At one point in time, there were at least three subjects that were considered inappropriate to talk about, at least in public: religion, sex (encompassing gender, gender identity, and orientation), and politics. In today’s evolving society, those conversational restrictions have become less and less prevalent as all three branches of the U.S. government attempt to adequately address those topics publicly on a regular basis. However, there still seems to be at least one topic that remains just as taboo now as it was before, and that topic is mental health and illness.
In October 2016, Chicago-born rapper Kid Cudi announced that he was checking himself into a mental health facility, and from this public exposure of his personal mental health issues, the hashtag #YouGoodMan? began to trend on social media. #YouGoodMan? was used to bring awareness to mental health among Black men and provided a platform that promoted honesty and openness about the emotional stress that Black men often face but do not discuss. I was somewhat surprised that it took an icon such as Kid Cudi to raise an issue for discussion that, to me, seemed important to talk about. It had me wondering just how off limits the topic of mental health was, not just for Black men, but for Black people in general. It was not until I attended an open meeting hosted by the University of Maryland’s Black Student Union on mental health that I realized that I was not alone in feeling as though I needed to keep my personal mental health issues private. I began to more actively wonder what it was about mental health and illness that caused some people – specifically the majority of Black people – to be so hesitant to even talk about it.
In addressing a problem, one needs evidence that there is, in fact, a problem. There is a good deal of research that shows significant disparities between Blacks and whites. A study that examined the presence of mental illness in Blacks and whites and its relationship to race found that, compared to white people, Black people are significantly more likely to be affected by a recurring mental illness or disorder (Lo et al. 254). If this is the case, then it seems imperative that we address it. According to Marya R. Sosulski and Amanda T. Woodward, in a study of help-seeking behaviors among African-American women, “[…] a larger percentage of African Americans report the need for mental health services compared to Whites, but significantly fewer receive treatment […] and many more report that their mental health care needs go unmet” (660). The article goes on to describe the misrepresentation of Blacks in the realm of mental health, both in the United States and the United Kingdom, by way of misdiagnosis of different illnesses, over-representation in psychiatric services and other methods (Mantovani et al. 374; Sosulski and Woodward 660). As a result, I was led to delve deeper and question the mechanisms by which these disparities occur and continue to occur.
One contributor lies within the perceptions by the Black community of the healthcare system. According to a study done on Black women with mental illnesses, “because of stigma and discrimination within health care systems and added stressors of gender roles and caregiving, younger women may be less likely to take opportunities for treatment that interfere with or are perceived to reduce their capacity for fulfilling obligations” (Sosulski and Woodward 667). This might have caused an aversion to treatment to develop, as it may seem that seeing a mental health care professional would only make matters worse. Instead of being treated properly, they might fear being discriminated against. These negative perceptions of the healthcare system are not unfounded. In 1932, there was a 40-year long study conducted in which approximately 400 Black men afflicted with syphilis were told they were receiving treatment for this disease when they, in fact, were not. According to physician and medical historian Vanessa Gamble, “Numerous articles, in both the professional and popular press, have pointed out that the study predisposed many African Americans to distrust medical and public health authorities [...] The Tuskegee Syphilis Study is frequently described as the singular reason behind African-American distrust of the institutions of medicine and public health.” However, she makes sure to point out the fact that “[...] the mistrust predated public revelations of the Tuskegee study” (Gamble 1773). Such a drastic and heinous deception as this study provides more than enough basis for distrust between the African-American community and the healthcare system, and unfortunately, as Gamble points out, there are several more painful situations like the Tuskegee Syphilis Study throughout American history.
Aside from these and other external factors, perhaps there are more internal, community-related contributors to the hesitation to seek treatment. According to a study conducted in the UK by Nadia Mantovani, there are various stigmas placed upon mental health, especially among members of the Black and African-descended communities. At the risk of entering speculative territory, perhaps by reaching out for help, one admits to having a problem in the first place. This may expose one’s peers to a level of vulnerability that is then perceived as weakness, and subsequently receives a negative response. In Mantovani’s study, it is suggested that the stigma that the people in one’s environment hold against mental illness and treatment can have a significant impact on one’s own view of the same issue (374). A negative response to mental health resources from one’s peers may cause one to view those resources negatively as well, in order to prevent further unfavorable responses from one’s friends and family.
Gender socialization is another significant factor to consider. In addition to the existence of traditional, binary genders, we are also subjected to certain expectations based on our respective genders. Daphne C. Watkins, author of “A Meta-Study of Black Male Mental Health and Well-Being,” defines male gender socialization as “…the process by which men learn the gender and culturally ascribed behaviors that characterize masculinity in a particular society” (Watkins et al. 304). For Black men, the expectation in our society is that they be what many might consider hypermasculine. They are expected to be invincible and invulnerable rather than the human beings they actually are, meaning that any show of vulnerability may be seen as weakness, or some level of inadequacy as a man. With the internalization of this mentality and the constant impact of racism and discrimination in every facet of our society, it is not invalid to think that Black men are justified in being skeptical about seeking treatment for mental health-related problems, let alone discuss them. How could they seek treatment for a problem whose existence they do not feel they can afford to acknowledge?
Another rationale for a negative stigma from African Americans about other African Americans’ mental health challenges may reside within the heritage of the African diaspora.For Black communities, more specifically ones of African descent, mental illnesses (or, at the very least, the symptoms of them) are typically perceived through a religious lens. Some families perceive mental illnesses such as schizophrenia to be the result of immorality or spiritual weakness. There is a belief that “African-descended people are supposed to be spiritually strong” (Mantovani et al. 376). Others may perceive it as “demon possession,” and “evil spirits” (376). As quoted in Mantovani’s study, “Mental illness […], we think it’s a curse. We think you’re possessed by the Devil, but it’s a mental health problem” (376). All too often, mental illnesses do not seem to be viewed as a medical issue, but rather an issue of one’s faith. Perhaps a fear of implying that one is spiritually weak, insane, or possessed leads people to refrain from talking about mental health or seeking medical treatment.
Even among more Americanized African-based families, such as my own, the topic of mental illness is more a religious topic than a scientific or medical one, especially in terms of treatment. I remember sitting with my father and my relatives discussing the recent unusual behavior of another family member, and throughout the discussion, there was a great deal of talk about praying for that person, but there was very little talk about getting him to see a psychiatrist or go to some sort of mental health care facility. I also recall being pulled aside by my aunt, after my own issues with depression, and having her tell me that no matter what, no matter how sad I might be feeling, that I should always pray. She even told me that mental illness was the work of “the Devil and his demons,” and that prayer was the only way to dispel them. While my faith urges me to pray in the midst of hard times, I wondered why there was no mention of therapy or professional help in conjunction with fervent prayer.
Whatever the roots of the issue, it is important that we within the Black community begin to seek a better understanding of the issues we face. Although there appears to be an increase in the research of mental-health-related issues in the black community, there is still much work to be done to understand and combat mental illness. By opening up the discussion to include theories on why our community has been skeptical to embrace mental health treatment, we normalize the expression of vulnerability, creating the possibility of beginning to work towards solutions. By taking the time and effort to understand the stigma around vulnerability, we can begin to remove those stigmas and improve our protection of the family members and friends closest to us suffering from mental illnesses. Perhaps University-affiliated, peer-reviewed studies can connect to the popular movements that have already started to increase the awareness of a need to talk about mental health issues specifically in the Black community. In addition to #YouGoodMan?, there are studies such as the YBMen Facebook Project that work to educate young Black men about mental health issues which could share important data and discussion points with scholars. In a self-examination of our own ideas, we can continue to alter them to better suit the needs of our loved ones and get them the help they may need, now or in the future.