Mental health stigma in ethnic minority communities can create critical barriers to treatment for groups including African Americans, Latinx Americans, Native Americans, and Asian Americans. One of the primary contributors to disparities in mental health treatment is mental health stigma, which refers to a collection of negative attitudes, thoughts, behaviors, or beliefs that help to facilitate fear, rejection, and discrimination against people with mental illness¹.

Double Stigma

Given that stigmas are perpetuated by stereotypes, ethnic minorities in the United States often experience what is called double stigma,” where individuals of ethnic minority status experience stigma related to both their ethnicity and their mental health status.¹ The United States has a long, undeniable history of discriminatory practices against African Americans, Native Americans, Latinx communities, and Asian Americans. These practices and the unhealthy beliefs generated from them impact access and experiences in health care, including mental health services.

Stigma from Without and Within

Stigmas can be perpetuated by the general public, clinicians, and mental health providers, as well as family members and friend groups of ethnic minorities seeking mental health assistance. For example, in some African American families, many were raised “not to tell strangers your business” or to “pray about [an issue causing distress].” In some Latinx communities, family emphasis on strength and work ethic can contribute to mental health treatment being viewed as a sign of weakness. In some Asian American communities, family pressure to become a high achiever can contribute to concealing mental health concerns in order to uphold standards of excellence.³ These ideas and beliefs are often generational and can impede help-seeking behaviors for the ethnic minorities that are impacted.^2,3

Protest, Educate, and Contact

Given that public and self-stigmas create critical barriers to care for ethnic minority groups, we as graduate students and early career professionals must do our part to ease the impact that harmful stereotypes and stigmas have on our clients. Sometimes, especially in today’s political  climate, issues of race and ethnicity can be difficult to talk about. However, matters and issues of diversity, race, ethnicity, stigma, and stereotypes will likely find their way into your clinical training, supervision, therapy, and/or assessment cases at some point along your graduate school or ECP journey. Literature suggests that the protest, educate, and contact model can be helpful in overcoming stigma.²

Here are some helpful suggestions that illustrate what this model could look like in practice: 

Protest

1. Always be willing to speak up and address harmful stereotypes in settings like supervision, peer-to-peer interaction, interdisciplinary meetings, and case presentations.
2. Get involved in activities that promote mental health awareness for ethnic minorities. Check your local mental health organization calendar, browse the hashtag #minoritymentalhealth on Twitter or Instagram, or ask supervisors who are engaged in advocacy work what they do to promote ethnic minority mental health.

Educate

In order to challenge harmful stereotypes and stigmas, we must educate ourselves on where the stigmas originate. Increasing awareness of the mechanisms that perpetuate inferiority status for African Americans,⁴ knowledge of how immigration and acculturation impact mental health for many Latinx Americans,⁵ understanding of the detrimental impact of “model minority”⁶ status attributed to Asian Americans, and increasing knowledge about spirituality practices for Native Americans who are sometimes pathologized³  are great places to start.

To promote self-esteem and self-efficacy for our ethnic minority clients as psychologists-in-training, we can:

1. Explore family dynamics that may contribute to the development of mental health stigma. Exploring these dynamics while also normalizing mental health treatment can help to empower your clients.
2. Encourage your clients to explore culturally-tailored mental health and wellness resources. Some examples include Therapy for Black Girls, Association of Black Psychologists, National Resource Center for Hispanic Mental Health, National Latino Behavioral Health Association, National Asian American Pacific Islander Mental Health Association, Asian American Psychological Association, National Alliance on Mental Illness, and so many more!
3. Build rapport by encouraging the idea that seeking mental health treatment is a sign of strength, not weakness.
4. Several divisions within the American Psychological Association (APA) provide information of diversity initiatives. The APA Public Interest division is also a resource dedicated to matters of diversity.

To further educate ourselves and our communities:

5. Use your social media pages as platforms to educate and share information with your community, if you are a psychologist-in-training of color.
6. If you’re not an ethnic minority psychologist-in-training, showing ally-ship and solidarity with your colleagues of color or learning how to do so is crucially important to breaking the stigma in our field.
7. Commit to obtaining cultural competence education wherever possible.
8. Use clinical supervision as a space to explore your own biases that can impact stigma.

Contact

9. Don’t know a lot about an ethnic minority group? Find ways to engage with them in your personal life. This may be the most difficult strategy in the approach to breaking mental health stigma, but it’s an important one. Feeling more comfortable around any minority group can help us provide better mental health treatment for those who depend on us.
10. Joining psychology associations and attending conferences can facilitate great opportunities to step outside of your comfort zone with the intent to learn about others who have different perspectives. Take advantage of conference socials, diversity symposiums, and diversity or special interest groups.

In summary, mental health stigma is a critical barrier to treatment for communities of color. Harmful stigmas can contribute to disparities in mental health care. Our generation of scholars has a unique opportunity to change mental health stigma narrative for communities of color. In changing this narrative, we can do our part to eliminate this stigma for generations to come. Together, we can #breakthestigma!

References

1. Gary, F. A. (2005). Stigma: Barrier to mental health care among ethnic minorities. Issues in mental health nursing, 26(10), 979-999.
2. Corrigan, P. (2004). How stigma interferes with mental health care. American psychologist, 59(7), 614.
3. Hays, P. A. (2008). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy. Washington, DC: American Psychological Association.
4. Guthrie, R. V. (2004). Even the rat was white: A historical view of psychology. Pearson Education.
5. Guarnaccia, P. J., Martinez, I., & Acosta, H. (2005). Chapter 2. Mental Health in the Hispanic Immigrant Community: An Overview. Journal of Immigrant & Refugee Services, 3(1-2), 21-46.
6. Mok, T. A. (1998). Getting the message: Media images and stereotypes and their effect on Asian Americans. Cultural Diversity and Mental Health, 4(3), 185.