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First, Do NO Harm.

As a psychotherapist, I heard this over and over again. Exhausting. Stressful. A lot of pressure! I am not a doctor I said. Does not matter, they said. According to the American Psychological Association’s Principle A: Beneficence and Non-maleficence it states that “psychologists strive to benefit those with whom they work and take care to do no harm”. Most, if not all, social workers, psychologists, psychiatrists are aware of this phrase. Sadly, what is said and believed in versus what is being done is starkly different when it comes to Black women’s mental health. Please humor me and consider some information I have gathered from my researchers lens about mental health as it relates to Black women: Depression and anxiety are significant mental health issues in the United States among Black women and people of color. There is also increasing evidence that experiencing discrimination may contribute to poor mental health among Black Americans, and according to Chae (Chae, D. H., Lincoln, K. D., & Jackson, J. S. (2011). Discrimination, attribution, and racial group identification: Implications for psychological distress among Black Americans in the National Survey of American Life (2001–2003). American), few studies have distinguished between discrimination attributed to race versus other forms of discrimination or have compared differences in their psychological implications.

Studies show that African Americans are just as much at risk for mental illness as their counterparts, yet receive substantially less treatment. Low income and African American patients in women’s health clinics are at risk for depression and under treated for depression. As current research indicates, the reality of living with mental illness in the 21st Century is reaching new heights, yet it is unclear what the liabilities and benefits are for Black women as they still find themselves falling behind Whites and other women in health and mental health indices. Leary states that mental distress in black populations has increased considerably over the past twenty years and the depression rate among African American women is estimated to be almost 50% higher than that of Caucasian women. The (NIMH) National Institute of Mental Health says that African-Americans have a lower lifetime risk of depression than whites but according to a 2014 study by the (CDC) Center for Disease Control (Centers for Disease Control and Prevention (CDC. (2004). Self-reported frequent mental distress among adults–United States, 1993-2001. MMWR. Morbidity and mortality weekly report, 53(41), 963.), African-Americans have the highest rate of current depression, 12.8 percent, which has increased from 8% over twenty years ago. For most minorities, the ability to receive access to care to assist with managing a mental health issue becomes difficult and the significance of severe mental health issues among black women are increasing, with serious consequences.

President Obama recently noted that women of color struggle everyday with biases that perpetuate oppressive standards for how they are supposed to look and how they are supposed to act. Too often, they are either left under the hard light of the scrutiny, or cloaked in a kind of invisibility. “When addressing the challenges women and girls of color face- challenges that often lie at the intersection of race and gender- we often fail to fully acknowledge, and account for, this opportunity.”

A report by Valencia et al (Valencia Jones, L., & Guy-Sheftall, B. (2015). Conquering the Black girl blues. Social work, 60(4), 343-350.), examine the literature on epidemiology, etiology, and use of services for this population reveals an insufficient application of culturally congruent approaches to intervening with black women. Black women have been and continue to be absent from research studies that might help them understand and identify their own emotional and mental voids. They are also at higher risk of internalizing powerlessness with the absence of limited or denied access to resources. To most effectively explore the issues of how and why black women experience undiagnosed pervasive mental illness, discrimination and access to care, a subset of literature has been selected based on its relevance to the following questions:

  1. How do Black women who have been diagnosed with severe, chronic mental illness describe their experiences with their own mental health challenges, and how do their interpretations compare to current sources of information about the experience of others living with mental illness as they vary with respect to race, class, and gender?

  2. Does current research effectively document how Black women interpret institutional and policy responses at the local and national level to their individual needs and attempts to create a functional environment for themselves and any dependents they may have?

  3. What, if any, evidence is there of efforts to form communities with the potential to create social change (e.g., economic or political coalitions or groups) based on commonalities among Black women with similar mental health concerns?

Despite major advances in the medical system, Bell (Bell, B. L. (2009). African American women’s perceptions of race, gender, socioeconomics, and stress on health outcomes (Doctoral dissertation, Saybrook University).) says that the inequalities in health outcomes of African American women persist. African American women represent 13% of the female population, yet they account for over 50% of AIDS cases, have death rates that exceed other women by 46% for stroke, heart disease, and cancer. Despite progress made over the years, racism continues to have an impact on the mental health of Black Americans. Negative stereotypes and attitudes of rejection have decreased, but continue to occur with measurable, adverse consequences. Historical and contemporary instances of negative treatment have led to a mistrust of authorities, many of whom are not seen as having the best interest of Black Americans in mind. When Black women face multiple disadvantages and there is evidence that confirms existing barriers to care, mental health stigma needs to be considered in a wider context. Basically, the pickin’s is slim people. Am I too angry to deserve adequate research about myself or women that look like me? I have so many questions. I am genuinely concerned. I still have questions. Me and my colleague, Dr. Marya Sosulski, will spend a ton of time addressing these questions and issues in future blogs. Stay Tuned!

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