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Breaking the Stigma: Mental Health and The Black Community

Therapist Akirah Robinson wants to serve Pittsburgh’s Black community but will the stigma associated with mental health care keep folks away?

As a Black therapist who struggles with her own anxiety issues, I’m very interested in mental health as it relates to the Black community–and the stigma often associated with it. I wonder why my family members and others in our community cringe when I tell them about my latest session with my therapist. Then, I wonder if my desire to break the stigma about mental health issues in the Black community is a worthwhile one. I’m eager to be a resource in Pittsburgh’s Black community and to encourage its members to take better care of themselves. But will Black people seek me out? Will they value my expertise?

I understand the importance of privacy. I understand that the medical field hasn’t always been kind to us. And I understand how hard it can be to find a good therapist, let alone a good Black therapist. According to the National Alliance on Mental Illness, Blacks make up only 3.7% of the American Psychiatric Association and 1.5% of the American Psychological Association. So I hold no judgment against Black people who hesitate to seek help. My role is to spread awareness and provide the most ethical, competent, and trustworthy services I can.

In “The Black Family in the Age of Mass Incarceration,” Ta-Nehisi Coates argues that the United States uses the criminal justice system as a social services agency. Rather than directly addressing the many issues faced disproportionately by Black people, including mental health issues, the US uses criminalization as an indirect solution. This approach has been used throughout history, from slavery to the present day, in various forms.

Coates writes:

Through the middle of the 20th century, America’s imprisonment rate hovered at about 110 people per 100,000. Presently, America’s incarceration rate (which accounts for people in prisons and jails) is roughly 12 times the rate in Sweden, eight times the rate in Italy, seven times the rate in Canada, five times the rate in Australia, and four times the rate in Poland. America’s closest to-scale competitor is Russia—and with an autocratic Vladimir Putin locking up about 450 people per 100,000, compared with our 700 or so, it isn’t much of a competition. China has about four times America’s population, but American jails and prisons hold half a million more people. “In short,” an authoritative report issued last year by the National Research Council concluded, “the current U.S. rate of incarceration is unprecedented by both historical and comparative standards.”

The US has only 5% of the world’s population, but 25% of world’s prisoners. Blacks are only 13% of the US population, but nearly 1 million of the 2.3 million who incarcerated here are Black.  While not shocking, these statistics are nevertheless painful.  And considering that African Americans are 20% more likely to experience serious mental health problems than the general population, but only 25% of us receive mental health treatment (compared to 40% of whites), I can’t help but wonder how many of those 1 million incarcerated Black people are in need of mental health care. I wonder what impact, if any, quality mental health services could have made–and could still make–in their lives.

While therapy alone won’t lower our incarceration rates, the impact of collective trauma on Black people’s experiences in this country, from slavery and its rocky aftermath, cannot be ignored. This collective trauma only compounds whatever individual traumas most of us have experienced at some point in our lives.

I want to help people do more than get by; I want to help people thrive.
I believe we need safe outlets to process our pain far more than we need to be locked up and separated from our families. We deserve safety, and in some ways, therapy can offer such safety.

There’s a long list of reasons why I love being Black. At the top of that list is the strength that so many of us live into on a daily basis. When I look in the mirror, I see strength. When I look at my mother and father, I see strength. When I’m looking at random Black people walking down the street, I see strength too. It seems that Black people can’t survive today without strength. It’s what keeps us alive, helps us thrive, and gives us hope.

Sometimes, though, strength can be a double-edged sword. Sometimes, strength is an expectation placed on us, against our will. Other times, it’s an expectation we place on ourselves, all for the sake of appearing in control and independent. Either way, strength can be a big reason why people close themselves off from others, don’t take advantage of resources, and refuse to ask for help. Living up to this ideal of strength can feel pretty isolating at times.

When strength leads to isolation, I’m not a huge fan. Strength that is fueled by shame makes me really uncomfortable, partly because I’m far too familiar with it. There was a time in my own life that I confused shame for strength, and that mistake suffocated me. Though I was hesitant to confide in a stranger and tell her all my business, I knew I needed to take that risk. I didn’t have much money, but I did have Employee Assistance Program (EAP) benefits through my job. So with much fear and trepidation, I called them up and started meeting with a therapist named Darla. About eight sessions later, the risk proved to be worth it. A few months after that, I started my Master of Social Work program at Pitt.

Does my success story mean every Black person needs to get a therapist? Certainly not. Again, I respect whatever reasons people have for not seeking support, even if their mental health is at stake. I know all too well how unproductive it is to push people beyond what they’re ready for. As long as no one’s safety is at stake, most folks are fully capable of getting by, day by day.

I got into this profession, however, because I want to help people do more than get by. Call me cheesy and idealistic, but I want to help people thrive. And in order to help people who look like me thrive, I’m going to keep working to understand this stigma associated with getting help.

About the Author

Akirah Robinson is a licensed social worker, writer, and therapist who loves helping women heal. She lives in Pittsburgh, PA with her handsome husband and their hyperactive hound dog, Walker. Her first book, "Respected" was released in November 2014.


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