Growing up in my Panamanian household, the term mental health was often synonymous with being homeless, a drug addict, or “crazy.” In my Catholic, middle class, two-family household sustained on the backs of two immigrants, I was taught that whatever I struggled with in life could be overcome by learning to be more motivated and not complaining about whatever I had.
I love my family, but this view of mental health meant that when I started struggling with body image, self-esteem, suicidal thoughts, and self-harm when I was 16, I knew I couldn’t open up about my problems to my parents. Instead, with the guidance of a friend, I started seeing my school therapist—which was the gateway to me knowing what it felt like to ask for help.
As I got older and began to learn more about mental health while studying for my Master’s degree in social work, I started to understand why mental health carries such a heavy stigma in black and brown communities. Many share the view of my parents that if our ancestors survived slavery, we should be able to carry the weight of stress on our shoulders. I’ve heard other people cite the need to be strong, because therapy has been seen as a resort for the weak—and weakness is something that black people can’t afford to feel in the face of oppression and racism. It doesn’t help that minority communities, particularly African Americans, have a history of mistreatment at the hands of the medical community, from more frequent misdiagnoses to unethical research practices, which has contributed to a general distrust of doctors.
Mental health, of course, is a big issue in the African American community as it is in others. Suicide is the second leading cause of death for African Americans aged 15 to 24, and data shows that of the black and African American population in the United States, 16 percent (about 6.8 million people) had a diagnosable mental health condition in the past year. But the cultural experience of this community makes fighting stigma and raising awareness look a bit different than it would for others.
All of this is to say that my history, both in the context of ethnicity and experience, made me aware of how important it is to be culturally conscious when discussing mental health at home and in the field. Here are some things everyone can start doing to be more aware and inclusive:
1. Diversify your circle and your knowledge
It can be hard to be culturally conscious if everyone you know looks like you. When we create community with people who experience life differently than us—people of different ethnicities, sexualities, and socioeconomic backgrounds—we learn their ways and their customs and we get invited into their worlds, which helps us to be more aware of their values and experiences. Do the work by reading books by writers of color, listening to podcasts featuring diverse hosts and guests, finding accounts on social media from people outside your usual sphere, and attending events where the crowd is diverse. You’ll open up a new window of learning, and have the chance to meet new people with different perspectives.
2. Confront your implicit biases
Implicit bias is when someone discriminates against a person without actively being aware of it, thanks to ingrained stereotypes and assumptions about that person’s group. It can affect how we interact with people and how we perceive their mental health concerns. It is common in the medical field for example, for doctors to under-estimate the pain of black patients because they believe we over-exaggerate our symptoms or can simply handle more pain.
Anyone’s judgement can be colored by implicit bias. It’s important to actively question your own assumptions and beliefs to root out implicit bias, because often bias prevents someone of color from getting the help they need. For example, do you find yourself often labeling black woman as aggressive or angry? That’s problematic for a number of reasons, but especially because anger is an often-overlooked symptom of depression. Think through why you’re reacting to someone in a certain way. Ask yourself, “If this was my struggle, what kind of support would I need?” When you have that answer, offer that same support to someone else with their permission.
3. Ask questions—and listen with compassion
I’ve found that the best way to learn about a person and their situation is to make fewer assumptions and simply ask questions. Every culture has a different perspective on mental health, so when discussing the topic, try asking these questions: What does mental health mean to you? What does asking for help look like in your community? What are some ways that I can support you? Is it okay for me to bring up this subject around your family or friends?
On a related note, being culturally conscious also requires knowing when it’s your turn to listen. The only way to close the racial gap within wellness is to allow people of color to speak for themselves. When asking someone about their mental health, for example, you don’t necessarily need to chime in with advice about your own experience, since everyone has different needs, abilities, and access points—meaning what has worked for you might not be desirable or attainable for another person. Listening to their experience and supporting them in their journey as they see fit is far more powerful.
Though mental health stigma still persists, the work of changing the narrative requires a collective effort. With respect for one another, our beliefs and our cultures, there is room for progress to be made.
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