When Black people experience mental health conditions, it often comes along with a unique set of barriers to diagnosis and treatment.

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Illustration by Brittany England

Mental health has become an increasingly important topic over the last decade or so, with more people than ever openly discussing their experiences living with mental health conditions. But more often than not, these discussions tend to overlook the impact that mental illness can have on minorities, especially the Black community.

We spoke with Dr. Francesca K. Owoo, LCPC, LMHC, a licensed therapist specializing in treating BIPOC (Black, Indigenous, and People of Color) couples and families, about the impact of mental illness on Black communities — including how we can best bridge the gap to ensure proper mental health care for Black folks in America.

Mental health conditions affect people from every racial and ethnic background. However, in Black communities, mental illness is pervasive and can have a myriad of negative social and economic impacts, shares Owoo.

Click here to learn more about mental health in the Black community.

She explains that a long history of systemic racism and oppression has not only worsened mental illness in Black communities but also led to higher rates of suicide, especially in younger Black folks. And it’s not just a worsening of mental health that impacts these communities — it’s also a lack of access to proper treatment.

For example, one recent study found that in addition to increased anxiety and depression rates, many Black Americans faced increased barriers to treatment during the COVID-19 pandemic (such as lack of access to services and medical discrimination) that made it harder to get a proper diagnosis and adequate treatment.

“Since the murder of George Floyd and its subsequent impact on race relations in the U.S., African Americans have experienced higher rates of anxiety, depression, and post-traumatic stress disorder (PTSD),” explains Owoo.

She’s supported by a 2021 study that found Black people are more likely to experience an increase in poor mental health following incidents of public racially-motivated violence, especially highly publicized incidents.

And the impact of these mental health changes cannot be overstated as many mental health conditions, especially when untreated, can have a significant impact on someone’s quality of life.

“Anxiety can manifest as difficulty concentrating, physical tension, excessive fear, a racing heart, avoidance of triggers related to trauma, anger, and irritability,” Owoo shares. “[And] depression entails decreased energy, feeling as if you are moving in slow motion, insomnia/hypersomnia, loss of interest in previously enjoyed activities, weight fluctuation, and potential suicidal ideation.”

In addition to anxiety and depression, PTSD is also prevalent in Black communities. This condition is likely linked, in part, to a long history of racism and systemic oppression.

According to recent research, multiple studies over the years have shown that PTSD prevalence and risk were highest for Black/African Americans, not just in the military but also in the general population. And in one study, racial discrimination was found to contribute to that increased risk, in Black Americans and Latino Americans.

How does depression affect the Black community?

Research from 2019 exploring the literature on depression in Americans found that studies place the prevalence of depression at roughly 17.9% in white people, versus only 10.4% in Black people — something that may be attributed to the underdiagnosis of this condition in minority populations.

However, despite rates of depression being seemingly lower in Black communities, Black folks tend to experience more chronic, severe, and debilitating depression than white people.

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Owoo explains that many factors drive mental health disparities among Black communities, such as institutionalized racism, racial trauma, healthcare disparities, poor access to services, cultural incompetency, and more.

For example, one study from 2019 explored the various factors that led to unmet mental health needs in Black adults. According to the researchers, there were four barriers that study participants cited as having the biggest effect on not having their mental health needs met:

  • nonhealthcare-related oppression
  • compounding discrimination
  • institutional mistrust
  • microaggressions

These barriers don’t just cause differences in prevalence or severity — they also prevent Black Americans living with mental health conditions from getting the help they need, which can result in untreated (or worsening) mental illness.

Learn more about why working with a Black therapist can remove some of these barriers.

What mental health conditions are more common in African Americans?

Black and minority Americans appear to have lower rates of certain mental health conditions, such as depression and anxiety, when compared to white Americans. However, research suggests that some of this discrepancy may be due to the fact that mental illnesses are more likely to be underdiagnosed or misdiagnosed in Black people versus white people.

Other conditions, like schizophrenia, seem more prevalent in Black communities — with research suggesting that Black Americans are 3–4 times more likely to be diagnosed with psychotic disorders than white Americans.

Although, once again, it’s possible that there are factors contributing to this disparity in prevalence rates, such as overdiagnosis of these conditions due to clinical or racial bias from providers.

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Owoo shares that the best way to support the mental health of Black communities is not only to create a supportive environment for Black folks but also to increase access to mental health services and resources.

“Starting with the basics — building a strong support system among family and friends. Lets normalize conversations in our interpersonal relationships about mental health. And also remember you can have Jesus and therapy,” she shares. “We also need to work toward increasing access to therapy and counseling services, providing information about available treatment options, and advocating for improved care from health systems.”

If you’re interested in reading more about the impact of mental health on Black communities, here are a few more Healthline pieces to explore:

You’re not alone

As we’ve discussed, getting proper mental health care as a Black person can be crucial to your emotional and physical well-being.

And if you’re looking for national organizations and resources that focus on advocating for Black mental health, here are a few to check out:

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Mental illness has a huge impact on Black communities — psychologically, socially, and economically.

As the prevalence of mental health conditions continues to increase in Black communities, Black Americans still remain disproportionately affected, all while facing barriers that make it difficult or even impossible to receive a diagnosis or treatment.

If we want to change the narrative around mental health and mental illness in the United States, it’s crucial that we focus on our most disproportionately affected communities and ensure that everyone — no matter their race, ethnicity, or background — is able to get the mental health care they need.