How stigma impacts access to mental health care for Black, Indigenous and people of color

Stigma plagues access to mental health care regardless of background, but this is especially true for Black, Indigenous and people of color (BIPOC). In 2018, non-Hispanic white people received mental health treatment twice as often as Hispanic and Black people. Even when BIPOC did receive care, they reported more dissatisfaction in their treatment experiences for mental health.

July was established as Minority Mental Health Awareness Month in 2008 to highlight the differences in mental health access and treatment based on background and identity. This year, Mental Health America (MHA) renamed the awareness month to BIPOC Mental Health Month to honor and discern the experiences of Black, Indigenous and people of color.

The acronym, BIPOC, aims to remove the inherent inferiority the term “minority” places upon underrepresented communities, and respects within group differences that exist in the term “person of color” (POC).

How does stigma and access to care relate to BIPOC Mental Health Month?

Every BIPOC brings with them different experiences and life stories, but overall, BIPOC are more likely to experience racism and stigma related to mental health.  BIPOC face systemic racism barriers in access to care and treatment selection. When they do seek services, BIPOC experience higher chances of being misdiagnosed, assigned to junior professionals and terminated from treatment prematurely.

The perpetuation of mental health stigma is reinforced by both negative experiences in counseling as well as language barriers that inhibit access to care. In a nationwide survey conducted by the American Psychological Association (APA) in 2015, only 5.5 percent of psychologists—regardless of race or ethnicity—said they could provide Spanish speaking services.

There are only about 5,000 Hispanic psychologists in the United States compared to a Hispanic population of more than 57 million. This is important, because in addition to linguistic barriers, there are barriers perpetuated by a lack of bicultural representation among psychologists. APA studies have found that only 16 percent of the field identify as a BIPOC group member.

“In addition to advocating for and removing barriers for more BIPOC to enter the field of psychology, training and equipping all therapists to continually work towards cultural competence is an important step to overcome these barriers,” said Kaylee Jackson, program coordinator of the Texas A&M Health Telebehavioral Care Program. “Health care professionals must be better equipped to provide high quality services for all regardless of race, ethnicity, gender identity, sexual identity, ableness and other identities that currently result in disparities in access and outcomes in treatment.”

What is cultural stress and what are some coping mechanisms for it?

Cultural stress refers to stressors that BIPOC experience as a result of their race or culture. With recent events stemming from racial and culture issues, cultural stress for many BIPOC has been elevated and hitting close to home. One survey showed that after the police killing of George Floyd, symptoms related to depression and anxiety increased for African Americans and Asian Americans.

Cultural stress can manifest in various ways. In addition to depression and anxiety, it may be expressed through anger or frustration.

To cope with cultural stress, BIPOC can engage in various self-care practices such as connecting with family and friends, engaging in religious or spiritual practices, engaging in things that bring them happiness, and being an advocate.

Additionally, self-care practices include identifying ways that cultural stress is affecting you physically (i.e. lack of sleep) and emotionally (i.e. irritability) and attending to it. Taking a break from media coverage to unplug when it becomes overwhelming is important for mental health and well-being. Lastly, BIPOC should consider seeking a culturally competent counselor if stressors continue.

“Cultural competence is a journey, not a destination for any health care professional, but there are some things you can look for,” said Carly McCord, PhD, director of the Telebehavioral Care Program. “Mental health professionals from accredited programs usually have required coursework that grow multicultural competencies and many mention experience or expertise in particular populations in their bios and websites. It is also appropriate to ask about their experience with an identity that is important to you before signing up for your first appointment. Find a mental health professional who is more interested in getting it right than being right.”

—Carlos Aleman, program coordinator, and Tyler Evans, practicum counselor, Texas A&M Health Telebehavioral Care Program