For many people, the fear of being judged prevents them from seeking mental health care. For African Americans, that stigma is often heightened. Historical mistreatment by health care professionals, cultural misunderstandings and religious beliefs often combine to make mental health care a daunting experience for many Black Hoosiers.
Across the nation, over 4.8 million African Americans reported having a mental illness, according to a survey from the Substance Abuse and Mental Health Services Administration in 2018. However, the survey found only nearly half of all African Americans reporting mental health disturbances sought care. Many, particularly Black men, cited stigma as a reason for not seeking treatment.
Dr. Danielle Henderson, a clinical psychologist at Indiana University Health, said misconceptions about mental illnesses play a large role in its stigmatization.
“One misconception is that mental health problems are a sign of weakness,” Henderson said. “Or a personality flaw, so for groups like African Americans who have faced prejudice and racism, there’s a stigma associated with reaching out [for help] outside of the African American community.”
Further, for many African Americans, seeking care from medical professionals can be intimidating if they’ve faced discrimination or racism. Henderson said it’s important that people find a therapist they feel comfortable with, and that includes having a mutual cultural understanding.
“Culture plays a big role in feeling seen, heard and understood,” Henderson said. “Particularly when you’re talking about difficulties in certain environments that you have to navigate, if your therapist has a foundational understanding, you don’t have to offer a lengthy explanation as to why you feel unsafe … and that’s so important, especially given the climate in the country right now.”
Another reason someone might delay or forgo mental health treatment is because they don’t feel “sick enough.” However, Henderson said that many of her clients don’t necessarily have a lifelong mental health issue, but instead just need help navigating a tough time.
“We try to fill their tool kit to help [patients] fly out on their own,” Henderson said. “I always say, ‘You can always come back if you need a refresher.’ My job is to help you figure out the tools you need to be successful, give you space to fly away and do this on your own.”
One issue often ignored as a side effect of mental illness is substance abuse. Charlotte Crabtree, program director of the nonprofit Overdose Lifeline, however, said we must discuss the link to help those suffering from substance abuse disorder.
“If a person is trying to overcome substance abuse, there’s usually an underlying issue,” Crabtree said. “A lot of people have drowned their problems, whether it’s depression or trauma, with whatever substance they’re using. If those issues aren’t addressed, they’re fighting a losing battle.”
Gina Fears, assistant director of recovery and community services at Public Advocates in Community Re-Entry (PACE), said PACE is working to educate the community about opioid use and the possible link between substance abuse and mental health.
“Discomfort from a mental health issue can sometimes lend itself to substance abuse,” Fears said. “It could be a form of release. If an individual is suffering from [multiple illnesses], they may view substance use as a release from what they’re going through.”
Fears and Crabtree said the pandemic caused an increase in substance abuse, as well as overdose deaths. Indianapolis, she said, is matching a nationwide trend: The use of opioids among African Americans has increased.
A report from the Department of Public Health found opioid-related overdose deaths among Black men rose 69% — from 32.6 in 2019 to 55.1 per 100,000 people in 2020. This was the highest increase of any ethnic or racial group.
One reason for this increase may be a disparity in recovery assistance. After receiving a grant last summer, Overdose Lifeline offers naloxone, an overdose reversal drug, to those who apply for it. Part of the registration asks for racial demographic. Between June and October 2020, Overdose Lifeline gave out over 10,000 doses of naloxone. According to racial demographic information, only one of those doses went to an African American.
“That’s more than a disparity,” Crabtree said. “We need to be focusing on community involvement. As far as the nonprofit groups, we need to join together and work with law enforcement, mental health and addiction professionals, and we need to put boots on the ground. We’re not going to beat this with commercials on TV. We have to go out and personally touch the community.”
Contact staff writer Breanna Cooper at 317-762-7848. Follow her on Twitter @BreannaNCooper.