I met with a group of approximately 40 Black women and proposed this simple question to them: “What Is It?”

In my clinical experience, I frequently listen to comments from other mental health professionals and agency representatives about why the Black community often seems to fail to seek mental health diagnoses, treatment, and services. Two phrases commonly used to justify the perceived reasons by these professions about the Black community include:

As this group of Black women answered my question, I realized one problem is that mental health professionals miss the opportunity to ask the Black community about their perceived resistance. Asking this group their thoughts opened up a wealth of knowledge to share with other mental health professionals. This post will attempt to dispel the myths generated in the mental health community about why the Black community can be resistant to mental health services and instead, explain the obstacles that cause this barrier. Four key topics were discussed with this group of women: stigma around mental health, barriers to accessing mental health care, lack of representation in the field, and historical mistrust of the health care system.

1. Stigma Around Mental Health

In persons with mental illness (PWMI), stigma acts as a barrier to engaging in help-seeking behavior. Black people are particularly vulnerable to the presence and effects of mental illness stigma. For PWMI, stigma manifests through three main mechanisms: experienced, anticipated, and internalized. These are the barriers that this group described as concerns when seeking mental health care in the Black community.

Internalized strength, resilience, and working through obstacles are highly valued in the Black community. Individuals facing mental health experiences are often seen as weak or failing, leading to anticipated fears about being stigmatized, judged, and even rejected. Negative stereotypes (i.e., "crazy”) are also concerns in the Black community. The thought of being labeled can carry negative consequences including........

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