How Stigma of Mental Illness Affects African American Communities

Feb. 6, 2020


“People of color, particularly African Americans, feel the stigma more keenly. In a race-conscious society, some don’t want to be perceived as having yet another deficit.” — Bebe Moore Campbell, author and journalist

When it comes to delivering appropriate mental health care to people who need it, stigma is the enemy for everyone involved. Feelings of shame about having a mental health disorder can prevent a person from seeking help, which unnecessarily delays their recovery and could lead to their condition worsening. And although people of every race and ethnicity experience stigma, it can be especially formidable for those in the African American community.

For example, even though rates of mental illness are similar for all races, only 31% of African American adults with mental illness receive treatment for their condition, compared to the U.S. average of 43%. Qualitative research has found that some African American mental health consumers reported delaying their treatment due to concerns about stigma. And most worryingly, the rate of suicide death among African American youth is increasing faster than for any other racial or ethnic group, suggesting that stigma and other barriers are preventing them from receiving the mental health care they need.

Although mental health stigma affects everyone, these statistics show that it’s especially challenging for the African American community. In observance and celebration of Black History Month, we here at Cummins Behavioral Health wanted to bring awareness to the unique difficulties that African American people face when seeking treatment for mental health issues. After all, it’s only by calling attention to problems in behavioral health care that we can begin to do our part to fix them.

To get a better understanding of the issue of stigma in the African American community, we spoke with Michelle Freeman, our Director of Operations for Marion and Hendricks Counties. She explained some of the roots of stigma among African Americans as well as what mental health organizations can do to address the needs of the community.

Trust and Distrust: A Key Facet of Stigma


Michelle Freeman, LMFT

There are several common explanations for why African American people tend to experience stigma differently, and in some cases more strongly, than people of other races and ethnicities. Many of these explanations involve trust, either of individuals or of entire institutions.

The African American community has endured many unique hardships throughout its history, from slavery to the civil rights movement and socioeconomic inequalities that continue to this day. Over the centuries, the community has developed a strong sense of resilience and self-sufficiency that has allowed it to endure the many struggles it has faced. The flip side of this resiliency is that acknowledging a mental illness can sometimes be perceived as an admission of weakness.

“I think part of the issue with stigma is around this long-standing idea in the African American community of who can be trusted with deep, personal issues that may be impacting a family, whether it’s ongoing trauma or medical or mental health issues,” Michelle says. If a person doesn’t trust that their community will support their decision to seek therapy or counseling, then they might refrain from doing so or feel ashamed that they need help.

On the other hand, centuries of institutional oppression and inequality has made some in the African American community distrustful of government organizations and even the medical establishment. Adding to the problem is the fact that African American mental health patients have historically been misdiagnosed at a higher rate than White patients, and that African Americans are far more likely to be criminally charged for substance use than their White counterparts. These factors often create feelings of suspicion among the African American community, adding to the stigma of seeking mental health care.

“We have to admit that we have a historical component regarding trust and how active one in the African American community would be to seek out services as a result of fear,” Michelle says.

How Mental Health Organizations Can Help Erode Stigma


Fortunately, the stigma surrounding mental illness can be challenged and weakened in two main ways. The first way is by individuals being open and honest about their mental health struggles and encouraging others in their community to do the same. Over time, this communal vulnerability can go a long way toward reducing stigma. However, mental health organizations can also help reduce stigma through community engagement.

“I think we really need to be engaged and active in the community, such as at the Black & Minority Health Fair, so that we can make sure people are getting the information they need and that individuals understand that we’re a safe place where they can come and seek treatment,” Michelle says. “We also need to engage our faith communities regarding education of mental health and seeking help when symptoms arise, because in the African American community, faith and the church community are often protective factors.”

Of course, the effectiveness of community engagement will be limited if mental health organizations don’t also take steps to better understand that community. According to Michelle, this is why it’s crucial to promote cultural competency among care providers:

“We need more culturally-competent physicians, therapists and psychologists. When we’re meeting with someone who belongs to a particular subculture, we need to recognize the role that might play in how we approach treatment. At Cummins, we’ve established a Cultural Competency Committee that helps us look at diverse populations, identify best practices for treating those populations, and engage our employees across the organization to be a part of this conversation so we can make sure we’re providing the best possible treatment for every population.”

Last but not least, ensuring that care is financially accessible for everyone in the African American community can help erode stigma by making therapy a normal self-maintenance practice rather than an extravagant expenditure. “It’s important that we’re looking at accessibility, affordability of services, and socioeconomic factors that might limit a person’s access to health insurance. It’s a multi-pronged issue that needs to be looked at systemically,” Michelle says.

Here at Cummins, we recognize the mental health realities and difficulties faced by the African American community, and we are committed to providing life-enriching care to people of all races and ethnicities. If you are having concerns about your mental health and would like to discuss the possibility of treatment, please give us a call at (888) 714-1927.

On behalf of the entire staff at Cummins Behavioral Health, we’d like to wish you a wonderful Black History Month 2020!


If you’d like to learn more about the unique mental health challenges of people from diverse backgrounds, we recommend our blog post from last year’s Minority Mental Health Month!