Approximately 7 million African Americans experience mental illness in a given year, according to Mental Health America, but only a small fraction get adequate treatment. Psychiatry.org notes just one-third of African American adults requiring mental healthcare receive care.
For white American adults, that number is closer to one in two. African Americans face a variety of structural barriers to appropriate care, including racism and stigma. Those who do manage to seek treatment are often met with culturally incompetent practitioners: a pattern that must change if the mental healthcare community is ever to be a viable resource for African Americans.
Why cultural competency
Cultural competency requires medical practitioners to approach care for patients with sensitivity to factors that affect their experiences and values, including race, social class, and history of discrimination. The numerous obstacles African Americans face before even reaching the point of interaction with mental health practitioners only magnifies its importance –– as discussed in a piece on the African American experience in mental healthcare from Counseling@NYU.
Culturally, for African Americans, seeking treatment for mental health issues can be seen as
an admittance of weakness or can potentially contribute to negative stereotypes. Stigma discourages African Americans from seeking mental healthcare as a routine self-care practice. Resistance to care and distrust of practitioners is also the logical byproduct of a long history of discrimination and abuse against African Americans by the medical community.
These barriers make it all the more distressing that African American people who do seek treatment often cross paths with racist or ignorant practitioners. Many report experiencing discrimination and microaggressions by therapists. Culturally incompetent practitioners drastically reduce the effectiveness of treatment and discourage African Americans from continuing to seek care.
What needs to be done
An intervention in cultural competency is critical in an American healthcare system designed for white people, and for the most part, carried out by them. As Norissa Williams, clinical assistant professor for the online master’s in mental health counseling program, points out, prognosis criteria designed for white people can lead to misdiagnosis in people of color.
The article cites, for example, the fact that an African American man might experience anger as a symptom of depression because of societal stigma against showing sadness, even though the same disorder would present itself differently in a white man.
Some have suggested an increased representation of African Americans on the practitioner side as a solution. While this is undoubtedly a step in the right direction for better quality of mental healthcare for people of color, African Americans are vastly underrepresented in mental healthcare professions. Failing to address cultural competency among white practitioners while devoting efforts to increasing African American representation in the field will not solve the issue.
How change can occur
According to the Georgetown University Health Policy Institute, adjusting accreditation standards to require more fluency in cultural competency can lead to improved care among practitioners. Other recommendations include
training in cultural awareness and skills, communicating with community health leaders, and including community members in decisions affecting their healthcare options.
The institute points out that training in practices of specific groups (i.e. “Latinos” or “Asian Americans” or “African Americans”) can lead to increased stereotyping, as people within these groups can have extremely varied values, socioeconomic status, and experiences. While it’s important to be aware of the way structural oppression can affect members of marginalized groups, it’s also vital for practitioners to be well-versed in empathy and listening skills to take in and connect to individual patients and adjust care to each person’s circumstances.
Those in positions of leadership in the mental healthcare community must acknowledge that the experiences of African Americans in America vary greatly from those of white people. Mental Health America points out that a long history of oppression against African Americans can contribute to factors that increase the likelihood of mental illness, such as low socioeconomic status and the trauma of experiencing racism and microaggressions.
Practitioners must take responsibility for the continued barriers African Americans face when attempting to manage mental illness and improve their cultural competency so all Americans requiring care have the opportunity to get healthy.
Alexis Anderson is a digital PR coordinator covering K-12 education at 2U Inc. Alexis supports outreach for school counseling, teaching, mental health, and occupational therapy programs.
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