Culture in Mind

Mental health, culture, and ethnicity

The Color of Mental Illness

Can racism make us mentally ill?

As defined by the World Health Organization (WHO) mental health is "a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community." Mental health is fundamental to health and there is no health without mental health.

According to WHO, mental health is determined by socio-economic, biological and environmental factors. These multiple factors interact to create vulnerability to mental illness. WHO acknowledges that social exclusion (discrimination), risks of violence and human rights violations are associated with poor mental health. These factors are some of the conditions that define racism and racism is an environmental risk factor that also creates socio-economic risks and therefore has a confounding impact on the vulnerability of people to mental illness.

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Using these definitions and factors that contribute to mental health, it would seem logical that racism would have a negative impact on mental well-being. As an environmental condition, racism limits an individual's ability to realize their own abilities, their ability to work productively and also restricts one's ability to contribute to their community—factors that define mental health as described in the first paragraph.

WHO states that "a climate that respects and protects basic, civil, political, socio-economic, and cultural rights is fundamental to mental health promotion." The implications for mental health in the USA are clear: people whose rights are collectively or individually violated are at higher risk for mental illness than people whose rights are protected. Thus power protects mental health and people whose cultures give them less power are thus at higher risk for mental illness.

So yes... Racism can make us mentally ill.

How does this manifest within the United States?

Using 2008 data from the National Institute for Mental Health (NIMH), the racial group of with the highest prevalence of serious mental illness are White. In descending order they are followed by American Indian/Alaska Native, Hispanics, Blacks then Asians. Interestingly, people with 2 or more races have the highest prevalence rate overall. Using the most severe measure of mental illness—suicide—in 2007, NIMH reported the following in descending order of prevalence (per 100,000 people): American Indian/Alaska Native Whites, Other Races, Asian/Pacific Islander, Hispanic and Black.

These data do not give us a clear picture of an adverse impact of oppression on the mental health of racial minorities in the USA other than to note that of all cultural/racial minority groups, the indigenous peoples of the USA suffer the most from mental illness. Although causality is not easily defined, it could be argued that being at the bottom of the power ladder in the USA, put native peoples at the highest risk for mental illness. Diana March, a mental health researcher at the Office for Research on Disparities and Global Mental Health, states that one key contributor to mental health in minority communities is that racial minorities have less access to mental health services so that they are not only less likely to be diagnosed but also less likely to be treated, receive lower quality treatment and have higher attrition rates. Which means not only are they at higher risk for mental illness but they are not likely to get treatment and if they do get treatment they are less likely to get the quality and length of care that brings them back to a state of mental wellness.

The stigma attached to mental illness is a major factor that may contribute to lower rates of mental illness among certain ethnic groups. Already experiencing the impact of discrimination, already marginalized groups will resist accessing mental health services because mental illness is stigmatized in American culture and even more so in some ethnic minority groups.

So how do we reduce the impact of racism on the mental health of marginalized cultural, racial and ethnic groups in the USA?
1. The most obvious is to reduce/eliminate racism
But until #1 happens
2. Develop ‘buffers' for racism such as social support, greater access to education and economic opportunities and education about behaviors that improve mental health
3. Fight to reduce stigma so that people who need mental health services will be more willing to seek them out.
4. Greater outreach to minority communities so that they can have access to high quality diagnostic and treatment services.
5. Education and training of mental health service providers on cultural beliefs and practices that impact mental health.

 

 

Ruth C. White, Ph.D., M.S.W., and M.P.H., is the author of Bipolar 101 and is an associate clinical professor at the School of Social Work at the University of Southern California. 

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