You have to act as if it were possible to radically transform the world. And you have to do it all the time.
Angela Davis
Angela Davis
Addressing Mental Health in America's Black Youth:
A Critical Inquiry
Black people are hurting. Though the hurt comes in many forms, mental illness is a very common manifestation of it. When someone has a mental illness it is said that they should turn to mental health services, yet for many reasons Black people often don’t show up for this form of help even if these services are available. Mental health services are rooted in theories of the medical field which has progressed historically through the exploitation and pain of Black people. Nowadays, Black youth are in need of support and additional knowledge to live with their mental ills. How, then, do the health service providers prove themselves worthy of being trusted after a history of such violence and superiority against Black people? Black youth believe the medical system, which would provide them with these mental health services, to be untrustworthy. Black youth are correct.
In order to grasp the realities that characterize the mental health field, one has to dig deep into the past and uncover the dark truths of modern medicine. Medical scientific progress has largely been obtained through the experimentation, pain, suffering, and death of marginalized and exploited communities. It is not uncommon to find that Black people have taken the brunt for much of this progress. From the cells of Henrietta Lacks to the enslaved women who endured unanesthetized vaginal surgical exploration for the sake of modern day gynecology; we have innumerable examples of how Black people have been raped of their health and dignity in the name of scientific progress. The mental health field in the United States is embedded in the greater medical discourse, including its exploitative origins; the way in which we treat mental illnesses is reflective of this medical framework. Though the illnesses are dire, distrust in the medical field has been, and currently is, a method of necessary survival. Black youth are, necessarily, trying to survive.
While historically essential for medical solutions available today, Black people are consistently without the benefits. In short, modern medicine is the way it is because of Black people, while they do not receive its fruits. This story is so blatantly present that social scientists, public health professionals, and activists alike are familiar with the disproportionate rates of disease, mental health issues, and the sheer mortality facing Black America today. An entire series exploring the way in which Black communities are plagued with curable, treatable illness and afflictions, could be delved into here. In the sphere of mental illness, suicidality (though not a result of all forms of mental illness) is one of the more solid and terrifying measures in which we can see problems--when the illness has gotten to be too much to bear for someone. Reportedly, 45% of Black transgender people have attempted suicide at some point of their life. Each day approximately one Black American dies by suicide every 4.5 hours. Black Americans consistently suffer at greater depths than their white counterparts, the Health and Human Services Office of Minority Health estimates that Black people are at least 20% more likely to present with severe mental health illness as compared to the general public. And in the case of Black youth: the rate of suicide for young Black men and boys has doubled in the last 20 years, and rates of suicide among Black male youth are three times higher than Black adults. Black youth are a part of this mental health epidemic facing the Black community, and they are in pain.
From the perspective of many service providers, the solution for helping Black youth to survive and heal is simply healthcare ‘access’. It seems that absent in this mentality is a recognition that Black youth make decisions based on logic (just as the white providers do). Though access to health care for a large percentage of Black people throughout the United States can be difficult, Black people will often choose not to seek out “professional help” even when it is accessible. The sentiment that service providers respond with is ‘How are Black youth supposed to heal if they refuse the help they need?’. The issue clearly lies in the way in which services are administered. Research shows that the tools, methods, environments of programs, and institutions themselves are built based on Eurocentric values rather than incorporating cultural values of Black Americans. These cultural practices trickle into every policy, method of diagnosis, and interaction that shapes the way therapists, doctors, and counselors operate. Black teenagers are smart and capable of recognizing that this system isn’t built for them; that these supposedly qualified ‘supports’ are not in fact useful for them. It is not that Black youth make an inappropriate decision in choosing not to access treatment, but rather that the practitioners available to them are often inappropriate resources.
This issue is a matter of justice not only because of the disproportionate and racial nature of the mental health epidemic, but also because of the way the issue has been characterized as one in which Black Americans are simply untrusting of what are deemed ‘trustworthy’ institutions. As Patricia Hill Collins explains, “To maintain their power, dominant groups create and maintain a popular system of 'common sense' ideas that support their right to rule. In the United States, hegemonic ideologies concerning race, class, gender, sexuality, and nation are often so pervasive that it is difficult to conceptualize alternatives to them, let alone ways of resisting the social practices that they justify”. Prying the current conversation around mental health and Black youth from its historical context is the injustice.
A vast majority of the literature discusses the topic of the aforementioned mental health disparities as being the result of ‘stigma’. What these researchers and writers often fail to mention is the way in which Black people are making logical decisions based on the history and current culture of racism within which they exist. Specifically, Black youth have shown brilliant resilience in the face of the circumstances they face. The average Black teenager has grown up in an educational system where most their teachers have been well-intentioned but ill-equipped white women; interacted with adult professionals who either spoke to them condescendingly, belittled their culture, or dehumanized them by pitying their circumstances; or have been handled with hostility by police (including school correctional officers) or detained by a corrupt judicial system. In the week of a Black teen, the adults they may have regular interactions with are consistently white, disconnected, and untrustworthy. These adults represent the outlook society and its institutions have placed on these youth, and consequently they are an everyday source of stress. Long term stress is a direct medical risk factor for the onset of mental illness. With this in mind, the last logical response for a Black youth in distress or in need of supportive services is to go to the same institutions that oppress them.
Simply stated, Black youth are correct to mistrust service providers as they are not able to properly help them, but rather consistently further harm them by over-diagnosing, misdiagnosing, and pushing them to an even worsened mental and emotional state. Why would Black youth choose this path of more stress? Society sets up a power dynamic where Blackness is in the position of “recipient”, and dominant whiteness is in the position of agent and power. Implicit in this type of set up is an undermining of the logic and decisions of youth, and the suggestion that the capacity to make choices and take action lies in the (non-Black) professionals with power. Black teenagers know that society paints them as “less than”, “incapable”, “lazy” or “criminal”, and they know that health practitioners are receiving these same messages. Knowledge of this viewpoint dissuades Black youth from ever seeking genuine help. Mental emotional assistance requires openness and vulnerability in the work. Why would someone ever be open with a practitioner who has been trained and socialized to think of you in such a manipulated light?
An ideal improved condition of the mental health practices and medical discourses of the United States relies on increased training, increasing the representation of Black practitioners, and teaching white providers how to recognize their mere cultural (non-scientific) basis for the values and methods they uphold, undoing the widely held belief that white values are implicitly neutral. To improve these elements does not solely make practices more appropriate for Black young people, it also pushes the institutions and practitioners to grow and become more whole. To help an individual heal, let alone an entire demographic of young people, you have to first view them as capable, powerful, intelligent, human. Until this happens Black youth will continue to find these institutions incapable--and they will continue to be correct.
In order to grasp the realities that characterize the mental health field, one has to dig deep into the past and uncover the dark truths of modern medicine. Medical scientific progress has largely been obtained through the experimentation, pain, suffering, and death of marginalized and exploited communities. It is not uncommon to find that Black people have taken the brunt for much of this progress. From the cells of Henrietta Lacks to the enslaved women who endured unanesthetized vaginal surgical exploration for the sake of modern day gynecology; we have innumerable examples of how Black people have been raped of their health and dignity in the name of scientific progress. The mental health field in the United States is embedded in the greater medical discourse, including its exploitative origins; the way in which we treat mental illnesses is reflective of this medical framework. Though the illnesses are dire, distrust in the medical field has been, and currently is, a method of necessary survival. Black youth are, necessarily, trying to survive.
While historically essential for medical solutions available today, Black people are consistently without the benefits. In short, modern medicine is the way it is because of Black people, while they do not receive its fruits. This story is so blatantly present that social scientists, public health professionals, and activists alike are familiar with the disproportionate rates of disease, mental health issues, and the sheer mortality facing Black America today. An entire series exploring the way in which Black communities are plagued with curable, treatable illness and afflictions, could be delved into here. In the sphere of mental illness, suicidality (though not a result of all forms of mental illness) is one of the more solid and terrifying measures in which we can see problems--when the illness has gotten to be too much to bear for someone. Reportedly, 45% of Black transgender people have attempted suicide at some point of their life. Each day approximately one Black American dies by suicide every 4.5 hours. Black Americans consistently suffer at greater depths than their white counterparts, the Health and Human Services Office of Minority Health estimates that Black people are at least 20% more likely to present with severe mental health illness as compared to the general public. And in the case of Black youth: the rate of suicide for young Black men and boys has doubled in the last 20 years, and rates of suicide among Black male youth are three times higher than Black adults. Black youth are a part of this mental health epidemic facing the Black community, and they are in pain.
From the perspective of many service providers, the solution for helping Black youth to survive and heal is simply healthcare ‘access’. It seems that absent in this mentality is a recognition that Black youth make decisions based on logic (just as the white providers do). Though access to health care for a large percentage of Black people throughout the United States can be difficult, Black people will often choose not to seek out “professional help” even when it is accessible. The sentiment that service providers respond with is ‘How are Black youth supposed to heal if they refuse the help they need?’. The issue clearly lies in the way in which services are administered. Research shows that the tools, methods, environments of programs, and institutions themselves are built based on Eurocentric values rather than incorporating cultural values of Black Americans. These cultural practices trickle into every policy, method of diagnosis, and interaction that shapes the way therapists, doctors, and counselors operate. Black teenagers are smart and capable of recognizing that this system isn’t built for them; that these supposedly qualified ‘supports’ are not in fact useful for them. It is not that Black youth make an inappropriate decision in choosing not to access treatment, but rather that the practitioners available to them are often inappropriate resources.
This issue is a matter of justice not only because of the disproportionate and racial nature of the mental health epidemic, but also because of the way the issue has been characterized as one in which Black Americans are simply untrusting of what are deemed ‘trustworthy’ institutions. As Patricia Hill Collins explains, “To maintain their power, dominant groups create and maintain a popular system of 'common sense' ideas that support their right to rule. In the United States, hegemonic ideologies concerning race, class, gender, sexuality, and nation are often so pervasive that it is difficult to conceptualize alternatives to them, let alone ways of resisting the social practices that they justify”. Prying the current conversation around mental health and Black youth from its historical context is the injustice.
A vast majority of the literature discusses the topic of the aforementioned mental health disparities as being the result of ‘stigma’. What these researchers and writers often fail to mention is the way in which Black people are making logical decisions based on the history and current culture of racism within which they exist. Specifically, Black youth have shown brilliant resilience in the face of the circumstances they face. The average Black teenager has grown up in an educational system where most their teachers have been well-intentioned but ill-equipped white women; interacted with adult professionals who either spoke to them condescendingly, belittled their culture, or dehumanized them by pitying their circumstances; or have been handled with hostility by police (including school correctional officers) or detained by a corrupt judicial system. In the week of a Black teen, the adults they may have regular interactions with are consistently white, disconnected, and untrustworthy. These adults represent the outlook society and its institutions have placed on these youth, and consequently they are an everyday source of stress. Long term stress is a direct medical risk factor for the onset of mental illness. With this in mind, the last logical response for a Black youth in distress or in need of supportive services is to go to the same institutions that oppress them.
Simply stated, Black youth are correct to mistrust service providers as they are not able to properly help them, but rather consistently further harm them by over-diagnosing, misdiagnosing, and pushing them to an even worsened mental and emotional state. Why would Black youth choose this path of more stress? Society sets up a power dynamic where Blackness is in the position of “recipient”, and dominant whiteness is in the position of agent and power. Implicit in this type of set up is an undermining of the logic and decisions of youth, and the suggestion that the capacity to make choices and take action lies in the (non-Black) professionals with power. Black teenagers know that society paints them as “less than”, “incapable”, “lazy” or “criminal”, and they know that health practitioners are receiving these same messages. Knowledge of this viewpoint dissuades Black youth from ever seeking genuine help. Mental emotional assistance requires openness and vulnerability in the work. Why would someone ever be open with a practitioner who has been trained and socialized to think of you in such a manipulated light?
An ideal improved condition of the mental health practices and medical discourses of the United States relies on increased training, increasing the representation of Black practitioners, and teaching white providers how to recognize their mere cultural (non-scientific) basis for the values and methods they uphold, undoing the widely held belief that white values are implicitly neutral. To improve these elements does not solely make practices more appropriate for Black young people, it also pushes the institutions and practitioners to grow and become more whole. To help an individual heal, let alone an entire demographic of young people, you have to first view them as capable, powerful, intelligent, human. Until this happens Black youth will continue to find these institutions incapable--and they will continue to be correct.