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  • Natasha J. Thomas, MD

How Stereotypes Contribute to Mental Illness in "Minority" Communities


Stereotypes are insidious little creatures. Some are considered lighthearted and harmless, but often they create a heavy burden for the group they're affecting. When it comes to mental health awareness and access to treatment, stereotypes are a major stumbling block for communities of color.

Let's be honest - society is riddled with stereotypes. We have stereotypes about those facing mental illness, stereotypes about medical professionals who treat them, and of course stereotypes about each and every racial/ethnic group. I think the prevalence of these very simplified ideas about groups of people are born out of fear and lack of understanding. If we don't "get" a group of people, or we see ourselves as different from them, putting them in a neat little box with surface-level concepts of who they are and how they function in the world is comforting. We don't try to get to know people up-close.

With July being National Minority Mental Health Awareness Month, this is the perfect time to encourage yourself to learn about the beautiful and varied cultures and groups that make up this country. It's also a great time to get free of limiting stereotypes that detract from our society and only serve to make it laden with illness, struggle, pain, and feelings of isolation, misunderstanding and fear.

 

Stereotypes about Mental Health Care Providers

Do you know one of the most common "compliments" I hear from my patients? "You're the most normal psychiatrist I've ever met!" That comment always makes me chuckle, though I suppose it's not really funny. If I'm hearing that comment from people who have invested enough in their mental health care to have seen several psychiatrists, imagine what people who have never seen a psychiatrist or therapist must think of us. Hollywood, bad doctors, and chatrooms/groups online complaining about care they've received, does nothing to help the misconceptions.

The overall distrust the general public has for helping professionals in the mental health field is staggering. Not only that, but many doctors in the medical field who are not psychiatrists have a lot to say about those of us that are - and it's often not great. In fact, I contribute the shortage America has in psychiatrists to the stereotypes that psychiatrists are "crazy" and are not "real doctors". Obviously, these ideas impair everyone's access to mental health care, but especially racial/ethnic minorities - whose cultures are often suspicious of the medical establishment anyway.

So let me help you with this. I have a host of wonderfully talented, warm, dedicated colleagues in psychiatry. They are not interested in playing mind games on you, overprescribing medicine, talking to you about their personal problems, or trying to seduce you. Of course, in anything run by people, you will find imperfections or even people that you should avoid. Do research on a provider before you see them, get recommendations, and when you visit, if the session feels very uncomfortable or like there may be a personality clash, visit someone else.

Stereotypes About Those Facing Mental Illness

People with mental health diagnoses, or even those who are not diagnosed but seem "off" to others, are often thought of as burdens to society. They are thought to be violent, weak, looking for attention, lazy and worthless. No wonder people will keep it a secret if they are struggling! No one would want to be seen like this, and no matter how supportive your family or friends may be, people with mental health issues have a very high chance of running into someone with these misconceptions.

The irony, though, is that the majority of society is facing some sort of mental or emotional challenge. 70% of Americans have experienced some sort of trauma by adulthood. 33% of women will be sexually assaulted at some point in their lifetime. 7% of Americans are depressed. 6% of Americans have social anxiety. I could go on and on...

The point is that by the time you add up all of the different mental and emotional conditions we have in America, you'll see nearly everyone is impacted in some way! If you're not directly impacted, your spouse, child, parent, or other loved one is. In fact, it is projected that by the year 2020, mental illness and substance abuse will be the most prevalent medical issues in our country. That's in less than two years, folks.

People with mental health issues are not "maniacs", "cuckoo", or "lunatics" howling at the moon. The truth is, they are just like you and I.

Stereotypes About Minorities

In order to change the impact that stereotypes have on us as a community, we have to identify what they are. Apparently, American society is expert at teaching stereotypes. I asked my daughter today to give me the top stereotypes she's heard about African-Americans, Asians, Latinos, and Native Americans. She could tell me 7 stereotypes, with at least one being about each group. She's 9 years old.

African-Americans and all others of the African Diaspora in America are often saddled with the stereotypes of being lazy, violent or aggressive, dishonest, and excessively strong. I don't mean a good strong, I mean not-quite-human strong. I mean so strong you have no feelings. For those outside this community, these stereotypes make it harder to identify signs of mental illness, empathize, or offer help. And for those of us within this community, these stereotypes keep us from feeling we can ask for help, or are even deserving of help. Hear more in this brief video shared by Lauren Taylor on YouTube:

Asian-Americans are unfortunately weighed down by stereotypes that appear to be compliments, but are more like prisons. The "model" minority, Asians are thought to be perfect students, perfect children, perfect employees. Because of these ideas, they are limited by familial and cultural pride that make signs of weakness an embarrassment. In addition, older Asian-Americans were not raised to discuss their emotions, or to even display them. As a result of these factors, Asian-American youth have the second highest rates of suicide in the country. I have always noted that when I see Asian-American patients, their symptoms are pretty severe. I think it's because they, like other groups, delay mental health treatment until they've reached a crisis point. See more of how positive stereotypes can be harmful in this video from Arizona State University:

Latinos are the highest uninsured group in America, and also have the highest number of teens considering suicide. I only expect that to worsen in the current political climate. Going to school in a place with a large Caribbean and Latino community, I have heard all manner of stereotypes about Hispanics and Latinos. Things like "Spanish people are family-oriented" sounds like a compliment on its face. But the concept of the solid rock of Latino families is a double-edged sword. It leads children who need mental health care to feel guilty for their struggle - as they feel it may hurt their parents' feelings or indicate that the family hasn't been good enough to them. Likewise, parents may feel guilty when their children need outside help from a counselor or psychiatrist - as if they have failed to provide enough emotional support. In school, I heard of the "HLF" or hysterical Latin female as a frequent stereotype. Hispanic women and Latinas are seen (and cast in Hollywood) as over-the-top, dramatic types. Obviously that stereotype is damaging to the woman who needs help and sees herself as being ridiculous - or the doctor that encounters her and thinks she is. Learn more here in this great video from We Are Mitu:

And what about Native Americans? Tragically, they make up only 1.2% of the American population today. Yet, there are over 800,000 Native Americans with mental health struggles. If ever a group had a reason to be distrustful and angry with the whole of American society, including the medical establishment, they do. When I asked my daughter what stereotypes she knows about them, she said they "all run around with bows and arrows and feathers on their head." Of course that's not true, but how many think it kind of is? And what's more, we have sports teams whose names essentially ridicule the killing of Native Americans, and the majority of Americans see nothing wrong with it. Even though addictions have damaged their community (and with good reason in my opinion), Native Americans are not a group of gambling, lazy, alcoholics - or government fund recipients. But when you know that's what people think of you, would you ask them for help? These young ladies from a 2016 Teen Vogue interview give us more insight:

Common ideas about mental illness amongst all racial/ethnic minorities are that mental health care and therapy is for "white people," greater strength or faith can get you through, and mental health issues are not something to publicly discuss, but should be kept within the family. And a common stereotype about ALL these groups, except Asians, is that they are lazy. That's laughable considering America's racial and ethnic minorities, including Asians, have had to be extremely resilient, perseverant, and hardworking to survive and thrive under a great deal of oppression.

 

For these reasons and more, I am so encouraged to see the ongoing development of advocacy groups that tend to the specific needs of each community. Just because you are not a part of a particular community by heritage doesn't mean you can't be part of them by heart! We all need to help ourselves and each other. Pledge today to STOP relying on default stereotypes when you think of yourself or others. Let truth and the pursuit of wellness set you free!

Resources

African-American/Black/Afro-Caribbean

National Alliance on Mental Illness: African-Americans

The Mental Health of Black Caribbean Immigrants by David R. Williams et. al.

Haitian Mental Health Network

*Most resources for African and Afro-Caribbean communities are based in the United Kingdom. Please research further online*

Asian-American

Asian Community Mental Health Services

Mental Health America

Asian Health Services

SAATHI South-Asian Mental Health Outreach

Latino American

National Alliance on Mental Illness: Latinos

Stress and Latino Mental Health by Erlanger A. Turner, Ph.D.

American Suicide Foundation for Suicide Prevention: Latinos

Native American

Mental Health America

Substance Abuse and Mental Health Services Native Americans

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