Since February 1st, 1976, the United States has recognized Black History Month, which celebrates the African American community and their significant historical contributions and achievements on a national level. As we commemorate this historical date in our present-day, figures like Rosa Parks, Maya Angelou, and Martin Luther King Jr. might come to mind. We may reflect upon the civil rights movement and our vast progress towards achieving a society of equal opportunity.
In light of recent events, namely the landmark protests for Black Lives Matter and the political unrest in 2020, a noticeable change was seen in how we converse about racial disparities. For many, these events brought conversations about racial inequality and systemic racism to the forefront. One particular conversation worth having is about racial disparities in public health care, specifically in regards to mental health. From a historical context, communities of color have either received inadequate treatment when it comes to mental health or are unable to receive treatment altogether. In present times, these same communities face similar challenges.
Today, historical dehumanization, oppression and violence against Black people has evolved into present day institutional marginalization propagated by a myriad of disparities, including inadequate access to and delivery of care in the health system. The differences in healthcare between communities of color and white populations are so deeply embedded that most fail to recognize that an issue exists. For example, something as small as noticing that the vast majority of medical textbooks show illustrations of white bodies is telling of the unequal representation. While this may not seem to be a significant disparity, consider how the lack of inclusion can influence how a dermatologist fresh from medical school would diagnose a skin rash on a Black person having never seen an illustration of how that rash may appear on a darker complexion. Now consider how many medical students are currently studying from books that do not accurately reflect the variations in demographics in populations.
When it comes to mental health, we are faced with similar challenges. There is considerable data emphasizing the fact that communities of color are:
- Less likely to have access to mental health services.
- Less likely to seek out services.
- Less likely to receive needed care.
- More likely to receive poor quality of care.
- More likely to end services prematurely.
Statistically, Black populations are one of the demographics least likely to engage in mental health services. This is partly due to intergenerational trauma and a historical mistrust of the medical community that has led to communities prioritizing pastoral guidance and religion over more traditional mental health services like counseling and medication. A lack of understanding and awareness regarding mental health, a noticeable lack in cultural awareness in mental healthcare providers, socioeconomic & cultural barriers and a demoralizing but persistent stigma that struggling with mental health concerns is somehow attributed with poor or weak personal choices are just a few of the obstacles that prevent those in need from obtaining mental health care or addressing mental health concerns.
As such, in keeping with the current trend of having “courageous conversation,” this pandemic has shed light on the need for widespread and quality mental health resources amongst the historically marginalized and ostracized communities of color. Unfortunately, not only do they experience stigma and marginalization related to their mental illness within the community, but also bias and discrimination related to race and class outside of their community as well.
Further compounding the pandemic stressors are the well-publicized and distressing incidents of police brutality that have sparked national protests and a collective outcry against racism and inequality. Anxiety and depression related to loss and coping with pandemic-related stress has increased in all demographics in America and communities of color were not spared. Considering how difficult and challenging this past year was for everyone, but specifically for communities of color, there is no better time to open dialogue to help begin dismantling the harmful stereotypes regarding mental health within the BIPOC community.
This leaves us with a resounding thought for Black History Month: What can we do and how? For change to happen on a large scale, it must start by acknowledging the issue. Discriminatory and exploitative behavior from the medical establishment toward Black Americans throughout American history has led to an understandable distrust among Black communities. Recent studies show that even now, a startling number of physicians still believe the dangerous and false myth that Black women are more resilient to pain, leading them to be less likely than white women to receive pain management medication.
Finally, as we anticipate the widespread distribution of the available Covid-19 vaccines, it is of utmost importance that we work to protect our most vulnerable communities and to combat the biases and archaic structures in place that are limiting care available to these individuals. We must acknowledge the current disparities in our health care system and engage in a sustained societal effort to increase empathy, awareness and availability.