Mental Health

Race and Mental Health

 
 
 

This webinar focuses on the negative impact of racism on mental health symptoms for people of color. Additionally, it provides some coping resources to deal with the stress, anxiety, and overall emotional toll of racism.

 

This is the first of seven videos from a 2 day conference at Harvard in 2018, Race, Racism and Mental Health. The other videos can be found here.

What is “Black Mental Health” and why does it “Matter”? Hear Phillip’s journey of trauma, resilience, and advocacy as he gives an impassioned talk discussing the impact of trauma on black identity, and black wellness, and why America’s current conversation on mental health is inadequate.

 

The following are presentations from the ISPS 2018 Annual Conference: Psychosis and Institutional Racism in the UK. Institutional racism is sometimes viewed as the elephant in the room in mental health and psychosis. We know that people from racialised minorities are more likely to be diagnosed with schizophrenia, more likely to be subject to the Mental Health Act, and more likely to be restrained or be under a Community Treatment Order. And yet- it seems to many working or campaigning in the field that we have failed to address these issues, and that too little has changed over the past few decades.

How do start talking about and addressing institutional racism, when so often it can feel invisible or taboo? How does institutional racism affect people who use services, but also family members and carers, and professionals (psychiatrists, psychologists, nurses, OTs, HCAs etc) who deliver services? What are the barriers which stop us talking about it – and how do we address what we struggle to recognise?

These presentations encourage discussion & reflection on how institutional racism plays out in the field of psychosis, from multiple perspectives. They reflect on how we can name it, and how, together, we can start to find ways of addressing it.

Hári Sewell is Founding Director of Health HS Consultancy, UK, which specialises in mental health and social care, social justice and equalities. A qualified social worker by background, he has held senior posts in mental health and social care in the health sector, local authorities and central government. He has worked in the field of Equalities and Mental Health nationally and internationally.

Dr Suman Fernando is an Honorary Professor on the Faculty of Social Sciences and Humanities at London Metropolitan University and retired psychiatrist. He is the author of several books including Cultural Diversity, Mental Health and Psychiatry: The Struggle Against Racism.

Colin King reflects on his experiences in the medical system.


A panel discussion hosted to begin a nuanced dialogue on the intersection of race and mental health within the Muslim community. The panel will address how prolonged exposure to racism and racial microaggressions act as a detriment to mental health and how mental health treatment is often deeply racialized. The panel will also address how the Muslim community can better address mental health issues in a manner that is culturally and racially sensitive.

 

Institutional Racism in Psychiatry and Clinical Psychology examines the deep roots of racism in the mental health system. Suman Fernando weaves the histories of racial discourse and clinical practice into a narrative of power, knowledge, and black s…

Institutional Racism in Psychiatry and Clinical Psychology examines the deep roots of racism in the mental health system. Suman Fernando weaves the histories of racial discourse and clinical practice into a narrative of power, knowledge, and black suffering in an ostensibly progressive and scientifically grounded system. Drawing on a lifetime of experience as a practicing psychiatrist, he examines how the system has shifted in response to new forms of racism which have emerged since the 1960s, highlighting the widespread pathologization of black people, the impact of Islamophobia on clinical practice after 9/11, and various struggles to reform. Engaging and accessible, this book makes a compelling case for the entrenchment of racism across all aspects of psychiatry and clinical psychology, and calls for a paradigm shift in both theory and practice.

Racism and Psychiatry addresses the unique sociocultural and historical systems of oppression that have alienated African-American and other racial minority patients within the mental healthcare system. This text aims to build a novel didactic curri…

Racism and Psychiatry addresses the unique sociocultural and historical systems of oppression that have alienated African-American and other racial minority patients within the mental healthcare system. This text aims to build a novel didactic curriculum addressing racism, justice, and community mental health as these issues intersect clinical practice. Unlike any other resource, this guide moves beyond an exploration of the problem of racism and its detrimental effects, to a practical, solution-oriented discussion of how to understand and approach the mental health consequences with a lens and sensitivity for contemporary justice issues. After establishing the historical context of racism within organized medicine and psychiatry, the text boldly examines contemporary issues, including clinical biases in diagnosis and treatment, addiction and incarceration, and perspectives on providing psychotherapy to racial minorities. The text concludes with chapters covering training and medical education within this sphere, approaches to supporting patients coping with racism and discrimination, and strategies for changing institutional practices in mental healthcare.

'Black and minority ethnic communities lack confidence in mental health services', according to the National Service Framework for Mental Health published by the Department of Health in 1999.  Cultural Diversity, Mental Health and Psychiatry examine…

'Black and minority ethnic communities lack confidence in mental health services', according to the National Service Framework for Mental Health published by the Department of Health in 1999.

Cultural Diversity, Mental Health and Psychiatry examines how and why this situation has come about, and makes specific practical, often surprising, suggestions for changing the status quo. The book reflects on the current situation in light of the author’s personal experience, academic research and anecdotal reports. He weaves together themes of immense importance for the future of psychiatry and mental health services in a multi-cultural setting.

 

Resources

Alang SM. Mental health care among blacks in America: Confronting racism and constructing solutions. Health Serv Res. 2019 Apr; 54 (2): 346–355.

Assari S, Moazen-Zadeh E, Caldwell CH, Zimmerman MA. Racial Discrimination during Adolescence Predicts Mental Health Deterioration in Adulthood: Gender Differences among Blacks. Front Public Health. 2017 May 29;5:104.

Ayalon L, Gum AM. The relationships between major lifetime discrimination, everyday discrimination, and mental health in three racial and ethnic groups of older adults. Aging Ment Health. 2011 Jul 1; 15 (5): 587-94.

Berger M, Sarnyai Z. "More than skin deep": stress neurobiology and mental health consequences of racial discrimination. Stress. 2015 Jan; 18 (1): 1-10.

Bor J, Venkataramani AS, Williams DR, Tsai AC. Police killings and their spillover effects on the mental health of black Americans: a population-based, quasi-experimental study. Lancet. 2018 Jul 28; 392 (10144): 302-310.

Britt-Spells AM, Slebodnik M, Sands LP, Rollock D. Effects of Perceived Discrimination on Depressive Symptoms Among Black Men Residing in the United States: A Meta-Analysis. Am J Mens Health. 2018 Jan; 12 (1): 52-63.

Brown MJ, Cohen SA, Mezuk B. Duration of U.S. residence and suicidality among racial/ethnic minority immigrants. Soc Psychiatry Psychiatr Epidemiol. 2015 Feb; 50 (2): 257-67.

Budhwani H, Hearld KR, Chavez-Yenter D. Depression in Racial and Ethnic Minorities: the Impact of Nativity and Discrimination. J Racial Ethn Health Disparities. 2015 Mar; 2 (1): 34-42.

Calzada EJ, Kim Y, O'Gara JL. Skin color as a predictor of mental health in young Latinx children. Soc Sci Med. 2019 Oct; 238: 112467.

Cheng JK, Fancher TL, Ratanasen M, Conner KR, Duberstein PR, Sue S, Takeuchi D. Lifetime Suicidal Ideation and Suicide Attempts in Asian Americans. Asian Am J Psychol. 2010 Mar; 1 (1): 18-30.

Cheref S, Talavera D, Walker RL. Perceived Discrimination and Suicide Ideation: Moderating Roles of Anxiety Symptoms and Ethnic Identity among Asian American, African American, and Hispanic Emerging Adults. Suicide Life Threat Behav. 2019 Jun; 49 (3): 665-677.

Ertel KA, James-Todd T, Kleinman K, Krieger N, Gillman M, Wright R, Rich-Edwards J. Racial discrimination, response to unfair treatment, and depressive symptoms among pregnant black and African American women in the United States. Ann Epidemiol. 2012 Dec; 22 (12): 840-6.

Evans N, Sheu JJ. The Relationships Between Perceived Discrimination and Utilization of Mental Health Services Among African Americans and Caribbean Blacks. J Immigr Minor Health. 2019 Dec; 21 (6): 1241-1247.

Fang K, Friedlander M, Pieterse AL. Contributions of acculturation, enculturation, discrimination, and personality traits to social anxiety among Chinese immigrants: A context-specific assessment. Cultur Divers Ethnic Minor Psychol. 2016 Jan; 22 (1): 58-68.

Fattore GL, Amorim LD, Dos Santos LM, Dos Santos DN, Barreto ML. Personal-Level and Group-Level Discrimination and Mental Health: the Role of Skin Color. J Racial Ethn Health Disparities. 2018 Oct; 5 (5): 1033-1041.

Ferdinand AS, Paradies Y, Kelaher M. Mental health impacts of racial discrimination in Australian culturally and linguistically diverse communities: a cross-sectional survey. BMC Public Health. 2015 Apr 18; 15: 401.

Gomez J, Miranda R, Polanco L. Acculturative stress, perceived discrimination, and vulnerability to suicide attempts among emerging adults. J Youth Adolesc. 2011 Nov; 40 (11): 1465-76.

Heald A, Vida B, Farman S, Bhugra D. The LEAVE vote and racial abuse towards Black and Minority Ethnic communities across the UK: the impact on mental health. J R Soc Med. 2018 May; 111 (5): 158-161.

James D. Internalized Racism and Past-Year Major Depressive Disorder Among African-Americans: the Role of Ethnic Identity and Self-Esteem. J Racial Ethn Health Disparities. 2017 Aug; 4 (4): 659-670.

Jochman JC, Cheadle JE, Goosby BJ, Tomaso C, Kozikowski C, Nelson T. Mental Health Outcomes of Discrimination among College Students on a Predominately White Campus: A Prospective Study. Socius. 2019 Jan-Dec; 5.

Matsuzaka S, Knapp M. Anti-racism and substance use treatment: Addiction does not discriminate, but do we? J Ethn Subst Abuse. 2019 Jan 14: 1-27.

Mouzon DM, McLean JS. Internalized racism and mental health among African-Americans, US-born Caribbean Blacks, and foreign-born Caribbean Blacks. Ethn Health. 2017 Feb; 22 (1): 36-48. Epub 2016 Jun 28.

Nazroo JY, Bhui KS, Rhodes J. Where next for understanding race/ethnic inequalities in severe mental illness? Structural, interpersonal and institutional racism. Sociol Health Illn. 2020 Feb; 42 (2): 262–276.

Oh H, Stickley A, Koyanagi A, Yau R, DeVylder JE. Discrimination and suicidality among racial and ethnic minorities in the United States. J Affect Disord. 2019 Feb 15; 245: 517-523.

Pachter LM, Caldwell CH, Jackson JS, Bernstein BA. Discrimination and Mental Health in a Representative Sample of African-American and Afro-Caribbean Youth. J Racial Ethn Health Disparities. 2018 Aug; 5 (4): 831-837.

Pieterse AL, Todd NR, Neville HA, Carter RT. Perceived racism and mental health among Black American adults: a meta-analytic review. J Couns Psychol. 2012 Jan; 59 (1): 1-9.

Polanco-Roman L, Anglin DM, Miranda R, Jeglic EL. Racial/Ethnic Discrimination and Suicidal Ideation in Emerging Adults: The Role of Traumatic Stress and Depressive Symptoms Varies by Gender not Race/Ethnicity. J Youth Adolesc. 2019 Oct; 48 (10): 2023-2037.

Pugh M. Racism, Healthcare Provider Trust, and Medication Adherence among Black Patients in Safety-Net Primary Care: A Strength-Based Approach. [master's thesis]. Richmond, VA: Virginia Commonwealth University; 2017.

Singh SP, Burns T. Race and mental health: there is more to race than racism. BMJ. 2006 Sep 23; 333 (7569): 648–651.

Stein GL, Castro-Schilo L, Cavanaugh AM, Mejia Y, Christophe NK, Robins R. When Discrimination Hurts: The Longitudinal Impact of Increases in Peer Discrimination on Anxiety and Depressive Symptoms in Mexican-origin Youth. J Youth Adolesc. 2019 May; 48 (5): 864-875.

Vu M, Li J, Haardörfer R, Windle M, Berg CJ. Mental health and substance use among women and men at the intersections of identities and experiences of discrimination: insights from the intersectionality framework. BMC Public Health. 2019 Jan 23; 19 (1): 108.

Walker RL, Salami TK, Carter SE, Flowers K. Perceived racism and suicide ideation: mediating role of depression but moderating role of religiosity among African American adults. Suicide Life Threat Behav. 2014 Oct; 44 (5): 548-59.

Wallace S, Nazroo J, Bécares L. Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the United Kingdom. Am J Public Health. 2016 Jul; 106 (7): 1294-300.

Wang KT, Wong YJ, Fu CC. Moderation effects of perfectionism and discrimination on interpersonal factors and suicide ideation. J Couns Psychol. 2013 Jul; 60 (3): 367-378.

Williams DR. Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-related Stressors. J Health Soc Behav. 2018 Dec; 59 (4): 466–485.