Racism’s Effect on African American Mental Health

For generations, mental illness, or even the mere mention of mental illness, in the African American community has been taboo. The reference to a family member who might possibly suffer from some type of mental disorder usually drew such comments as “his elevator doesn’t go all of the way to the top” or “all of his folks aren’t at home” or “that’s Uncle Joe, he’s harmless.”

As far as mental illness is concerned, the African American community often wears blinders. For example, in the movie “Soul Food,” viewers were introduced to Uncle Pete, who had some kind of mental issue. He was relegated to his room, where the only hint that the character existed were vague references and a closed bedroom door with a plate of food left outside of it.

The stigma of mental illness for African Americans can be traced back to slavery, says health writer Glenn Ellis. According to several writers, one scientific report deliberately falsified the black insanity rates from the 1840 U.S. census to show that the further north blacks lived, the higher their rates of lunacy n strong “evidence” implying that freedom drove blacks crazy.

But mental illness is no joke, and for far too long mental illnesses in the African American community hasn’t been given adequate attention.

A report from the United States Surgeon General says that African Americans “may be less likely to suffer from major depression and more likely to suffer from phobias” than whites. The report also notes that while whites are nearly twice as likely as African Americans to commit suicide, suicide rates among young black men are as high as those of young white men. The suicide rate among African Americans ages 10 to 14 increased 233 percent, compared to 120 percent of comparable non-Hispanic whites from 1980 to 1995.

African Americans, reportedly, are particularly more at risk for mental illness than any other group because they are over-represented in the “high-need populations.” African Americans make up about 40 percent of the homeless population and nearly half of all inmates in state and federal prisons. African American children and youth make up 45 percent of children in public foster care and more than half are waiting to be adopted. And African Americans are exposed to more violence. One study reported that more than 25 percent of African American youth exposed to violence met diagnostic criteria for post-traumatic stress disorder (PTSD). Among Vietnam War veterans, 21 percent of black veterans, compared to 14 percent of white veterans, suffer from PTSD because of the greater exposure of blacks to war-zone trauma.

Although psychologists cannot pinpoint exactly what causes depression in every case, they have identified three factors n biology, genetics and environment n that could either directly cause or predispose an individual to depression.

“What we believe is that, No. 1 ... depression seems to run in families, and so we know that there is some predisposition, some genetic piece to it” said Dr. Freda Lewis-Hall, an African American psychiatrist who is a clinical research physician at U.S. Medical Operations and is director of the Women’s Health Center at Eli Lilly and Company. “The other piece of it is what happens in the environment. And there are certain things that we recognize as risk factors for the development of depression, and they include things like having been a victim of abuse, or violence, poverty, chronic or serious illnesses, cancer, heart disease, diabetes.”

Since African Americans suffer disproportionately from diabetes, high blood pressure, cancers and heart disease, the mental health community believes the 20 percent to 35 percent rate of depression among persons with serious or chronic illness is likely to account for a larger portion of the black population than the white population.

According to some black psychologists though, whether the white clinicians or the white establishment will admit it, slavery, Jim Crow segregation and the stresses of racism, such as the kind implied in the 1840 report, have contributed to and continue to play a major role in the mental health issues that plague the African American community today.

Lewis King, Ph.D., a psychologist and founder of the National Council for Substance Abuse Counselors, said the biggest mental health challenge in the African American community today is “a lingering depression” that can be attributed directly to the slave experience, resulting in consequences such as low performing schools, drug abuse, substance abuse n all of the issues that led to or cause African Americans to over-represent in “high-needs population.”

“Slavery is one of elements that left us with some degree of vulnerabilities such as not having clarity and our legacy. (It’s) persistent stress, beginning with racism and its many forms of manifestation, such as economic deprivation, loss of opportunity and the big one n continuing self disrespect n we are not tolerant of each other. We would rather hit each other and shoot each other rather than shoot the enemy,” King said.

Lewis-Hall adds, “If we look at the exposure of African Americans to things that we recognize as risk factors in developing depression, (we see that) we get exposed to those more often. What we don’t think is that there is a genetic predisposition on the part of African Americans to be depressed.”

Both King and Lewis-Hall agree that the stresses of racism can cause low self-esteem, which can ultimately lead to depression.

Findings by the National Institute of Mental Health reveal that racial discrimination n or even the belief that one is being discriminated against because of one’s race n can lead to anxiety and depression.

Depression can make someone feel exhausted, worthless, helpless, and hopeless. Signs of depression include:

• Nervousness and worry

• Feelings of sadness that don’t go away

• Loss of interest in and withdrawal from usual activities

• Irritability or restlessness

• Lack of energy

• Trouble sleeping or sleeping too much

• Feelings of sadness

• Poor appetite or eating too much

Dr. King says that if you think you are suffering from depression, the first thing to do is seek out someone to talk to.

“That’s important, find a close intimate friend. It can be a family member, someone at your church,” he said.

If that fails, he said to seek the assistance of a professional counselor, psychologist or psychiatrist.

The Los Angeles County Department of Mental Health (DMH) operates more than 50 program sites throughout the Los Angeles County, and contracts with more than 1,100 other providers. The department offers a wide variety of help, including mental health assessments, crisis intervention, case management, and medication support in both residential and outpatient settings.

The department offers free, confidential mental health information, referrals to service providers, and crisis counseling on a 24-hour basis. For information, call (800) 854-7771.