Ask the Doctor: The Crossroads between Race and Mental Health

Carmen McIntyreQuestion: I’m a person of color, but I’m afraid of getting help because of how my people have been treated historically. How can I know that it’s safe for me to get the help I need?
What a powerful question. The crossroads between race and mental health are incredibly relevant topics in America. At least one in four people will experience a mental illness in their life, but less than half will seek treatment, because of the stigma against mental illness.
This stigma is far worse in many communities of color. Admitting to a mental illness is often seen as a personal weakness, or a source of shame for the family. But would anyone ever say that a person having difficulty breathing due to lung cancer is weak? Should the family of a person who died from that lung cancer feel ashamed? No to both. So why should anyone say that someone with symptoms of depression, bipolar disorder or schizophrenia is weak? Why should anyone be ashamed when a loved one dies from suicide?
What makes the problem worse is that many communities of color are at greater risk for mental illness. A history of adversity, including slavery and racism, resulted in ongoing exclusion from social services. These have included health, educational, and economic opportunities, keeping African Americans poorer, in general. Poverty increases the likelihood of incarceration, substance abuse, and homelessness, which increase the risk for mental illness.
Another example of the need for cultural education is the Muslim and Arab American communities. Post 9/11 ostracism, prejudice and fear of this community have swelled to outright violence and threats of exclusion from America, particularly in the current political season. Republican presidential candidate Donald Trump has given a very public voice to this Islamophobia, practically normalizing it. Similarly, Trump’s anti-Mexican rhetoric has increased bullying and violence against Hispanic people. This applies to people of color whether or not they are legal citizens.
It is easy to understand how this environment increases stress in communities of color. Mixed signals of welcoming and dismissing diversity creates a chaotic experience. With the highly publicized injustices against people of color, it is easy to understandscreen-shot-2016-10-21-at-5-52-00-pm that these communities would feel that their lives don’t matter. Combine this with the general stigma against people with mental illness, and you get a person of color suffering in silence.
The Centers for Disease Control published in 2015 that suicides among black children doubled between 1993 and 2013. This is no coincidence. With the rise in Internet use and the dip in the economy, young people are more aware of income inequality in America. Depression is claiming more lives than ever before. Even though it’s too late for some, there is still hope for change as a community.
Education to American communities of color is vital. I hope that one day it will be just as acceptable to discuss depression as it is cancer. Recovery from mental illness is possible, and the shame often does more harm than good. For that to work, training must include an awareness of how to access treatment. Faith communities, schools, job sites must be on the same page. Ideally, everyone would understand mental illness, warning signs, and how to respectfully refer people to treatment.
Finally, the mental health professionals must deliver culturally competent care. Treatment and prevention services must be available from people who look like the person in need, in the language that they prefer. For people for whom faith and spirituality are an important component of their life, professional services must be delivered by persons who are familiar with the ways in which spirituality impacts their life, incorporating these elements into the treatment plan.
Regardless of your culture, I encourage you to seek help if you are struggling with symptoms of mental illness. Decide what is important for you in a mental health professional. Gender, age, language, and office location can all impact quality of care. Talk to people in your community, including your place of worship, school, work, family, or friends on social media to find out if there are professionals they have had good results with. And if you don’t feel the fit is there, talk directly to the professional. They are responsible for steering you toward someone who will better suit your needs. In addition, telling that person what made you uncomfortable could help them improve their practice in the future.
Dr. Carmen McIntyre is the Chief Medical Officer at Detroit Wayne Mental Health Authority. If you have a question for Dr. McIntyre, please submit it to AskTheDr@dwmha.comAs always, if you need help, call (800) 241-4949.

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