Good mental health consists of maintaining strong social connections and living a fulfilling and productive life while effectively coping with stress and making positive contributions to family, work and their community To maintain good mental health, many people turn to friends, family, the church and other community supports, especially when they are going through emotional difficulty.

However, there may be times when these supports are not enough to maintain emotional wellness and seeing a mental health professional, such as a psychiatrist, is needed. Despite the need for some individuals to seek out professional mental health services, they are hesitant to approach the mental health system due to barriers such as stigma and distrust of the health care system. This is particularly likely among people from communities of color. The lack of diverse representation within the field of psychiatry further reinforces these barriers to accessing mental health services and contributes to poor mental health outcomes for our communities of color.

About 44 million people, 13.4% of the U.S. population, identify themselves as Black or African American. However, only 6.2% of psychologists, 5.6% of advanced-practice psychiatric nurses and 12.6% of social workers are members of minority groups. Even more shocking is the reality that there are only 2,000 Black psychiatrists in the U.S. Researchers also found that 40% of whites who were in need of mental health care initiated treatment, compared to only 27% of Hispanics and 24% of African Americans.

Research indicates that Black/African Americans believe that mild depression or anxiety would be considered “crazy” in their social circles. Furthermore, many believe that discussions about mental illness would not be appropriate even among family.

It can be quite isolating for individuals from communities of color who are living with mental illness and feel conflicted about seeking out treatment, especially when there is lack of mental health professionals who look like them and have an appreciation of the burden that the stigma of mental illness has on the community. Increasing the diversity within the field of psychiatry could potentially reduce the barrier to seeking out treatment and foster a sense of appreciation and understanding of the unique challenges that communities of colors face when struggling with mental illness.

As a community, we need to normalize the experiences of seeking mental health treatment, support each other when one discloses seeking mental health treatment and share our stories to the broader community of the value in seeking professional mental health treatment. We can do this by:

• challenging negative stereotypes of who seeks mental health treatment
• share our own stories of seeking mental health treatment
• support those who are going through difficult times such as accompanying them to see a mental health professional
• advocate in your communities for supportive mental health policies in schools and work

Although there are structural, racial and institutional barriers that hinder blacks from entering the psychiatric workforce, we can each do our part at a community level by having open dialogues about our mental well-being, seeking support and ending the stigma. Through these open discussions the hope is stigma will decrease, people will not only seek help, but young people of color will consider careers in the mental health workforce.  The more representation that we can have within the field of psychiatry, the better the emotional well-being and mental health support that could be available.

By

• Christine Crawford, M.D., M.P.H.,
  Assistant Professor of Psychiatry,
  Boston University School of Medicine
• Michelle P. Durham, M.D., M.P.H.,
  Assistant Professor of Psychiatry,
  Boston University School of Medicine