Although things are changing within mental health communities, only a few mental health professionals have competent awareness of cultural and racial identity, let alone incorporate this awareness in clinical treatment.
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July is BIPOC Mental Health Month, a month that recognizes the mental health experiences and struggles unique to Black, Indigenous, and people of color in North America. Not many people know of this month, but whenever we hear about it, we typically read about the numbers on how many of us are experiencing mental illness and distress, the disparities within these numbers, how many of us are getting professional help, and how many are not. These reports aren’t inherently bad, but what doesn’t get discussed as often are the causes as to why mental illness and distress exist in the first place. The stats are over-reported, but the causes and contexts are under-reported. I suspect that this might be a way to exempt the system at large from being responsible for maintaining a capitalist and racist status quo, which consequently causes cumulative stress. By leaving these systemic causes unmentioned, it becomes easy to blame the patient of color for being sick and for staying sick—a form of racial gaslighting in clinical contexts. Whatever the agenda behind these reports (or the attempts to under-report), it has to be clear, at least here, that the causes for mental and emotional distress are systemic and societal for Black, Indigenous, and people of color.
A widely known reason why it is more challenging for BIPOC to access mental health services is racial poverty. Black and Indigenous communities have the highest poverty rates in the U.S., with Black Americans at 19.5% and Native Americans at 25.4% as of 2018 (the U.S. Census Bureau data on poverty for 2019–2020 does not show Native Americans or Alaska Natives as a category for a racial group; more information here). Latinx communities’ poverty rate has increased to 17% since 2020, and Asian communities’ to 8.1%. Therapy is expensive, and with the reality of racial inequity, the majority of racialized communities likely cannot afford it—or their insurance cannot adequately cover these sustained services.
Another reason why racialized communities do not pursue mental health services is our common suspicions toward therapy. For some of us, there is a historical stigma ingrained when it comes to the topic of mental illness. Years ago, when I talked with my family about the potential need for therapy due to depression and anxiety, they responded by labeling it as “a White people issue” or “First World problems.” They even went as far as indicating that my depressive episodes were a sign I wasn’t grateful enough for my family’s sacrifices and generosity, that I would still need extra help to get by in life. Other racialized families also have concerns around “family business,” where there’s an expectation to want to keep—or hide—issues of the family within the family. Looking back at it now, I know my feelings were invalidated, but in a way, I can see their point. It is hard for BIPOC to entrust their mental health struggles to an institution that is largely run by White people.
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