There are many people in Black community with mental health concerns who are hesitant to seek mental health care. Why is this? My research set out to answer this question. 

I interviewed Black men and women from across Canada and asked them: “Think of a time when you had a mental health concern. How willing were you to seek help from a mental health professional?” Most of the people I spoke to said they were not very willing to seek mental health treatment.  

Throughout these conversations I found out that a lot of the unwillingness had to do with cultural norms. Some of these norms included experiences with anti-Black racism, relying on internal resources, and turning to social, familial, and spiritual sources of support. Essentially, seeking help from a mental health professional often clashed with cultural norms. As a result, people felt that seeing a mental health professional might mean being misunderstood by the mental health professional; feeling judged by oneself and people close to them; and feeling pessimistic that the mental health service would be useful or worthwhile. 

In addition, most of the people I interviewed had experiences with seeking mental health care. Many of them said that when they first began having mental health concerns, they were unwilling to seek professional help but after having positive experiences with mental health services they were more willing to go again in the future. 

Ultimately, we want everyone to be able to benefit from receiving mental health services. It is my hope that research like this will give us information that we need to make mental health services as culturally inclusive and welcoming to as many people as possible. 

Dr. Renee Taylor, C.Psych. (Supervised Practice) is a psychologist in supervised practice at the Centre for Interpersonal Relationships (CFIR). Dr. Taylor provides psychological services to individual adults and couples experiencing a wide range of challenges related to mood, anxiety, trauma, and relationship difficulties. In her work she integrates therapeutic techniques from emotion-focused therapy (EFT), psychodynamic therapy, and cognitive-behavioural therapy (CBT).

by: Dr. Sela Kleiman, C.Psych.

Throughout life, especially during early life, we internalize messages sent to us by caregivers, siblings, extended family, peers, and larger social and cultural institutions. Growing up, if caregivers are attuned to our emotional needs and respond in a warm and empathic way, we are more likely to internalize, or have an unconscious felt sense, that we are a person worthy of being loved. If, on the other hand, caregivers respond to our emotional bids for affection with rebuke, derision, anger, and so forth, we instead may internalize a felt sense that we are unlovable in some way.

The messages we receive about ourselves from others profoundly impact how we feel about ourselves and how we relate to others. 

Messages sent from the cultural and social milieu in which one lives can greatly influence how we feel about our own worth. Growing up in North America where racism is prevalent, for instance, folks of colour are subject to many recurrent and demeaning messages about their racial identities. These messages often are subtle. For example, they may be revealed in television shows and movies where people of colour represented stereotypically and cast in a narrow range of roles. Additionally, these messages are found in schools. For instance, some children who have to pass through security guards checkpoints every morning before class undoubtedly receive the message that they are dangerous and not to be trusted. Unkempt school grounds and poorly supplied classrooms are a consistent reminder to some students that their education is not as important as those who live in more affluent neighborhoods. Consistently receiving these messages takes its toll on an individual; one result may be internalized racism. 

Internalized racism is a phenomenon whereby people of colour constantly exposed to demeaning messages that imply their inherent badness or lower worth may unconsciously start to feel this way about themselves. One of the most disturbing yet illuminating examples of this was the doll experiments conducted by Clark and Clark in the late 1930s/ early 1940s in which they asked children to rank Black and White dolls (everything the same except for their skin colour) on various characteristics. They showed that both Black and White children typically preferred White dolls over Black dolls in terms of appearance, niceness, and so forth. To Clark and Clark, Black children preferring White dolls for these reasons was an example of internalized racism. 

Aside from cultural and social shifts needed to combat internalized racism, a more intimate domain to work through this issue is in therapy. For this to happen, psychologists, psychotherapists, and other helping professionals must be multiculturally-competent practitioners. Indeed, they must be well-versed in psychological and emotional manifestations of discrimination and be able to engage in meaningful dialogue with clients as these issues arise. Ignoring internalized discrimination and placing the locus of responsibility solely within the client risks reinforcing oppressive patterns responsible for internalized racism. Using therapy as a space to explore themes of badness, worthiness, and so on through a culturally sensitive lens can empower clients to gain a better understanding of their pathogenic beliefs and, through deep and meaningful processing of these themes, detoxify these negative feelings about the self.