Therapy with Janelle Brady
Individual, Adolescent, and Family Therapy
Emotional Well-Being      Psychological Well-Being      Social Well-Being

Black and African American About 17% of Black and African American people in the U.S. live with a mental illness. This equates to about 6.8 million people.2 Financial issues, misdiagnosis, and systemic racism hinder Black and African American people from receiving quality mental health care. For example, Black and African American people who live below the poverty line are twice as likely to self-report mental distress than those who live above it.3 Research shows that poverty closely correlates with chronic stress, depression, and relationship problems, all of which can exacerbate mental illness. As of 2018, one in five Black/African American people lives below the poverty line.4 Frequently, Black and African American people do not receive psychiatric services as frequently as white Americans for mental health issues. And they are more likely to be diagnosed with a psychiatric disorder like schizophrenia than white people with the same symptoms, who are instead diagnosed with more easily treatable mood disorders.5 Systemic racism and dismissal of certain cultural factors may be reasons for this effect. Adults in this community are also more likely to report symptoms of depression — like overwhelming sadness and hopelessness — than their white counterparts, even though Black and African American people receive treatment less often.6 Suicide has also risen in the Black and African American population in recent years. In 2019, it was their second leading cause of death in those aged 15-24.7 Between 2008-2018, suicidal thoughts rose in the Black and African American community from 6% to 9.5%. And 1.5% of Black and African American people made a suicide attempt in 2008 compared to 2.4% in 2018.8 Asian American About 13% of the Asian American population in the U.S., or 2.2 million people, live with a mental illness.2 Mental health disorders are on the rise among Asian Americans and Pacific Islanders (AAPI), with the number of AAPI people reporting severe mental illness increasing from 2.9% in 2008 to 5.6% in 2018.9 Cultural pressures seem to dictate Asian American hesitancy to access mental health care, including avoiding stigma and family judgment. Because of the standards set by family, society, and cultural beliefs, Asian American women particularly report low self-esteem and tend to remain silent about issues like depression when they witness it in family members or themselves.10 Latinx and Hispanic About 8.9 million Latinx and Hispanic people in the U.S. live with a mental illness, which is about 15% of the Latinx and Hispanic population.2 For this community, religion and culture play a pivotal role in attitudes toward seeking mental health care. Some Latinx and Hispanic people may see mental health issues as resulting from crises of faith or sinful behavior as opposed to diagnosable and treatable illnesses.11 There are also attitudes within Latinx and Hispanic communities that having a mental illness or even conversing about mental illness is a source of shame or embarrassment for the family. This also causes fewer people to seek treatment.12 Issues stemming from immigrant status and language barriers also result in a lack of quality care for Latinx and Hispanic communities. Both adults and young people experience mental anguish because of the treatment of immigrants in the U.S. This includes pressures to assimilate into American culture.13 Furthermore, concerns about deportation remain a legitimate fear for many immigrants. Because of a shortage of Spanish-speaking mental health care providers, Latinx and Hispanic people often can’t access care. If they do, they are evaluated differently in English and often don’t receive the care they need.13 Native and Indigenous About 830,000 Native and Indigenous people live with mental health issues, about 23% of the Native and Indigenous population.2 And even though they comprise about 2% of the population, they have the highest rates of substance use disorders. Arguably, Native and Indigenous people experience the most severe barriers to mental health care because of their general lack of access to resources. This is a direct result of the U.S. government’s past and current treatment that has caused many Native and Indigenous people long-term mental health distress, including PTSD and other complex problems. In fact, Native and Indigenous people experience serious psychological distress 2.5 times more often than the general U.S. population.3 More than double the amount of Native and Indigenous people between 15-19 in the U.S. die by suicide each year compared to the white population.14 Cultural and religious influences also keep Native and Indigenous people from pursuing mental health care. Research shows that Native and Indigenous people are more likely to seek healing from spiritual leaders within their communities than medical professionals.15 How racism impacts mental health Historic and systemic racism impacts the BIPOC community’s ability to access quality mental health care. While it would be impossible to cover every aspect of how white supremacy functions as a barrier to care, we’ve provided a few statistics and other information revealing some of the most obvious ways it has impacted mental health care. -When speaking with Black patients, physicians are 23% more verbally dominant (asserting control and coming from a place of established authority) and use 33% less patient-centered language than when they treat white patients.1 -Even when presenting the same symptoms, Black people are more likely to be diagnosed with schizophrenia than a mood disorder compared to white patients.1 -Multiracial people are more likely to report a mental illness than any other racial or ethnic group.1 -22.7% of Native Americans and Alaskan Natives report a mental illness, compared to 19% of white people.1 -The BIPOC community is disproportionately represented in the criminal justice system, where 50-75% of youth meet the criteria for mental illness.1 -More than any other racial or ethnic group, Native Americans and Alaskan Natives report higher alcohol abuse and PTSD rates.1 Consult Mental Health America’s publication The State of Mental Health in America | Mental Health America (mhanational.org) the American Psychiatric Association’s Mental-Health-Facts-for-Diverse-Populations.pdf (psychiatry.org) for more information about racism’s impact on mental health. Barriers to care The BIPOC community’s lack of access to mental healthcare services is a complex issue that has been discussed in the healthcare field for many years. Barriers to care include systemic issues that result from the racialized history of mental health care in the U.S., resulting in BIPOC community members not receiving mental healthcare as frequently as their white counterparts.16 Other barriers to care include BIPOC community members: -Being less likely to seek mental healthcare -Receiving substandard care -Ending mental health treatment prematurely -Experiencing racial bias in healthcare services and providers -Encountering a language barrier with providers -Perceiving a social stigma around mental health and care -Not having health insurance or funds to afford care17 There are many more issues that BIPOC community members face when trying to access care. This explains why access to online services and culturally competent providers is crucial to the mental well-being of this community. ​Here are some important facts to know about barriers to care: -Only one-third of Black people who need mental healthcare receive it.18 -Around 34% of Latinx people who need mental healthcare receive it yearly.19 -Every year, only about 23.3% of AAPI adults with a mental illness receive treatment, which is the lowest of the documented racial categories.20 -Indigenous people face some of the toughest barriers to care because of a lack of interpreter services, providers’ deficiency in cultural competence, and distrust of government programs due to historical racism and genocide.21 -At the same time, Indigenous communities face some of the highest substance abuse and suicide incidences. -Suicide was the second leading cause of death for American Indian/Alaskan Natives between the ages of 10-34, according to a 2019 survey.22 -A sizeable Canadian survey of over 16,000 people who come from historically marginalized groups found that those who belong to ethnic minority groups and who self-identify as having poor mental health access mental health services much less often compared to the white population.23 -63% of Black people believe that mental health issues are a sign of personal weakness. -According to a survey, Black and African American men are particularly concerned about the stigma resulting from a claim of mental illness.24 -The racial and ethnic makeup of mental healthcare providers does not match the demography of the U.S. A 2015 survey showed that 86% of psychologists are white, while only 62% of the U.S. population is white.25 -Only 5% of psychologists are Asian; 5% are Hispanic; 4% are Black/African-American, and 1% are multiracial.25 Changes at the policy level and how care is delivered are necessary to close the mental health care gap.26 Researchers advocate for intersectional approaches to care that acknowledge and combat historical oppression and systemic racism. These approaches could broaden the availability of care and help more members of the BIPOC community get the mental health resources they need.27 Until that happens on a large scale, there are online resources available for the BIPOC community to begin conversations around mental health and seek culturally competent help. We’ve outlined many of those resources below. Mental Health Resources for the BIPOC Community (innerbody.com) ​​ Mental health disparities: Diverse populations. (2017). American Psychiatric Association. Retrieved May 11, 2022, from https://www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-Health- Facts-for-Diverse-Populations.pdf BIPOC mental health. (2022). Mental Health America. Retrieved May 11, 2022, from https://www.mhanational.org/bipoc-mental-health Health, United States. (2017). Centers for Disease Control and Prevention. Retrieved May 11, 2022, from https://www.cdc.gov/nchs/data/hus/hus17.pdf Semega, J., Mohanty, A., Creamer, J., & Kollar, M. (2021, October 8). Income and poverty in the United States: 2018. Census.gov. Retrieved May 11, 2022, from https://www.census.gov/library/publications/2019/demo/p60-266.html Mental health disparities: African Americans. (2017). American Psychiatric Association. Retrieved May 11, 2022, from https://www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-Health-Facts-for-African-Americans.pdf Black and African American communities and mental health. (2022). Mental Health America. Retrieved May 11, 2022, from https://www.mhanational.org/issues/black-and-african-american-communities-and-mental-health Mental and behavioral health - African Americans. (2020). The Office of Minority Health. Retrieved May 11, 2022, from https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=24 2018 national survey on drug use and health: African Americans. (2020). Substance Abuse and Mental Health Services Administration. Retrieved May 11, 2022, from https://www.samhsa.gov/data/sites/default/files/reports/rpt23247/2_AfricanAmerican_2020_01_14_508.pdf 2018 national survey on drug use and health: Asians/Native Hawaiians and Other Pacific Islanders (NHOPI). (2020). Substance Abuse and Mental Health Services Administration. Retrieved May 11, 2022, from https://www.samhsa.gov/data/sites/default/files/reports/rpt23248/3_Asian_NHOPI_2020_01_14.pdf National Asian Women’s Health Organization. (2001). Breaking the silence: A study of depression among Asian American women. San Francisco, Calif: National Asian Women’s Health Organization. Caplan S. (2019). Intersection of cultural and religious beliefs about mental health: Latinos in the faith-based setting. Hispanic Healthcare International: The Official Journal of the National Association of Hispanic Nurses, 17(1), 4–10. https://doi.org/10.1177/1540415319828265 Jimenez, D. E., Bartels, S. J., Cardenas, V., & Alegría, M. (2013, October). Stigmatizing attitudes toward mental illness among racial/ethnic older adults in primary care. International Journal of Geriatric Psychiatry. Retrieved May 11, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672370/ Mental health disparities: Hispanics and Latinos. (2017). American Psychiatric Association. Retrieved May 11, 2022, from https://www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-Health-Facts-for-Hispanic-Latino.pdf Suicides among American Indian/Alaska natives - National violent death reporting system, 18 states, 2003–2014. (2019, March 5). Centers for Disease Control and Prevention. Retrieved May 11, 2022, from https://www.cdc.gov/mmwr/volumes/67/wr/mm6708a1.htm Mental health disparities: American Indians and Alaska Natives. (2017). American Psychiatric Association. Retrieved May 11, 2022, from https://www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-Health-Facts-for-American-Indian-Alaska-Natives.pdf Perzichilli, T. (2022, February 7). The historical roots of racial disparities in the mental health system. Counseling Today. Retrieved May 11, 2022, from https://ct.counseling.org/2020/05/the-historical-roots-of-racial-disparities-in-the-mental-health-system/ Mental illness doesn’t discriminate, so why do BIPOC communities have difficulty accessing care? (2020, July 31). Jefferson Center - Mental Health and Substance Use Services. Retrieved May 11, 2022, from https://www.jcmh.org/mental-illness-doesnt-discriminate-so-why-do-bipoc-communities-have-difficulty-accessing-care/ Black/African American. (2022). National Alliance on Mental Illness. Retrieved May 11, 2022, from https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Black-African-American Hispanic/Latinx. (2022). National Alliance on Mental Illness. Retrieved May 11, 2022, from https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Hispanic-Latinx Asian American and Pacific Islander. (2022). National Alliance on Mental Illness. Retrieved May 11, 2022, from https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Asian-American-and-Pacific-Islander Indigenous. (2022). National Alliance on Mental Illness. Retrieved May 11, 2022, from https://www.nami.org/Your- Journey/Identity-and-Cultural-Dimensions/Indigenous Mental and behavioral health - American Indians/Alaska Natives. (2020). The Office of Minority Health. Retrieved May 11, 2022, from https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=39 Chiu, M., Amartey, A., Wang, X., & Kurdyak, P. (2018, July). Ethnic differences in mental health status and service utilization: A population-based study in Ontario, Canada. Canadian journal of psychiatry. Revue Canadienne de Psychiatrie. Retrieved May 11, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6099776/ Ward, E. C., Wiltshire, J. C., Detry, M. A., & Brown, R. L. (2013). African American men and women’s attitude toward mental illness, perceptions of stigma, and preferred coping behaviors. Nursing Research. Retrieved May 11, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4279858/ Lin, L., Stamm, K., & Christidis, P. (2018). How diverse is the psychology workforce? Monitor on Psychology. Retrieved May 11, 2022, from https://www.apa.org/monitor/2018/02/datapoint Alegría, M., Alvarez, K., Ishikawa, R., DiMarzio, K., & McPeck, S. (2016, June 1). Removing obstacles to eliminating racial and ethnic disparities in behavioral healthcare. Health Affairs. Retrieved May 11, 2022, from https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.0029 Langwerden, R. J., Thompson, M. G., & Wagner, E. F. (2021). Multidimensional conceptualization of identity and psychopathology: Assessing mental health disparities from an intersectional and dimensional framework. Personality and Mental Health. Retrieved May 11, 2022, from https://pubmed.ncbi.nlm.nih.gov/34132042/ Native and Indigenous communities and mental health. (2022). Mental Health America. Retrieved May 11, 2022, from https://www.mhanational.org/issues/native-and-indigenous-communities-and-mental-health Latinx and Hispanic communities and mental health. (2022). Mental Health America. Retrieved May 11, 2022, from https://www.mhanational.org/issues/latinxhispanic-communities-and-mental-health Asian American and Pacific Islander communities and mental health. (2022). Mental Health America. Retrieved May 11, 2022, from https://www.mhanational.org/issues/asian-americanpacific-islander-communities-and-mental-health​