African Americans and Behavioral Health Disorders
• June 2021 •
Every year, Juneteenth — June 19th — commemorates the end of slavery in the United States. On that day in 1865 federal troops finally arrived to enforce the law in Galveston, Texas – and they were late. It had been two and a half years since President Lincoln signed the Emancipation Proclamation declaring Black people in confederate states “shall be then, thenceforward, and forever free.” Today, observance of Juneteenth takes place primarily in local celebrations. Traditions include public readings of the Emancipation Proclamation, singing traditional songs, reading works by noted African American writers, and enjoying traditional foods.
And yes, America still has far to go in remediating the wrongs of inequity to Black people. This includes behavioral health disparities. One of the best reports I’ve ever read is We Ain’t Crazy! Just Coping with a Crazy System: Pathways into the Black Population for Eliminating Health Disparities . The study was conducted right here in California by the California Reducing Disparities Project (CRDP). Even though it was published in 2012 – before the inequities of the pandemic and recent civil unrest – it is relevant today. This was the first report written from the perspective of Black people, not from the established system.
We have long known that African Americans are subject to disproportionate rates of arrest/incarceration, discrimination, racism, and related toxic stress. It’s no surprise that the CRDP report provided proof of high rates of psychological distress, depression, suicide attempts, dual diagnoses, and other mental health concerns among Black respondents. Co-occurring medical conditions, including heart disease, cancer, stroke, substance use, and violence, were also noted in large numbers. This data paints the picture of a population in crisis. If our African American community is to free themselves from the slavery of addiction and mental health disorders, we need systems change, specifically:
- Correct diagnosis
- The funding of more Black treatment providers
- Fighting back against stigmatization of Black people with alcohol, drug, and mental health issues
- The expansion of care beyond the church– there are few linkages between the church and the formal mental health system
- The inadequacy of service integration for primary healthcare, mental healthcare, and substance use disorder treatment for African Americans.