Erasing the stigma: how shame about mental health has affected African American families for generations
By Ciara Jones, Davon Harris, Reggie Payne and Erin Burnett
Sidney Davis did not want to be known as that kid. The one with the mental illness.
Davis has attention deficit hyperactivity disorder, but she didn’t want people to know. So she hid it. Growing up, her parents didn’t talk about things like that. So neither did she.
“It’s hard to talk to my parents, who are West Indian, they can’t acknowledge it exists and growing up they didn’t make it a known thing,” said Davis, now a student at Morgan State University.
The Davis family is not alone.
Like many African American families, the Davises didn’t address mental illness because of the stigma that surrounds it. While African Americans aren’t the only ones to shun mental health treatment, as a group, they disproportionately don’t seek help for depression, bipolar disease and other illnesses. Mental illness is embarrassing and considered a sign of weakness in many black families. It is not something to be proud of.
“Our parents grow up semi-ignorant to anything about pain, and due to that, their kids aren’t aware of pain,” said Davis, who has since gotten a better handle on her mental illness. “And then their kids’ kids create a mental mindset disease that continues to be passed down from generation to generation.”
Twenty percent of African American people are more likely to have mental health problems compared to the general population, according to the U.S Department of Health and Human Services Office of Minority Health. And of this 20 percent, few are likely to get medical or psychiatric help. Most of the time, it’s perceived as a weakness and brushed off as “just the blues.”
Many African Americans avoid treatment for mental health problems because of pride, shame and stigma. They are more likely to turn to family, faith, and community to deal with their issues, according to the Office of Minority Health. Others don’t want to take the medication sometimes needed to ease mental health symptoms.
“Mental health illness has been passed down through generations,” said Dr. Benjamin Dukes, an independent clinical social worker at Richard Wright Public Charter School for Journalism and Media Arts in Washington D.C. Intergenerational trauma isn’t unique to the African American community, but it does play a big part in the community’s response to mental health, he said. History – from slavery to modern-day racism – has contributed to a distrust of the healthcare system that many African Americans have, he said.
In one study published in the American Journal of Public Health, African Americans reported consistently higher levels of distrust in doctors than whites or a mixed relationship dependent on their socioeconomic status. “We don’t have the best relationship with the United States, and it has never treated African Americans fairly,” Dukes said.
Centuries of physical, emotional, and mental abuse under slavery and the way doctors have treated African Americans in the past have left a lasting stain on the way they view the medical system. Research has backed up the idea that the stigma mental illness carries still exists because the legacy continues to be passed down. Many still recall the Tuskegee Experiment when federal health researchers knowingly withheld treatment of the disease syphilis from African Americans, so they could track full progression of the disease. Many died or suffered severe health problems, such as blindness.
The project, which started in 1932 and lasted 40 years, still lingers in the minds of African Americans even today. Researchers at Tuskegee University found that the experiment fostered distrust in the medical community. In response, a center was created to try and transform the negative legacy into opportunities to collaborate on research and encourage African Americans to once again participate in research and seek medical care for the health of the entire community. Without healing the past, the stigma will continue to be a force. In the 2013 study, “Mama just won’t accept this: Adult Perspectives on Engaging Depressed African American Teens in Clinical Research and Treatment,” researchers found the two biggest barriers to mental health treatment for teens was access, being able to get an appointment, and stigma.
Families wary of the negative connotations society already places on African Americans, worried about the effect a mental health diagnosis would have on their children. “An unfortunate consequence of this perspective is that families may allow a depressed teen to suffer in silence as a means of ‘protecting’ the teen from mental health stigma associated with seeking care,” the researchers from Duke University and the University of Illinois at Chicago wrote. This, an issue that continues to flourish in homes.
“Every day, families deny that mental health exists, which forces me and everyone else to cope in silence,” Davis said.
Parents can play a big role in the Code of Silence. Parents often adopt this mentality that “what happens at home stays at home,” which prevents their children from receiving proper treatment. The code of silence affects financially stable households and those in lower-income communities.
“Especially children in poverty,” said Dukes. “They have a higher likelihood to live in an area with a lot of violence. Living in a lot of violence leads to having PTSD.”
The rate of posttraumatic stress disorder (PTSD) among urban populations is about 31 percent, compared to 17 percent of returning Iraq war veterans of 17 percent, according to the Illinois Criminal Justice Information Authority. Those who are fortunate are able to get treatment, therapists said. But too many don’t.
Stephanike Moore, a Maryland therapist, said, “African Americans have an image of strength to uphold so they hold things in. This hinders patients.” She tells patients to be brutally honest or else therapy doesn’t work. Teens, in particular, feel as though nothing is wrong with them or they don’t have a problem. More needs to be done to stop the generational spread, she said.
“The question we should all be asking is, how can we stop this issue from reaching the next generation,” she said. “This situation is urgent. Our children are dying, and we need to find a way to destroy the stigma entirely.”
A New Jersey man, Amir, who chose not to give his last name, said he often felt sad and anxious growing up. He sometimes couldn’t get out of bed because of the emotions. But the 29-year-old didn’t know what he was suffering from was depression until he was an adult. People didn’t talk about mental health when he was growing up. They didn’t get treatment. Some friends turned to drugs and alcohol as a way to cope. In college, he hit his lowest point emotionally and realized something had to change. After hearing from his mother that she had depression, he began to do his own research. Still, he was skeptical about treatment because he didn’t think it would help. Just like his mom, who never got therapy, he dealt with it on his own.
“I noticed a cycle between parents [ignoring] it, then children [ignoring] it, and the cycle continues,” he said. He finally went to therapy after he became an “actual adult.” He just felt it was time. Now he has three children and makes a point to speak about mental illness so the next generation won’t stumble along as he did. Amir believes more education about mental illness and conversations with parents is a major step to break the stigma.
“Education is the key to liberation,” he said.
The good thing is more attention is being brought to mental illness, and the stigma is slowly being erased, therapists said. Some of the attention is being brought by celebrities. Actress Taraji P. Henson started her own foundation to bring awareness to the issues in honor of her father, who suffered from mental illness. The Boris Lawrence Foundation will give scholarships to African American students who are planning to major in mental health-related fields. It will also offer complete mental health services.
Henson isn’t the only celebrity who advocates and talks about mental health. Rappers DMX, Lil Wayne and Kanye West have publicly discussed their battles with mental health. DMX discussed his struggles living with bipolar disorder on the Dr. Phil Show. He said he has two personalities. One is X, the man on the stage, and the other is Earl, his stable half. West shares similar struggles as DMX. In his songs, he quotes words including, bipolar, multiple times to describe his illness. He wants the stigma to be removed from it.
Celebrities aren’t the only ones pushing for the destigmatization of mental illness. Orkeem Davis, a therapist who treats Amir, said people might not get treatment because of the way society views mental illness. “The more people talk about it, the more accepted it will become,” he said.
“The world we live in specifically associates mental health with being delusional and crazy, and that’s by far not the case,” he said.
Davis believes something must change to break this stigma. Like his patient, he believes “knowledge is key” and that African Americans need to be better educated about mental illness that affects their communities. Resources are also an issue, he and other therapists said. There are not enough treatment facilities in minority communities, and there is also a lack of funding, he said. He does what he can by offering cheaper rates and devotes his time to educating people who live in South Jersey about mental health illness.
Davis isn’t the only one spreading awareness about the limited treatment options in these communities. Dr. Sheila Robinson-Kiss, a New Jersey therapist, also believes that minority communities lack the resources to fully tackle this topic head on. When these resources are actually made available, there is still a struggle in finding the exact form of effective treatment. She said there are little steps people can take to break the stigma, such as creating healthy relationships between parents and their children. Therapy can be quite effective if executed correctly. Dukes believes strongly in therapy. He does the best he can to try to get people to open up during sessions.
“I create a space that’s safe enough to allow that person to be all of who they are,” he said.
Many people find therapy helpful once they are willing to try it, Dukes said. The younger generation is helping to open their parent’s eyes to mental health treatment. Princyana Hudson, a student at Richard Wright, thinks that mental health is generally viewed as a weakness in the black community.
“People think it’s embarrassing,” she said.
But she thinks people her age are more open to therapy even if their parents are less inclined to it. Children can have more open conversations with their parents to help change their perspective. Hudson said therapy sessions she participates in at school have helped her learn to deal with mood swings. She stops and thinks about things before acting on them. This has helped her to get a better handle on her emotions, she said.
“Kids go through things that could scar them for the rest of their lives, so why not start early?”
Duke also sees hope in the next generation in erasing the shame around mental health.
“Let’s not keep it a secret,” he said.