Black Americans' Mental Health: Fear In the "White Space"

“When you combine a recession with COVID-19, and a pandemic of racial inequality and police brutality, you see that throughout social media, you see African Americans getting a double and triple dose of stress.

“And so what we see is an all time high need for mental health services. So there's not a psychologist that I know who was not booked thoroughly because of the need in the African American community.”

– Dr. Alduan Tartt, Psychologist, PhD

While George Floyd's death has emerged as a pivotal moment amid a national reckoning on race, the issue extends far beyond one summer and one man. Before Floyd, there was Tanisha Anderson, a unarmed Black woman seeking mental health assistance killed by police in Cleveland in 2014, Shereese Francis, a Black woman who was suffocated during a police encounter in 2012, and countless others.

(Ryan Shepard. “Black American anxiety at all-time high, experts say.”

ABC News. September 05, 2020.)

The surging coronavirus pandemic and subsequent social unrest from police violence have resulted in a toxic daily environment that can have a deleterious effect on Black Americans' mental health, experts say.

Dr. Thomas A. Vance of Columbia University suggests that Black Americans are 20% more likely to experience "serious mental health problems" than the general population. The Black community suffers from an increased rate of mental health concerns, including anxiety and depression. They also found that Black youth who are exposed to violence are 25% more likely to experience PTSD.

Suicide rates are rapidly rising in the Black community, particularly among children. Among high schoolers, 9.8% of Black students report attempting suicide, compared with 6.1% of their white peers.

Suicide attempts among white teens decreased between 1991 and 2017, but the rate rose in Black teens in the same period.

(Thomas A. Vance, PhD. “Addressing Mental Health in the Black Community.” Columbia University Department of Psychology. February 8, 2019.)

The increased incidence of psychological difficulties in the Black community is related to the lack of access to appropriate and culturally responsive mental health care, prejudice and racism inherent in the daily environment of Black individuals, and historical trauma enacted on the Black community by the medical field. 

Moreover, given that the Black community exists at the intersection of racism, classism, and health inequity, their mental health needs are often exacerbated and mostly unfulfilled. Issues related to economic insecurity, and the associated experiences, such as violence and criminal injustice, further serve to compound the mental health disparities in the Black population.

In 2018, researchers from the Perelman School of Medicine at the University of Pennsylvania and the Boston University School of Public Health examined data from police killings between 2013 and 2016 and their effects on the mental health of Black Americans.

"Our estimates, therefore, suggest that the population mental health burden from police killings among black Americans is nearly as large as the mental health burden associated with diabetes," the authors of the study wrote.

(Jacob Bor, SD; Atheendar S Venkataramani, MD; Prof David R Williams, PhD; Alexander C Tsai, MD. “Police killings and their spillover effects on the mental health of black Americans: a population-based, quasi-experimental study. The Lancet. June 21, 2018.)

Furthermore, the study indicated that police killings during that time period contributed to 55 million poor mental health days among Black Americans annually. These 55 million days can have a negative impact on people at work or even everyday activities like going to the movies.

"[Police killings] have affected people's everyday functioning. From people being hyper-vigilant when you're just going outside to the onset of having a panic attack when you're pulled over by the police, it has an effect," Saleemah McNeil of the Oshun Family Center said.

Psychiatric Help for Blacks

With one in five Black Americans living in poverty, mental health care can be economically unavailable for many. In 2018, Statistica (2020) shows 13.6 percent of Black Africans have no health insurance. This can make it extremely difficult to afford therapy.

Compounding the issue is a severe lack of Black mental health professionals. Even with coverage, it is a challenge to find a quality therapist who insurers will cover. In 2017, the American Psychological Association reported that only 2% of its members identified as Black or African American.

Some research shows more stigma against those who seek mental health care in Black communities. In many families, being Black means they should be resilient and triumph against the odds. If they have a mental health condition or seek mental health care, it may feel like a sign of weakness.

Racism may also play a more direct role in mental health stigma. Some Black people worry that if they seek mental health care, people will see them as crazy or dangerous. This could intensify the effects of systemic racism. Of course, Black parents often have tough conversations with fairly young children about police brutality and racism.

“I was socialized in such a way that I thought was healthy, but it was precluding me from dealing with mental health for what it truly was and the great impact that it had. We are raised to believe that we have to walk outside with a tough skin at all times to survive in the world.”

– Shaun J. Fletcher, professor at San Jose State University whose research covers health disparities among African-American men

In other cases, white therapists may use racist norms in therapy, or fail to acknowledge racial trauma in Black mental health.

Living in White Space

What is it like to be Black in America? Most Whites, understanding legal segregation was struck down more than 50 years ago, do not comprehend even the simplest pressures that still confront African Americans. Just consider this: American society is still rife with overwhelmingly white neighborhoods, malls, schools, restaurants, universities, workplaces, religious institutions and other associations. Blacks perceive such settings as “the white space,” which they often consider to be informally “off limits” for people like them.

Desegregation efforts didn’t bring about actual racial integration, as Kevin Kruse, a history professor at Princeton University, notes in his 2005 paper. Instead, it created “a new division in which the public world was abandoned to blacks and a new private one was created for whites.”

(Kevin M. Kruse. “The Politics of Race and Public Space: Desegregation, Privatization, and the Tax Revolt in Atlanta. Journal of Urban History. July 1, 2005.)

De facto segregation has reinforced a situation it which it is the norm for black people to be “typically absent, not expected, or marginalized when present” in shared spaces ranging from Ivy League universities to middle-class suburbs, Elijah Anderson, a sociology professor at Yale University, notes in his 2015 paper. It’s in these spaces where many social rewards lie, from having a nice night out on the town to accessing good education, employment, and money. There are severe consequences when black people enter these white spaces.

(Elijah Anderson. “The White Space.” Sociology of Race and Ethnicity. 2015.)

Today, “protecting” the white space often takes the form of making an unnecessary phone call to the police. Racism is always about power. It is this systemic, racist power that threatens the lives of Black Americans.

“Almost any white person present in the white space can possess and wield this enormous power” of excluding or bringing harm to black people who enter these spaces. And those who feel especially exercised and threatened by the rise of blacks may feel most compelled to wield that power.

“For some white people, the presence of a black person in a shared, white-dominated space becomes a threatening symbol of black advancement at the expense of whites. While certainly not all are guilty of such acts, many can be mobilized in complicity to ‘protect’ the white space.”

– Elijah Anderson