By Kyle Hudson •
“Me personally, I don’t believe in depression. I don’t. I don’t believe it. I consider it a pity party. It’s excuses. I don’t believe in excuses,” said a test subject in a 2016 study published by the American Journal of Men’s Health. Despite the three year gap between this study and now, some African-American men still hold this theory of depression and other mental health illnesses to be true. However, researchers have reported that depressive symptoms are more disabling among African Americans compared to their white counterparts.
Identified as one of the most common mental disorders in the country, depression affects an estimated 17 million people each year. In fact, according to the World Health Organization, depression is projected to become the leading cause of disability and the second leading contributor to the global burden of disease by the year 2020. However, data on mental health issues among African-American men are still limited. This is a result of an underutilization of mental health treatment and services by black men.
There are a number of factors that contribute to the lack of treatment-seeking black men as it relates to mental health issues. These difficulties include socioeconomic status, affordability of healthcare, and a general stigma of mental health issues in not only the black community, but specifically the black male community. In a study published by the American Journal of Health, participants stated that although they felt it was important to seek help for depression, they also felt it was better left alone if they did not have health insurance or sufficient financial resources to treat it.
According to a 2016 report by the Agency of Healthcare Research and Quality, disparities in black adults with a major depressive episode who received treatment for depression showed little to no change between 2008 and 2015. Additionally, the same report showed that the percentage of African-Americans who didn’t have access to health insurance compared to their white counterparts remained the same as the 2014 report, which showed that 15.9 percent of African-Americans versus 11.1 percent of white americans were uninsured.
However, clinical social worker and child psychologist, JoAnn Mussenden, claims inadequate access to healthcare isn’t the only factor contributing to the lack of treatment-seeking black males. Mussenden, who has been working as a clinical social worker for over 20 years, has worked with hundreds of African-American males and says that the relationship between medical services and the black community is also a strong contributing factor.
“We [African-Americans] have received dubious medical care over the years so trusting providers has been a big issue and we haven’t had that many people trained in the African-American community to provide [adequate] mental health care treatment.”
Based on a study published in the American Journal of Men’s Health, minority men who sought mental health services felt that they were judged negatively by their providers or felt like their providers couldn’t relate to their everyday stressors. This is a similar story to Kevin Dedner, founder of Henry-Health, an online app and teletherapy program targeted specifically for black men.
Dedner, who has suffered from depression himself, recalls seeking help from three different therapists before finding the right fit. As a result, he created the Henry-Health app which provides members with access to therapists equipped with training solely outlined for treating African-American men. In addition, the app provides members with culturally centered content such as affirmations, articles, and testimonies.
“Just as there is a demand on the medical side for physicians to have a cultural competency to interact with their patients, that demand also exists in behavioral health,” said Dedner.
“One of the things we think is really important at Henry Health is to equip our therapists with a better understanding of how to support the emotional and mental health needs of black men so we’ve designed a training that helps our therapists be more culturally responsive and culturally sensitive to black men.”
Culturally competent therapists and practitioners are imperative to effective treatment according to Nikki Webber Allen, founder of I LIVE FOR..., a 501c3 nonprofit that uses storytelling, through multiple media platforms, to end the stigma around mental health discussions, agrees that culturally competent therapists and practitioners are imperative to effective treatment. Although when seeking treatment for herself she preferred an African-American therapist, she acknowledges that due to the expense of mental health care, it isn’t a reality for everyone.
“If they’re not black, they absolutely have to understand those cultural nuances so they can understand things that are relevant within our culture and the language we use,” said Allen.
In addition to her nonprofit, Allen was chosen for the TED Residency program where she spent four months in an in-house incubator for breakthrough ideas at the New York City Headquarters. In her TED Talk, Allen opens up about her own struggles with depression and anxiety after the loss of her nephew, who also suffered from depression and took his own life. Moreover, Allen discusses the importance of acknowledging mental health issues in communities of color and breaking the stigma that deems depression a weakness and
further prevents those affected from seeking treatment.
“Your relationship with your therapist has to be one of trust. If you don’t trust this person to help you, there is no point of even going. So for me I went in with my guard way up, I thought to myself ‘I don’t know if I should trust this person with all of my private secrets’ and I thought ‘I don’t want someone who doesn’t understand or respect my culture and might be projecting their stereotypes on me.”
In 2007, Daphne Watkins and Harold Neighbors conducted a study in efforts to grasp the perspectives on depression and depression treatment in a sample of African-American men despite their mental health history or previous experience seeking mental health services.
The study featured twenty-six African American men with the only eligibility criteria being that participants be over the age of 18 years old. In the results, researchers discovered a potential factor contributing to the lack of treatment-seeking among a good amount African-
American males in today’s society.
“The number one thing that is really causing damage in a lot of the lives of black men is this idea that to express emotions, to feel your pain and process it is equal to being weak and then beyond that asking for help is also seen as a weakness. You’re expected to just toughen up, toughen out, man up, all that kind of stuff when actually being vulnerable and speaking up is actually one of the strongest things you can do,” said Allen.
One man in the study described depression as volitional and acknowledged the feeling as something one could choose to succumb to or ignore. This description sheds light on a common perception among black males that depression is a problem that can be fixed rather than an illness that affects one’s daily life. Like Allen, Dr. Mana Ali, a psychologist at MedStar National Rehabilitation Hospital, says that societal factors have caused black men to mask their emotions to the point where they resemble desensitization and says that this strategy that the black community as a whole relies on.
“It’s not apart of our culture to seek mental health treatment. We’ll go to the doctor if we break our leg but we won’t go if we can’t get out of bed because we’re too depressed and I think it also has something to do with the stigma that the country has against black people as being inherently broken people,” said Ali.
When discussing the perceptions of mental health and mental health treatment in the black community, Mussenden said that most stigmatization has been around so long that it has become subconscious.
“You have to be taught to be tough a resilient and to take time to cry or to say I am overwhelmed is seen as a luxury that is kind of nonverbally instilled into our young African-American males,” said Mussenden. “Think about a little black boy running. He falls down, his leg is bleeding and the first thing his mom says is ‘It’s fine, you’re ok, don’t cry,’ so you’re being taught that you’re fine and that you have to move on instead of expressing emotion.”
There are several factors stacked against black males that hinder them from being able to maintain full mental health. Despite the stigma against the existence of mental health and seeking treatment, having conversations about mental health in the black community have become more socially acceptable and received.
Although societal factors such as access to health care and wealth are still affecting the African-American community as a whole, through the utilization of alternatives such as culturally sensitive treatment and transparency about conditions, the disparities that exist between black males and their white counterparts should soon be statistics of the past.