Barriers to the Psychiatric Illness Treatment Among Patients Belonging to the Black Community

Mental healthcare has been stigmatized in Black communities. It subtly happens in various ways. According to the World Health Organization (WHO), one in every four individuals may face a mental health condition in their life at least once.

The concept of mental health among Black people has been filtered through the lens of systemic racism for centuries. As compared to white patients, mental illness is reported 20% more among Black patients. Within the framework of social discrimination, Blacks suffer from more severe consequences during mental illness due to the lack of opportunities to seek appropriate treatments.

Here are the top eight barriers for the Black community in approaching adequate mental healthcare.

Limitations of culturally competent expertise

Cultural barriers are the foremost even if someone is newly migrated or has been in a different culture than the background state. The staff working especially at private healthcare facilities and clinicians who are dealing with Blacks might not be equipped with culturally competent skills and knowledge of the disorders. American Psychological Association has mentioned the number of culturally specific symptoms in the diagnostic and statistical manual of mental disorders. The awareness of cultural differences in illness experience may clarify the treatment goals and outcomes among experts and patients. The impairment in the capability of proper assessment and diagnosis specific to the cultural experiences of a patient directs the expert towards suggesting effective output in the form of tailored strategies to mitigate future risk.

    In the Black community, the mental healthcare service needs to multiply and intensify when left unattended or misguided and misinterpreted for any reason. Both the patient in need and the experts hinder the recovery without being aware of it. It must be considered immediately. There is evidence of the requirement to learn culturally specific information around the globe. The role of religion is also a potential factor to study deeply to ease the Black patients in communicating with an expert. Decision-making about recommendations is solely based on cultural competency.

    Unavailability of financial resources

    The lack of funds is another chief issue when it comes to covering the continuous expenses of mental healthcare and travel costs to the experts for follow-ups or technological devices for online help. The reliance on insurance may not be possible in every country. Migration policies and high rates of care services discourage Black patients from even moving towards counseling and consultation services during the experience of mild levels of mental health conditions. An example is that a patient with anxiety and depression from mild to moderate severity may need a few sessions from a clinical psychologist but when the patients are addicted to any chemical substance and non-chemical behaviors require long-term intensive care to recover from the fatal consequences.

    The scarcity of financial resources becomes a reason to perceive spending on healthcare as unnecessary. These negative attitudes prevent a person from identifying symptoms as a priority.  Those individuals who cannot rely on any other sources of funds than their part-time job and citizenship benefits stay away from the primary and integrative settings of healthcare. Low-resource settings for treatment within the community are also not offered in all the regions of the world. There is an inability to determine the appropriate interventions among most of the patients when they are ignorant of the population in which they live.

    Poor familial and social support

    The unique nature of certain demographic factors creates a difference in the care utilization of mental health treatment and management facilities serve as a barrier. Poor quality of patients’ relationships with family members, friends, and other people in life creates a huge gap in the social support of the person. Social support and a sense of belongingness is one of the significant emotional needs for human beings. In the Black community, older people suffer more from poor prognosis than younger adults. The complexity of co-occurring physical and mental illnesses leads to the intense need to engage in the psychiatric treatment process regularly.

    To seek and access mental health treatment at any age may not be smooth even in the presence of loved ones. So, it is understood that Black people have difficult relationships and poor availability of social support to protect them from worsening the effects and vulnerabilities of their illness. This barrier combines with further problems such as extreme dependency on caregivers and transportation services.

    The variety of stigma

    Higher levels of stigma prevail in the Black community as compared to Hispanics, Whites, Asians, and others. There is a loop of hierarchal stigma that passes from each other and stops the patient from asking for help and finding means of sufficient healthcare. Internalized stigma and stigma from the community are harmful for Black patients similar to the harm that racism and practitioner’s discrimination does.

    One form of stigma is self-stigma in which the patient does not find motivation to access and seek treatment because of the shame they experience about their condition. Then comes the public stigma in which patients listen to the perceptions of people around them about patients with mental illness. The disapproval of the people who live around patients stops the treatment seeking. Community stigma is demonstrated when Black people have no support group to join or they are not allowed to seek certain treatment services. Mental healthcare stigma is commonly moved within organizational and professional institutions where Black employees work.

    Prolonging poor physical health causes a decline in acknowledging the mental health treatment needs. Socially, the acceptance of physical health conditions is better recognized in all contexts while realizing the importance of mental health is a constant battle among all generations.

    Blacks living in developed countries have major concerns when it comes to accessing mental health services and support. Being a minority increases their chances of neglect and cultural insensitivity during healthcare visits. For effective care among Black patients, improving equity in healthcare services is strongly recommended.

    For more reading:



    • https://journals.lww.com/practicalpsychiatry/Fulltext/2020/09000/A_Systematic_Review_of_Barriers_Faced_by_Older.4.aspx?casa_token=BITdafFZN5MAAAAA:1eDoxsTJkNh1tS-YO62nkGoiMkfGhnT4h-bT03uHgXny0h8VeCFeGVdADJT5-Vf7MUq7WdHBlRGwMRhYLXe3CtG5Ow
    • https://dworakpeck.usc.edu/news/why-mental-health-care-stigmatized-black-communities
    • https://bmjopen.bmj.com/content/6/11/e012337

    About the author

    Dr. Nazish Idrees Chaudhary

    Dr. Nazish Idrees Chaudhary is a registered clinical psychologist. Holding a doctorate, she is currently working as an assistant professor at The University of Lahore and working as a Director of Operations at the Grace Rehabilitation Center. She has been working with people around the world, including minorities and those with special needs. Her culturally sensitive approach in clinical settings for the last 12 years and diverse experience made her a unique writer in this field

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