Black Mental Health: A British community’s unspoken dilemma
Can I start this article with a confession? When I first sat down to write about the mental health issues experienced by the black community, my first thought was… “how on earth would I know? I have no idea!” Now you may think that an odd thing to say or even admit as a black woman in this line of work, but I must be honest – based on experience alone, I can’t say that I fully know the plethora of issues the black community face in this area. I can only speculate. And that is because I simply do not come across enough Black people within my day to day, outpatient clinics. However, if I worked in the prison system, or even psychiatric wards, I would be spoilt for choice as the Black community are present in abundance. So here we have a dilemma – black minority ethnics are over-represented in forensic and psychiatric settings, yet under-represented in primary care settings. What does this mean exactly and what are the implications? Well, it means that black individuals are more likely to be sectioned under the mental health act and detained in a hospital, or are more likely to be incarcerated in the judicial system rather than receive therapy or counselling from their GP or local NHS psychology service. Fortunately, this has been considered an important issue which required a call to action from the Department of Health – yet there has been slow progress despite the various policies introduced. You can read more about this issue here and here.
This is a problem for many obvious reasons and it goes without saying that more needs to be done on an institutional level. But what I’m particularly concerned about is what we as a community are (not) doing to help ourselves. What stops us from receiving help when an issue first presents itself, rather than latterly at the peak point of crisis? In my opinion, there are likely to be a number of contributing factors.
Firstly, admitting there is a problem is necessary. Actually, scrap that. Before admitting there is a problem one must first recognise that there is a problem. I think I can safely assume that unlike our white counterparts, people of colour living in Britain will not view stress as a recognisable trigger for anxiety, depression, or burn-out. I say this because somewhere along the line, it has been conceded that we are to be strong, and strong to the point of weakness. Stress and the implications of it are not taken seriously enough. What do we have to be stressed over? We have children to raise (sometimes without the help of a father), money to send back to our families in the Caribbean or Africa, we have our own bills to pay, exams to study for (whilst working a full-time job), and on top of that we may have the added pressure of trying to not only survive but thrive in a culture which systematically favours non-ethnics. It’s a lot to deal with, but I can guarantee that most black individuals who find themselves in this situation will argue that there isn’t time to feel stressed. With this mindset, however, it is only a matter of time before the pressure mounds and the cracks begin to show. In the worst-case scenario, stress can have implications not only on one’s own mental wellbeing, but it can also spill out onto others around them - i.e. children who are being conditioned to believe that to admit you need help is a sign of weakness or failure. In short, stoicism and pride are doing us no favours.
Then we have the younger generation of the diaspora who have seen their parents hustle and work themselves to the ground to provide a better life for them in Britain. So much pressure to succeed and go even farther than their parents, but in this culture of instant gratification, insta-fame, youtube and reality TV, a new opportunity has been afforded to them, and this one requires a fraction of the cost to attain in hard work ethic. But I argue that it is beginning to take its toll on the mental wellbeing of these youngsters. The need to be liked, or to be seen as popular on social media has no doubt had an impact on this generation’s self-esteem and confidence. Self-doubt, depression, social anxiety, cyber-bullying and trolling have been instrumental in the rise of self-harm and suicides.
And then there are the perceptions that have been projected onto us, and the personal identification with such labels - the ‘angry black woman’ being a popular one. We’ve taken something on as an identity so much to the extent that we personify them. We live up to the stereotype. I am well aware that this is part of a larger racial socio discourse which I won’t address here, for the purpose of this article is to think about how we can do something different, and how we can do better. Perpetuating the idea that we don’t need help, or that we can do it all alone, or even that everyone out there is out to diminish us as part of a racial vendetta is not wise. It’s keeping us isolated and thus unreachable.
But what of our communities? Do we feel we can access help and support from one another? I have heard many people claim that they can’t trust anyone to not disclose confidential information, to others who have no business knowing their personal affairs. The fear that their cry for help will be used as ammunition against them is a real and thriving one, and sadly one which I cannot say has no validity. But what makes a secret powerful? It is the belief that what is being shared is shameful, degrading, or horrific. It is my belief that encouraging openness and transparency will disarm the power of a secret shared in spite or for the purpose of gossip and entertainment. If more people were to ‘come out of the closet’ and into the open, the less scandalous and controversial this issue would be. And there have been the beginnings of such open discussions. Recently there was the BBC 3 documentary Being Black, Going Crazy? presented by twitter personality and radio host Keith Dube which sparked a lot of attention. Conversation has also paved the way for more creative forms of dialogue and expression. I attended an art exhibition by Nicole Crentsil last summer which showcased beautiful artwork, poetry and thought-provoking discussions about black women’s experiences of mental health. More recently still BBC 1Xtra facilitated a discussion with a number of artists sharing their experiences of dealing with mental health issues.
To say I was encouraged would be an understatement; people are starting to sit up and take notice. But with any type of movement or revolution, momentum is key. We need to keep fanning the flames and making room for one another. We need intentionality and conviction. But most of all we need understanding and compassion. On that note, I end with an encouragement for people to seek help which is out there. You are not alone and you are not weak for admitting that you are struggling. I often say that to be vulnerable is to be courageous and there is strength in acknowledging your need for help.
You can always talk to your GP for your first port of call, but you can also self-refer to your local Talking Therapies service. Alternatively, you can go down the route of paying for private therapy to find a counsellor or psychologist. If the thought of speaking to someone from a non-black background seems daunting, you could look through the online directories listed below which aim to connect you with therapists of a similar race and background. If you have any queries or would like further information on anything I’ve discussed here, please feel free to contact me on my details listed below.
Dr Victoria Uwannah is a Chartered Counselling Psychogist, working primarily in the NHS, as well as in her private practice. She is passionate about raising awareness of mental health issues and reducing the stigma associated with talking therapies.
She has a podcast, 'Dirty Laundry' where she has topical conversations with a psychological twist. She also has a keen interest in taking Psychology to the masses, rather than waiting for them to walk through the front door. This involves being available for the Black community at large - often through engaging with faith groups and charitable organisations.
You can keep up to date with Dr Vicki Uwannah on the following platforms: