At the New York City Psychotherapy Collective, we believe it's fundamentally necessary to acknowledge and address mental health stigma to help people overcome the obstacles to getting help when they're struggling. An often overlooked part of mental health stigma is acknowledging the different obstacles that people face in communities of color. Therapy and medical care should be accessible to everyone and something that all people can feel comfortable and confident using to feel and live their best.

Jemair Lewis is a therapist on our team who is experienced working with young adults and adults in community and college mental health settings helping them with anxiety, depression, and adjustment issues they face in the transition to adulthood. In addition, as a woman of color, Jemair has a heart and passion for helping destigmatize mental health care in the Black community.

To more completely address stigma in this article, Jemair shared her experience and expertise with us. This is not meant to speak for all people of color but is Jemair's perspective on the topic. People of color are not a monolithic race of people. Some people may relate to Jemair's experiences and some may not, but we hope that giving readers an insight into how one clinician of color views and experiences the therapy world would be helpful.

We hope that you find this insightful and that it helps spread awareness of the situation and moves us towards breaking the barriers of mental health stigma.

Q: What is different about mental health stigma in the Black community?

Historically, there is a mistrust of the Healthcare system within the Black community. This can be tied back to The Tuskegee Study which "was one of the most egregious examples of medical exploitation in U.S. history." It's linked to an increase in medical mistrust in Black communities and a decrease in seeking necessary medical attention. If you're unfamiliar with the study, we encourage you to research it to have a clearer understanding of the abuse of lack of medical care that took place along with the rippling impact it had on the Black families.

As people of color, we are used to being mistreated, underdiagnosed, and overdiagnosed by healthcare professionals. Our words and symptoms have been weaponized because there's a fundamental lack of understanding of who we are and how our experiences shape us as human beings. That's why cultural competence is so important in the mental health field.

Growing up in a Black household, most of us are taught to keep our business and our families' business to ourselves. In some Black households, the more you keep the outside world out, the better.

From what I have observed, Black people are automatically expected to be strong because we have been historically placed in situations where we have to go into survival mode and have no other choice. The only option we have is to be strong. The problem lies in the word strong and what it means. There is strength in asking for help but there's guilt and shame associated with doing so in the Black community. In many cases, that's not how we were raised. Unfortunately, the idea of keeping our business to ourselves has shown to be detrimental to our mental wellbeing as a community.

Historically, the Black community has relied on Spirituality and religion as core resources to guide them through trying times. Spirituality and religion can help deepen one's understanding and meaning of life experiences, which can improve wellness on many levels. One of the most alarming findings of help-seeking behavior within the United States is that ethnic minorities tend to seek treatment for mental illness at a lower rate than those of European American ethnicity even when controlling for education level attained and socioeconomic status.

Q: What specific obstacles do people of color face regarding mental health that others do not?

There can be a lot of barriers that prevent people of color from seeking mental health care such as financial barriers, lack of health insurance coverage, lack of availability, and stigma toward mental health in our communities. 

Mental Health stigma plagues a lot of ethnic minority communities which can be perpetuated by experiences of mistrust, unjust racism, cultural and communication barriers. Some people simply feel misunderstood by their providers and therefore, the foundation of trust is not there.

That foundation is very important to have especially when you are seeking mental health services and sharing your innermost thoughts with someone else.

Q: What obstacles get in the way of people reaching out for professional help?

Based on my experience in the field thus far, I believe a lack of BIPOC (Black, Indigenous, and People of Color) representation in the field negatively impacts people of color seeking help. Sometimes having some shared experience with your therapist, whether that be from the same race or similar background, is helpful in developing a healthy therapeutic relationship. One's ability to trust may be based on these similarities. That's not the case for everyone, though. Some people like or prefer to have a therapist that is different from them and that is fine too.

More BIPOC representation in the field will set an example for other generations to know that prioritizing your mental health needs is a must. Younger generations are paving the way towards destigmatizing mental health now, as many are more open to talking about their mental health concerns with family, friends, and therapists.

Q: What tips can you share with people of color who are experiencing mental health struggles?

It's okay to prioritize yourself and your health. Doing so does not make you selfish, it makes you selfless. By seeking support for your mental health/emotional concerns, you break the cycle for yourself and for future generations to come. This cycle can also be referred to as intergenerational trauma. Intergenerational trauma is defined by the American Psychological Association as a phenomenon in which the effects of one person’s trauma are passed down to their children and their children’s children, often through the future generations reacting to a similar triggering event as if they have been through it before on some level.

These reactions vary but often include shame, increased anxiety and guilt, a heightened sense of vulnerability and helplessness, low self-esteem, depression, suicidality, substance abuse, dissociation, hypervigilance, intrusive thoughts, difficulty with relationships and attachment to others, difficulty in regulating aggression, and extreme reactivity to stress.

Intergenerational trauma is basically collective trauma passed down to us through no fault of our own. This can be trauma passed down from experiences of our parents, families, the justice system, and laws within our respective country or the society in which we grew up. These experiences can all be consequential to our wellbeing without us even recognizing it.

For example, racial injustice and inequality have contributed to the intergenerational trauma passed down in the Black community. This is something that is unfortunately ingrained in our nation's history. It's time for us as people to move from collective trauma to collective healing and that can only start on an individual level. The struggle did not start with you, but it can end with you if you take that brave step of asking for help.

Q: How can people do a better job of supporting others in their communities with mental health challenges?

It starts with educating yourself on the signs that someone may be struggling with mental health concerns. Sometimes we see family members or friends struggling and we just do not know how to help them. Those struggles can be a symptom of a mental health disorder that the person experiencing it has no control over.

It's important to know that most mental health challenges are exacerbated by a chemical imbalance within the brain. So, if you think someone is struggling and you're not quite sure what's going on with them, be kind. Inquire about their wellbeing and don't be afraid to ask questions and verbalize your concerns as long as it's a safe situation for you to do so. Think about how you would want to be treated if you were experiencing a mental health crisis. Sometimes we have gotten so used to how we feel that it takes someone else making an observation with love for us to realize that we are not okay.

Q: What are things people can do at home to protect or improve their mental health? 

Check in with yourself. We can experience stress in so many different ways including physically, emotionally, and mentally. Ask yourself, "How am I feeling emotionally? Mentally? Physically?" Take a few moments to do a full body scan, and identify any areas in your body where you are carrying stress. Maybe your jaw is clenched, your shoulders are up by your ears, or you are hunched over, protecting your organs from an unknown threat. Often, our unidentified emotions show themselves in our physical being.

Remember, if you are not fulfilling your basic physical needs of getting sufficient sleep, drinking enough water, eating healthy meals, exercising and moving your body for at least 30 minutes a day, it can also negatively affect your mental health. So, prioritize taking care of yourself. Engage in an activity you enjoy doing to break up the workweek to help you find balance with all your other responsibilities. Rest is not a reward for working yourself to the point of exhaustion. Rest is a necessary component to your overall being in order to function. You deserve it simply because you exist, and the being part of “human being” is an active verb!

How to reach out for help if you're struggling

If you're struggling with stress and anxiety or other mental health challenges, we're here to help. Don't hesitate in asking for help because you think your challenges aren't "serious enough" or "bad enough." Therapy can help you learn to manage and overcome diagnosable mental health disorders as well as daily stress and anxiety. As Jemair said, there is strength in reaching out for the help you need.

Follow the steps below to get started:

• Click here to share some information about you so that we can match you with the perfect therapist for your needs.

• Have a low-pressure, 20-minute call with your therapist to make sure they are the right fit.

• Schedule your first session and start on your journey to feeling better right away.

We offer specialized services for related issues like Anxiety, Depression, LGBTQ Affirming Therapy, and Therapy Specifically for Young Adults. We can help you feel less overwhelmed, more relaxed, and more like the self you want to be.

Contact us here to get started today!