Our Health Matters: Tackling Mental Health Stigma

By Darius Spearman (africanelements)

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Systemic Solutions for Black Mental Health Equity and Anti-Racism Initiatives

Our community is strong. We’ve faced down so much, yet the fight for our well-being continues, especially when it comes to mental health. Black communities carry a heavy mental health load, made worse by systems that just weren’t built for us. It’s a harsh truth that only about one in three Black adults struggling with mental illness actually get the treatment they need (Mama, I’m Here). This isn’t about individual weakness; it’s about deep-rooted issues like stigma, structural racism, and not enough access to care that understands our culture. Consequently, these challenges keep the disparities going, even as we see more depression, anxiety, and sadly, suicide attempts among our people (Racism as a Social Determinant of Health: A Systematic Review). But there’s hope and action. New efforts are working to change the story around Black mental health. These focus on solutions driven by our communities, teaching about anti-racism, and using our cultural strengths, like our robust spiritual networks, to heal (Tuskegee Legacy Project).

The Heavy Toll: Understanding Racism and Mental Illness

When we look at the numbers, it’s clear that Black adults are more likely to face severe mental health conditions like major depressive disorder—about 20% more likely than our white peers. Each year, about 22.4% of Black folks report having a serious mental illness (Racism as a Social Determinant of Health: A Systematic Review). Our young people are in a growing crisis, too. Between 2008 and 2018, the number of Black teens thinking about suicide went up from 6% to 9.5%. Even more alarmingly, suicide attempts among them jumped by 60% in that same time (Behavioral Health Provider Distribution). To make things worse, Black patients are four times more likely to be misdiagnosed with psychotic disorders, often because of biases held by clinicians (Biological Aging from Stress in Black Americans).

Money worries also play a huge part. Those of us living below the poverty line are three times more likely to deal with severe mental illness (Rural Mental Health Deserts). Constant stress, like the kind that comes from police violence, causes something called “biological weathering.” This means our bodies and minds wear down faster from the chronic stress of systemic racism, leading to things like high blood pressure, anxiety, or a weakened immune system. It can show up as aging too quickly or having too much of the stress hormone cortisol (Biological Aging from Stress in Black Americans). For example, exposure to police violence can mess with cortisol levels in our communities for a long time (Racism as a Social Determinant of Health: A Systematic Review). Even though overall rates of mental illness might be similar or even lower for us compared to white populations, our symptoms often last longer and are more disabling. This is mainly because we often don’t get help until much later (Tuskegee Legacy Project). Ultimately, the relentless pressure of these stressors speeds up mental health decline.

Breaking Walls: Systemic Barriers to Our Mental Health

Systemic racism isn’t just a buzzword; it’s a public health crisis that directly impacts our mental well-being. It shows up in mental health systems through biased clinicians, unequal insurance coverage, and a severe lack of providers in Black neighborhoods (Mama, I’m Here). A 2024 study from Rochester highlighted something stark: premature death rates for Black people were 67% higher, directly linked to how racism limits access to jobs, healthcare, and education (Rural Mental Health Deserts). Moreover, the fear of discrimination itself stops many from seeking help. About 33% of college-educated Black folks say stigma and racism are reasons they avoid care, worried about racial profiling or being unfairly labeled with a psychiatric condition (Tuskegee Legacy Project).

Money is another huge barrier. Uninsured Black adults are 4.7 times more likely to skip mental health care because of costs compared to those who have insurance (Tuskegee Legacy Project). But even having insurance doesn’t solve everything. Only 31% of Black individuals get mental health treatment, while 49% of white individuals do (Persistent Effects of the Tuskegee Study). This gap reflects how clinicians sometimes dismiss our concerns and the reality of “provider deserts”—areas, often where we live, that simply don’t have enough mental health services. These provider deserts mean insufficient clinics, hospitals, or trained professionals are unavailable. Indeed, 18% of counties with mostly Black populations have no mental health providers at all, compared to only 7% of white counties (Health Equity and Geographic Access to Behavioral Health Services). This lack of access is often a direct result of historical underinvestment and practices like redlining in our communities (Redlining and Mental Health Care Access).

Strength and Spirit: New Narratives for Mental Health Stigma in the Black Community

We’ve all heard about the “strong Black woman.” While it sounds like a compliment and connects with our culture, this idea can be dangerous. It often pressures Black women to hide their emotional pain and act like they can handle anything (Persistent Effects of the Tuskegee Study). This expectation to always be strong normalizes suppressing distress, which can delay getting help and make conditions like depression and anxiety worse. In fact, a staggering 76% of Black women say they feel criticized if they try to express their mental health needs, showing how much society expects them to be invulnerable (The “Strong Black Woman” Schema, Depressive Symptoms, and Coping). Such rigid roles increase the risk of depression because Black women often internalize stress instead of reaching out for care (“Mama, I’m Here:” The Strong Black Woman Archetype in Black Women). However, things are starting to change.

A 2023 Healthline Black Mental Health survey showed that attitudes are shifting. For instance, 58% of Black churches are now bringing mental health ministries into their work to help reduce stigma (Redlining and Mental Health Care Access). Grassroots groups like Therapy for Black Girls and the Boris Lawrence Henson Foundation also make a big difference. They’re training providers in cultural humility, helping them understand and respect our experiences. These efforts have led to a 22% increase in Black therapist representation since 2020 (Tuskegee Syphilis Study and Its Legacy).

Additionally, campaigns that use art and storytelling are powerful tools against stigma. Since 2017, This Is My Brave’s theater productions have given over 1,000 Black participants a stage to share their recovery stories publicly (Racial Microaggressions and Mental Health Among Black Women). These initiatives directly counter the deep medical mistrust sown by historical traumas like the Tuskegee experiments. For those who don’t know, the Tuskegee experiments (1932–1972) involved 600 Black men who were infected with syphilis without their consent and were denied treatment, leading to severe illness, death, and a lasting distrust in medical institutions (Tuskegee Syphilis Study and Its Legacy). Instead of focusing on such betrayals, new efforts center on our community’s healing traditions.

Action and Access: Building a Future with Black Therapy Access and Anti-Racism Initiatives

Real change needs action at the systemic level. The 2021 Mental Health Equity Act is a step in this direction. It requires implicit bias training for Medicaid providers, which is crucial when studies show Black patients are 40% less likely to receive evidence-based therapies (Tuskegee Legacy Project). We also need more Black clinicians. Partnerships with Historically Black Colleges and Universities (HBCUs) are expanding the pipeline. For example, Fayetteville State’s psychology program has been graduating 90% Black clinicians annually since 2022 (Redlining and Mental Health Care Access). These efforts are vital for creating a mental healthcare workforce that truly understands and reflects our community.

Technology has also opened some doors. After the pandemic, telehealth became more common, and it helped narrow some access gaps. Black teletherapy use shot up by 189% between 2019 and 2023 (Tuskegee Syphilis Study and Its Legacy). However, challenges like limited broadband internet access in rural areas still exist. Advocates are also pushing hard for Medicaid expansion, especially in Southern states. In these states, 68% of Black residents lack mental health coverage, compared to 42% nationally (Rural Mental Health Deserts).

Furthermore, we need to see more Black voices leading research. Currently, the National Institutes of Health (NIH) allocates only a tiny 1.7% of its funding to mental health studies led by Black researchers (Persistent Effects of the Tuskegee Study). Achieving true mental health justice means taking down structural racism through holding providers accountable, building care models rooted in our communities, and creating policies that understand trauma. Sustainable progress will only happen when we combine anti-racist approaches with real investments in affordable services. This will ensure our community’s historical resilience leads to a future of equitable well-being.

ABOUT THE AUTHOR

Darius Spearman has been a professor of Black Studies at San Diego City College since 2007. He is the author of several books, including Between The Color Lines: A History of African Americans on the California Frontier Through 1890. You can visit Darius online at africanelements.org.