Patrice Harris, MD, a psychiatrist and Everyday Health’s chief health and medical editor, examines the stigma associated with mental illness, mistrust of the healthcare system, and other factors that have prevented Black Americans from receiving appropriate treatment in the past. She also looks at how to make mental health as important as physical health.
Stigma — the negative attitudes, beliefs, and perceptions — surrounding mental health issues is extremely common. “I’ve heard people say that if you have a mental illness, it means you have a character flaw, a moral failing, you are weak in character, or perhaps you didn’t pray hard enough,” says Dr. Harris. “But there is no shame in having a mental illness and no shame in seeking help.”
Mistrust of the medical community by Black Americans is rooted in a history of mistreatment, including 19th century gynecologic operations on enslaved women without the use of anesthesia, the 40-year-long U.S. Public Health Service Syphilis Study at Tuskegee, the extraction and examination of Henrietta Lacks’s cervical cells without her knowledge, and more. But existing socioeconomic and healthcare system inequities also play a role, as does the lack of cultural diversity and competence among clinicians. Trust is a critical component in improving health outcomes. Harris says, “To be trusted, you have to be trustworthy.”
Finding a mental health care professional who’s a good fit can be challenging for anyone, but it’s especially so for Black Americans who want to ensure that they’re working with someone who can identify with their experiences. With so few Black professionals in the field, this can be difficult. Cost can also be a problem whether you have health insurance or not.
Still, Harris insists you can find the right fit in a mental health professional — it may just require a little work. “Talk to or interview several, and make sure they understand your needs. Make sure they are comfortable with addressing any issues regarding race and racism in this country. The key is to ask questions. You may not find the perfect fit or a good fit on your first try. Keep trying.”
Practicing regular self-care helps prevent stress and leads to better physical and mental health. Getting regular exercise, sleeping eight hours a night, and eating a healthy diet are all important for maintaining a sound body and mind.
“Black Americans are more likely to experience persistent feelings of sadness and hopelessness, partly as a result of generational trauma from centuries of racism and systemic oppression,” says Harris. “The question is, what can we do to take care of ourselves? We want to make sure that we prioritize ourselves and we practice self-care.”
Historical narratives of Black women’s strength are prominent within Black culture. The strong Black woman persona can promote a positive perception of unwavering strength and getting things done, but it can also encourage an obligation to put everyone else’s needs above your own and discourage showing vulnerability and practicing self-care, potentially harming your own health. In addition, society’s perceptions and expectations of Black women likely contributes their lower rates of treatment for depression.
“As Black women, we have to take off that mantle of being the strong Black woman and make sure that we participate and prioritize self-care,” Harris says. “We have to make sure that we do all that we can to take care of our physical health, as well as our mental health. And that includes seeking therapy, if you need it, or support from friends and family.”
Close to 700 women die in the United States each year as a result of pregnancy or delivery complications, and Black women are more likely to experience these preventable deaths than white women. “Black women aren’t being heard. Even women with all the resources in the world — Serena Williams, Beyoncé, Allyson Felix — who had issues around pregnancy and childbirth were not listened to,” says Harris. “We need to make sure that women are heard and that their complaints are taken seriously, whether that’s around pain or leg swelling or their depressed mood.”
