Black Mental Health Matters

After reading one of the most devastating news stories I have read in a long time, the death of Cornelius Fredricks16 year old boy at a treatment center who died from cardiac arrest in residential treatment center after a staff had used an improper restraint on him after throwing a sandwich at another resident. Fredricks was at Lakeside Academy receiving mental health treatment. I am a white female who has struggled with Obsessive Compulsive Disorder and anxiety and it felt nearly impossible for me to first accept I needed help and find the treatment necessary for me to overcome my mental illness. Obviously I have never experienced the difficulties experienced by the black community and have only  read some of the research on the difficulties for those in the black community to find mental health resources and accept that they need the help. I can only imagine and assume that the majority of those who are black had a much longer and more difficult journey than myself on their road to recovery due to the systemic racism that plagues our country.

The Columbia University Department of Psychiatry reports that the black community overall has an increased rate of mental health concerns. These concerns stem from various factors including the lack of access to appropriate and culturally responsive mental health care, classism, health inequity, violence, criminal justice, and economic insecurity. The prejudice and racism those who are black experience on a daily basis and historical tragedies also contribute to the increased rate of health concerns in the black community. Research shows trauma (ensavelemt, colonialism, racism, oppression, and segregation) can produce biological changes that last through generations. As with many other cultures, those in the black community tend to view mental illness as a sign of weakness and may opt out of receiving help.

Black American adults are 20% more likely to experience mental illness than the general population. In comparison to white adults between 18 and 25, those who are black experience higher rates of mental health problems and lower rates of mental health service utilization. The reasons for the lower utilization of mental health services in the black community include: the lack of trust in the medical system, past history of discrimination in the mental health system, lack of culturally responsive mental health providers, the financial burden, and inadequate insurance. 

Today’s problems in the black mental health community can be traced back to the sixth United States Census surveyed in 1840. Similar to today the 1840 census asked questions about age, gender, race, and job to help understand the different segments of society. The 1840 census also asked two questions concerning mental health:

  • The number of White persons who were insane or idiots (at public and private charge).
  • The number of Colored who were insane or idiots (at public and private charge).

This wording was the exact wording used in the 1840 census. In 1840 insane and idiot along with lunacy were medical terms used to classify the severity of a mental illness. Sadly enough the data from the 1840 census was falsified and used as pro-slavery propaganda by the Southern States prior to the civil war. The Census was used to argue that freedom was driving black Americans insane and claimed free black persons’ level of insanity was almost eleven times more prevalent than unfree black persons’ and six times more prevalent than white persons. Former Vice President, John C. Calhoun went as far as to say, “Here is the proof of the necessity of slavery. The African is incapable of self-care and sinks into lunacy under the burden of freedom. It is mercy to give him the guardianship and protection from mental death.”

Professor King Davis PhD. has spent his whole life researching and studying mental illness particularly in the black community. Dr. Davis created the idea of an “exaggerated risk hypothesis” and uses this idea to describe the pro slavery propaganda which stemmed from the “results” of the 1840 census. Dr. Davis also stresses the idea that black Americans were historically failed by America’s mental health system. 

Fortunately enough Dr. Edward Jarvis discovered the gross numerical inaccuracies of the 1840 census. Dr. Jarvis noticed that there were 133 black patients reported at an Asylum in Wooster, MA when he knew from personal experience all 133 patients were white. Dr. Jarvis had noticed some cities had reported more insane black persons than living in the city than black residents. Dr. Jarvis concluded that one’s skin color has no correlation with having mental illness or the ability to support one’s self. Below is a photo of one of the charts Dr. Jarvis made describing the inaccuracy in the data.

Click here to read the journal Dr. Jarvis had published in 1852! Although it was not his intention and Dr. Jarvis was more concerned about accurate data for medical discoveries than the rights of black Americans, he did get the ball rolling for the census committee in 1880 to determine the data regarding mental health was useless and those questions were removed in the 1900s. 

The 1840 census is a really upsetting chapter of American history and it is despicable that politicians forge data about an illness to marginalize a group of individuals. According to Columbia University Department of Psychiatry today black Americans represent about 12% of the United States population but represent about 40% of the homeless population, 50% of the prison, and 45% of the foster system which can all harm mental health or be a byproduct of mental illness. I have listed my sources below for anyone who is interested in learning more about the topic and below are three tips from the Columbia University Department of Psychiatry for those in the black community seeking mental health treatment.

Here are three tips clients could do to seek out culturally responsive providers:

  1. Ask the provider questions about their treatment approach and if they provide care including ones’ culture.
  2. Seek attention from someone who is aware and affirming of your intersecting identities (social categorizations such as race, class, and gender, that are overlapping and interdependent systems of discrimination or disadvantage) and your cultural background.
  3. Be mindful that some providers do not use methods that involve a cultural treatment framework, so ensure your provider is culturally responsive and respectful of your needs and how to infuse these beliefs into treatment.

Davis, Dr. King,. “A Century of Stigma for Black America and Mental Health.” Apple Podcasts. HISTORY This Week. HISTORY, June 1, 2020. Web. June 24, 2020. https://podcasts.apple.com/us/podcast/a-century-of-stigma-for-black-america-and-mental-health/id1493453604?i=1000476394488

Deutsch, A. (may, 1944). THE FIRST U. S. CENSUS OF THE INSANE (1840) AND ITS USE AS PRO-SLAVERY PROPAGANDA. Bulletin of the History of Medicine, 15(5), 469-482. Retrieved June 24, 2020, from https://www.jstor.org/stable/44446305?read-now=1&seq=1#metadata_info_tab_contents

Grob, G. N. (spring 1976). Edward Jarvis and the Medical World of Nineteenth-Century America. Bulletin of the History of Medicine, 50(1), 9-12. Retrieved June 24, 2020, from https://www.jstor.org/stable/44450311?read-now=1&refreqid=excelsior%3A656ebc230ac01659ae27aaa6a90a32de&seq=1#page_scan_tab_contents

Jarvis, E. (1852). Insanity Among The Colored Population Of The Free States. Philadelphia : T.K. & P.G. Collins, Printers, 1844, 4-15. Retrieved June 25, 2020, from https://collections.nlm.nih.gov/ext/mhl/101475758/PDF/101475758.pdf

Jason Gauthier, H. (n.d.). 1840 - History - U.S. Census Bureau. Retrieved June 24, 2020, from https://www.census.gov/history/www/through_the_decades/index_of_questions/1840_1.html