BIPOC Mental Health Month is also in July (along with Disability Pride Month) and I feel this month provides a focused opportunity to break silences, confront biases, and collectively imagine more equitable mental healthcare for BIPOC individuals.
As a mixed-race Latinx person, I am no stranger to the complex tapestry of cultural stigmas about mental health that exist in many of our BIPOC communities. From taboos around discussing mental health to the perpetuation of stoic fronts, the intersection of mental health and our identities remains a critical conversation.
In Latinx cultures, like many BIPOC cultures, mental health discussions are often swept under the rug, dismissed as unimportant, or even frowned upon. There is an enduring expectation to maintain a facade of contentment, a cultural norm likely enforced by historical colonization and the imposition of certain forms of Christianity designed to disempower and control indigenous populations.
These enforced norms not only downplay the importance of mental health but also discourage us from sharing our struggles and seeking help. These barriers become even more apparent when we consider therapy, a tool often stigmatized or misunderstood within our communities.
But it’s crucial to remember these norms are not intrinsic to our cultures. They were imposed on our ancestors, designed to silence and suppress us. And they’re not indicative of the values our cultures once held pre-colonization.
In the heart of pre-colonial cultures lies a reservoir of what we who are colonized might now call “progressive” values. From community-oriented philosophies to profound respect for diversity, these principles provide a blueprint for reimagining our approach to mental health.
By revisiting these roots, we can begin to deconstruct stigmatized narratives. We can create new conversations that openly discuss mental health, view therapy as a valid and beneficial process, and break the cycle of silent suffering.
The Harm of Colonization – Persistent Mental Health Disparities for BIPOC Individuals
Mental health statistics reveal deeply concerning disparities faced by BIPOC communities in the US. Compared to white adults, Black and African American individuals are more likely to report persistent symptoms of emotional distress, while Native communities have the highest rates of suicide among all ethnic groups, and Asian American college students exhibit a high prevalence of depression and anxiety. Despite the higher rates of mental health issues in many key areas, BIPOC are accessing mental health care and treatment at lower numbers than whites.
In a study called the Youth Risk Behavior Surveillance System (YRBSS) the Centers for Disease Control and Prevention (CDC) has reported that Black high school students had the highest reported suicide attempts of all their peers in any other racial groups. The study also found that Hispanic/Latinx and multiracial students had the highest levels of hopelessness and sadness reported amongst their peers of other races.
A report from the Substance Abuse and Mental Health Services Administration (SAMHSA) showed that in 2018, approximately 16.9% of U.S. Latinx adults experienced mental illness in the year prior, which equates to over 10 million individuals. However, only 33.8% of Latinx who experienced mental illness received mental health services, indicating a significant gap in access to care. In 2021, that figure jumped to 22% reporting mental health issues and 36% receiving care (compared to 52% of whites with mental health issues receiving care).
These inequities arise from intersecting systemic barriers, including lack of cultural representation and competency in mental healthcare, insurance and language constraints, and stigma surrounding mental illness. Additionally, the exacerbation of mental health conditions among BIPOC communities can be attributed to various sociopolitical factors. Racism, xenophobia, and socioeconomic inequalities contribute to stressors that significantly affect mental health. The impact of intergenerational trauma also cannot be dismissed. These stressors are often chronic and pervasive, extending into educational, occupational, and healthcare environments.
The cultural stigma against mental health issues and treatment (passed down from colonization) further compounds the reluctance to seek help. Those who do seek help encounter the scarcity of culturally sensitive services available and may leave treatment early due to frustrations and incompatibility with their treatment providers.
The combination of systemic barriers and cultural factors leads to delayed treatment, which can result in more severe, longer-lasting mental health issues within these communities.
Together, these factors create a troubling picture of mental health disparities for BIPOC individuals. Addressing these disparities requires significant shifts in how mental health services are delivered, and it also illustrates the need to challenge and change the systemic issues contributing to these disparities.
Valuing Traditional Practices Existing Before Colonization
In examining the stigmas around mental health that have been imposed upon us by colonization, along with the harm caused, it’s vital to recognize and honor the significant role of traditional healing practices and communal values that form the backbone of mental healthcare in many BIPOC cultures that have resisted colonization.
For example, in some Native cultures, mental health is seen through a lens of holistic wellness across spiritual, emotional, physical, and mental realms. Practices like talking circles allow for collective healing through shared experiences and storytelling. Traditional ceremonies can include elements like dance, drumming, or the use of natural elements such as fire or water, which are used to restore balance within the individual and community. Meditation practices and guidance from tribal elders also work to restore balance and promote healing. Herbal medicines, often prepared and administered under the direction of healers, address not only the symptoms but also the spiritual root causes of distress.
In some Latinx communities, traditional healing practices also hold significant importance. Curanderos or curanderas, traditional folk healers, use an integrative approach to address mental health issues, often incorporating spiritual interventions, massage, and herbal remedies to treat issues believed to have roots in supernatural causes. These traditional healers often hold a respected role within the community and can provide a culturally sensitive alternative or supplement to Western mental health treatments. Additionally, community gatherings and support from family and religious leaders often form a crucial part of the healing process.
Many African societies also offer a rich history of communal and holistic approaches to mental health. In these societies, mental illness is often seen not merely as an individual problem but as an issue affecting the entire family and community. Public discussions, ceremonies, and rituals often play a therapeutic role, aiming to restore the individual’s social equilibrium. For example, the Igbo people in Nigeria traditionally use a form of group therapy, called ‘Ilonze’, where family and community members come together to address issues causing mental distress. In Somali culture, ‘Waaq’, a spiritual belief system, is often used alongside Western therapy, with the belief that the spiritual intervention will provide a cure.
By acknowledging and validating the efficacy of traditional healing practices, we can see the importance of holistic, community-oriented mental health care. These practices remind us that mental health is not just an individual endeavor but is deeply interconnected with our community and environment. Incorporating these elements into contemporary therapy can provide a path towards a more culturally sensitive and effective approach to mental health care for BIPOC individuals.
Fighting for Equity
The fight for equity within the mental health system is an ongoing battle, and it’s one that cannot be won without a systemic transformation of the ways in which care is conceptualized, delivered, and accessed.
Firstly, mental health treatment for BIPOC individuals must be culturally competent. This requires a radical shift in the understanding and delivery of mental health services. Professionals must be trained to understand the impact of culture on mental health, and to address mental health within the context of a person’s cultural identity. This involves more than just a superficial understanding of different cultures. It requires the willingness to embrace a different paradigm of health, one that values and incorporates cultural beliefs and practices.
In addition, our approach to mental health must be decolonized. This involves re-centering traditional healing practices and wisdom within the context of mental health care. We must move away from a model that pathologizes difference, and towards a model that values diversity, and recognizes the harm done by the imposition of colonial beliefs and practices.
This means acknowledging the validity and value of traditional healing practices, and incorporating them into our approach to mental health care where appropriate. Traditional healing practices provide a wealth of knowledge and expertise that can be leveraged to improve mental health outcomes for BIPOC individuals. These practices should not be seen as alternative or supplementary, but as central and crucial components of a holistic approach to mental health care.
The journey to achieving these goals begins with us, the BIPOC mental health professionals, who live at these intersections. We carry the responsibility and the opportunity to advocate for change within our communities and within our profession. We must challenge and disrupt the status quo, and work towards creating more inclusive, equitable, and culturally competent mental health services. BIPOC clients and patients also can advocate for themselves where possible, and demand better care from their providers.