed at removing the barriers that Black people experience getting access to or staying connected with emotional health care and healing. They do this through education, training, advocacy and the creative arts.
Black Men Heal
Limited and selective free mental health service opportunities for Black men.
Black Mental Health Alliance
Provides information and resources and a “Find a Therapist” locator to connect with a culturally competent mental health professional.
Black Mental Wellness
Provides access to evidence-based information and resources about mental health and behavioral health topics from a Black perspective, as well as training opportunities for students and professionals.
Black Women’s Health Imperative
Organization advancing health equity and social justice for Black women through policy, advocacy, education, research and leadership development.
Boris Lawrence Henson Foundation
BLHF has launched the COVID-19 Free Virtual Therapy Support Campaign to raise money for mental health services provided by licensed clinicians in our network. Individuals with life-changing stressors and anxiety related to the coronavirus will have the cost for up to five (5) individual sessions defrayed on a first come, first serve basis until all funds are committed or exhausted.
Brother You’re on My Mind
An initiative launched by Omega Psi Phi Fraternity, Inc. and NIMHD to raise awareness of the mental health challenges associated with depression and stress that affect African American men and families. Website offers an online toolkit that provides Omega Psi Phi Fraternity chapters with the materials needed to educate fellow fraternity brothers and community members on depression and stress in African American men.
Ebony’s Mental Health Resources by State
List of black-owned and focused mental health resources by state as compiled by Ebony magazine.
Provides culturally sensitive self-care support and teletherapy for Black men and their families. Currently in pilot program available only to residents of MD, VA and DC. Residents of other states can join their waiting list and will be notified when Hurdle is available in their state.
Melanin and Mental Health
Connects individuals with culturally competent clinicians committed to serving the mental health needs of Black & Latinx/Hispanic communities. Promotes the growth and healing of diverse communities through its website, online directory and events.
Provides information on promoting mental health and developing positive coping mechanisms through a podcast, online magazine and online discussion groups.
POC Online Classroom
Contains readings on the importance of self care, mental health care, and healing for people of color and within activist movements.
Organization that provides mental wellness education, resource connection and community support for Black women.
Therapy for Black Girls
Online space dedicated to encouraging the mental wellness of Black women and girls. Offers listing of mental health professionals across the country who provide high quality, culturally competent services to Black women and girls, an informational podcast and an online support community.
The SIWE Project
Non-profit dedicated to promoting mental health awareness throughout the global Black community.
The Steve Fund
Organization focused on supporting the mental health and emotional well-being of young people of color.
Online community for African American women to seek support.
Stress & Trauma Toolkit for Treating African Americans in a Changing Political and Social Environment (American Psychiatric Association)
Video: NAMI Urban Los Angeles co-founder Nancy Carter discussing her work with Bebe Moore Campbell to bring mental health awareness to the black community, the origins of National Minority Mental Health Awareness Month, and her personal mental health journey as a peer and family member.
Video: Gigi R. Crowder, Executive Director of NAMI Contra Costa, sharing her story as a family member with lived experience advocating for underrepresented communities.
Video: NAMI California member Mykel Gayent sharing his story of mental health recovery as a veteran with bipolar disorder and PTSD.
Video: NAMI California member Jessie Wright sharing her story as a peer and mental health advocate living with bipolar disorder.
Video: Chris Hubbard of the NFL in NAMI’s “Tackling Mental Health Stigma” video
Video: Dr. Thomas Vance on mental health in the Black LGBTQ+ Community
Fighting Racial Injustice in our Communities (Gigi Crowder, NAMI Contra Costa)
Mental Health in the Black Community: Why We Can No Longer Be Silent (BlackDoctor.org)
More on the Subject
NAMI’s Ask the Expert webinar on the Impact of Racism and Trauma on Black Mental Health
Mental Health in the African American Community (Each Mind Matters)
Statistics on Mental Health and African Americans (U.S. Department of Health and Human Services – Office of Minority Health)
African Americans and Latinos are more likely to be at risk for depression than Whites (National Institutes of Health)
Mental Health Research—Diversity Matters (National Institutes of Health)