Unmasking White Supremacy in Mental Health: A Call for Decolonisation
The field of mental health, like many other sectors, is not immune to the pervasive influence of white supremacy. Despite advancements in understanding and treating mental health conditions, systemic biases and inequities continue to shape the experiences of marginalised communities.
Historical Context of White Supremacy in Mental Health
The roots of white supremacy in mental health can be traced back to the colonial era, where European settlers imposed their values, beliefs, and practices on Indigenous populations. This colonisation of mental health extended to the development of psychiatric diagnoses and treatments that are often based on Eurocentric norms and excluded the cultural contexts of non-white communities.
For example, the concept of "drapetomania," a pseudo-scientific term coined in the 19th century to describe the supposed mental illness causing enslaved Africans to flee captivity, illustrates the blatant racial biases embedded in early psychiatric thought. Such pathologising of natural responses to oppression highlights the intersection of racism and mental health.
Manifestations of White Supremacy in Contemporary Mental Health
Diagnostic Bias
Research has shown that racial and ethnic minorities are more likely to be misdiagnosed or underdiagnosed compared to their white counterparts. For instance, Black individuals are often misdiagnosed with schizophrenia at higher rates, while their symptoms of mood disorders like depression and anxiety are overlooked (Schwartz & Blankenship, 2014). This misdiagnosis can lead to inappropriate or harmful treatments and a lack of proper care.
Access to Care
Structural barriers, including socioeconomic disparities and geographic location, disproportionately affect communities of color. These barriers limit access to mental health services and contribute to poorer mental health outcomes. According to the American Psychiatric Association (APA), only one in three African Americans who need mental health care receives it (APA, 2017). This disparity is further compounded by a lack of culturally competent care providers and financial constraints.
Cultural Incompetence
Many mental health professionals lack cultural competence, leading to ineffective or harmful treatments for non-white clients. Cultural competence involves understanding and respecting the cultural backgrounds and experiences of clients. The lack of training in cultural competence can result in misunderstandings and mistrust between clients and providers (Sue et al., 2009). This gap often leads to a failure to address the unique stressors and traumas experienced by marginalized groups.
Stigmatisation and Stereotyping
Stereotypes and stigmas around mental health issues in communities of color can discourage individuals from seeking help. The fear of being labeled or judged can prevent people from accessing the care they need, perpetuating cycles of poor mental health (Williams & Mohammed, 2009). For example, the stereotype of the "strong Black woman" can lead to Black women not seeking help for mental health issues due to societal expectations of resilience.
Research and Representation
There is a significant lack of representation of non-white populations in mental health research. This underrepresentation can lead to a lack of understanding of the unique mental health needs and challenges faced by these communities (Smedley, Stith, & Nelson, 2003). Without inclusive research, mental health interventions may not be effective for all populations.
Decolonising Mental Health: Pathways to Equity
Culturally Relevant Interventions
Developing and implementing mental health interventions that are culturally relevant and sensitive to the needs of diverse populations is crucial. This includes incorporating traditional healing practices and community-based approaches that resonate with non-white communities (Gone, 2013). Programs like the Healing Our Spirit Worldwide initiative, which focuses on Indigenous health and well-being, exemplify culturally relevant interventions.
Anti-Racist Training for Providers
Mental health professionals must undergo training to recognise and address their own biases and the systemic racism that affects their practice. Anti-racist training can help providers become more aware of the impact of white supremacy on their work and empower them to advocate for change within the system (Tervalon & Murray-Garcia, 1998). Institutions like the National Association of Social Workers (NASW) offer resources and training on cultural competence and anti-racism.
Policy Reforms
Advocating for policy changes that address the social determinants of mental health, such as housing, education, and employment, can help reduce disparities. Policies should aim to eliminate barriers to care and ensure that mental health services are accessible and affordable for all (Marmot, 2015).
Community Empowerment
Empowering communities to take an active role in their mental health can lead to more sustainable and effective outcomes. This includes supporting grassroots organizations and community leaders who are already working to address mental health issues in their communities (Nelson & Prilleltensky, 2010). Community health workers, who provide culturally appropriate health education and services, are a vital component of community empowerment.
Increasing Representation in Research
To better understand and address the mental health needs of marginalized communities, it is essential to increase their representation in mental health research. This involves not only including diverse populations in studies but also ensuring that research questions are relevant to their experiences and that findings are disseminated back to the communities involved (Scharff et al., 2010).
Culturally Tailored Interventions
Creating interventions tailored to specific cultural contexts can significantly improve their effectiveness. For instance, integrating spirituality and community support into mental health interventions for African American communities can enhance engagement and outcomes (Hodge, 2017). Similarly, incorporating traditional healing practices in mental health services for Native American communities can respect and utilize their cultural heritage.
Addressing Social Determinants of Mental Health
Recognising and addressing the social determinants of mental health, such as poverty, education, and discrimination, is crucial in promoting mental health equity. Policies and programs that focus on improving these determinants can have a profound impact on mental health outcomes (Allen, Balfour, Bell, & Marmot, 2014). For example, initiatives that provide job training and employment opportunities can reduce the stress associated with economic instability.
Promoting Mental Health Literacy
Improving mental health literacy within marginalized communities can empower individuals to seek help and support others in doing so. Educational campaigns that are culturally relevant and accessible can reduce stigma and increase awareness of mental health issues (Jorm, 2012). Programs like Mental Health First Aid, which train community members to recognize and respond to mental health crises, are effective in increasing mental health literacy.
Conclusion
White supremacy in mental health is a deeply rooted issue that requires a multifaceted approach to address. By acknowledging the historical and contemporary impacts of racism on mental health and advocating for decolonization, we can work towards a more equitable and just mental health system. It is only through collective effort and commitment to anti-racist practices that we can dismantle the structures of white supremacy and promote mental health for all.
References
Allen, J., Balfour, R., Bell, R., & Marmot, M. (2014). Social determinants of mental health. International Review of Psychiatry, 26(4), 392-407.
American Psychiatric Association. (2017). Mental Health Disparities: African Americans. Retrieved from APA
Gone, J. P. (2013). Redressing First Nations historical trauma: Theorizing mechanisms for indigenous culture as mental health treatment. Transcultural Psychiatry, 50(5), 683-706.
Hodge, D. R. (2017). Spirituality, religion, and the interrelationship: Assessing the possibility of integration. Social Work, 62(3), 242-250.
Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action for better mental health. American Psychologist, 67(3), 231-243.
Marmot, M. (2015). The health gap: The challenge of an unequal world. Bloomsbury Publishing.
Nelson, G., & Prilleltensky, I. (2010). Community psychology: In pursuit of liberation and well-being. Palgrave Macmillan.
Scharff, D. P., Mathews, K. J., Jackson, P., Hoffsuemmer, J., Martin, E., & Edwards, D. (2010). More than Tuskegee: Understanding mistrust about research participation. Journal of Health Care for the Poor and Underserved, 21(3), 879-897.
Schwartz, R. C., & Blankenship, D. M. (2014). Racial disparities in psychotic disorder diagnosis: A review of empirical literature. World Journal of Psychiatry, 4(4), 133-140.
Smedley, B. D., Stith, A. Y., & Nelson, A. R. (Eds.). (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. National Academies Press.
Sue, S., Zane, N., Hall, G. C. N., & Berger, L. K. (2009). The Case for Cultural Competency in Psychotherapeutic Interventions. Annual Review of Psychology, 60, 525-548.
Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. *Journal of Health Care for the### Unmasking White Supremacy in Mental Health: A Call for Decolonization