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    Normalizing the “Invisible” Illness 

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    Over 6.8 million African Americans have had a diagnosable mental illness in the past year (NAMI). African Americans live in a hush culture that dismisses mental illness as a “phase “and a clear sign of a weak relationship with God. These common misconceptions shed light on the stigmas of mental illness in the black community. These stigmas have created a barrier between mental health professionals and African Americans, which has caused misdiagnosis due to fear and invulnerability between both parties. African Americans would rather walk around as “ticking time bombs” than destroy their integrity, by accepting their mental state has been compromised.

    In addition, the stigmas have also harmed the relationship between the African American children and their parents, in terms of communication on their health. Parents silence their kids with the common phrases of “Pray it away” & “God doesn’t give you more than you can handle”. These negative stigmas are formally known as public and self stigma (internal stigma), which are products of ignorance, culture, and mostly fear. They stem from African Americans’ distrust of the system and fear of becoming another statistic. Mental illness in the Black community is the “hushed invisible illness”, that has left many individuals reluctant to display certain emotions, hence we must psychoeducate ourselves while establishing open forums that are safe, familiar, and comfortable.

    African Americans have been suffering from the lack of little to no help in battling their mental illness, which is partly due to the cultural stigmas associated with mental illness. “According to Goffman (1963), [a] stigma is identified as a mark of characteristic, which disqualifies those possessing the mark from full social acceptance into society. This includes the perceptions, attitudes, and beliefs had about individuals that have this characteristic (Conner, Koeske, Brown 697).” Through these words, Goffman establishes the definition of a stigma and how it is characterized by isolation. Unlike the effects of a stereotype, stigmatized individuals or concepts are made as outcasts in society. When stigmatized, individuals and/or ideas are unable to be fully accepted into the society in which they desperately seek to be part of.

    Mental illness possesses these characteristics, specifically in the African American community. Not only is mental illness seen as taboo, or even fake, it is also seen as something anti-black. The idea that Black people just don’t have mental illnesses has been so ingrained into the black society, that individuals suffer without help and live in isolation rather than face the social disgust that comes with announcing that they need help.

    The stigmas associated with having a mental illness manifests itself as public and self or internalized stigmas (Conner, Koeske, Brown 697). These 2 main divisions explain the negative attitudes resulting from the stigmas of a mental illness. The most obvious one is the public stigma, seen through social isolation, whispers, gossip, or even blatant shaming. These stem from a lack of knowledge on mental illness. This ignorance allows others to shame those in need of help into embarrassment or even isolation. “Public stigma refers to the negative beliefs, attitudes, and conceptions about mental illness held by the general population which [stereotypes], [is prejudiced], and [discriminates]against individuals with mental health disorders (Corrigan and Watson 2002)”(Conner, Koeske, Brown 697). These stigmas result in debilitating labels placed on those seeking help. These labels, stemming from ignorance, are largely developed out of fear, of a topic, society is not as knowledgeable on, hence further isolating those in need of immediate help.

    In African American communities, public stigmas manifest itself, in terms of what black people associate or identify as mental illness or compromised mental health. Often times, they associate mental illness with “being detained in a hospital and involuntary treatment in a confined and restrictive environment (Keating and Robertson 440)”, which highlights their misconstrued ideas of mental illness, thereby proving that cultural public stigmas serve as an impediment, which hinders problem recognition in the black community. Although these false truths are partly due to media, the majority of the blame should be placed on families themselves, who accept a single story as a representation of the whole population. This single story that has been imbedded into the minds of black people, has produced a critical misunderstanding, making it impossible for them to see mental illness as anything else but death. Their refusal to normalize mental illness, has sealed the fate of many African Americans with curable mental illnesses, into one of impending doom.

    Self stigma has a deleterious effect in the lives of those with compromised mental states. Conner, Koeske, and Brown quote Corrigan 1984 & 2004 who states, “Internalized stigma refers to devaluation, shame, secrecy, and social withdrawal triggered by the application of negative stereotypes about mental illness to oneself”(698). While public stigma can be very harmful, internalized stigma can be deadly. When the shame of their illness becomes internalized, victims often see themselves as less than perfect, a product of the shame placed upon them. They see themselves and are seen as the “black sheep” of their families, resulting in devaluation and secrecy. It reaches to a point where the victim hates themselves, as the volatile effects of the illness combine with the shame of their illness. This internalized shame and self hatred is a byproduct of public stigma. This affects the victims’ attempts to seek help, as they feel that their disease is reason to be ashamed and often fear shame being brought to their family if their “secret” was ever to be discovered, thereby preventing victims from fully healing.

    Self stigma, the fruit of public stigma, becomes apparent as the individual internalizes all the stereotypes of being mentally ill, making the stereotypes the only story of what it means to suffer from a mental illness. Refusal to accept the diagnosis makes the individuals become obsessed with proving to their circle of friends or family that they are not crazy. In the black community, when you admit to a mental illness, you are stripped of your dignity, as news of your issue spreads like wildfire throughout the whole community, making you a “dreg of society”. Prejudice is manifested in the behavior of the individuals as their self esteem diminishes to an insubstantial level, as they begin to depend on societal approval and others for happiness. They begin to depict low self efficacy, as they start to take a step back from everyday life, giving up on opportunities, and living in the shadows of merely existing while letting their potential go to waste.

    Internalized stigma is very detrimental in the lives of African American youth because during the adolescent age they are trying to figure out their identity as a person and how they fit into society. This impacts help seeking behaviors and attitudes towards any form of help received from mental health professionals, in order to protect their reputation and not be rejected or excluded by their peers (Kranke et al 64).

    Fear of mental illness has been constantly prevalent throughout black society, which has been induced through the media and culture. Throughout history, the racist environment has portrayed African Americans as hostile and animalistic, hence leading to emergence of stereotypes such as the “mad black woman” and labeling of the whole population as the “Other”. Keating and Robertson state, “Black people are constructed as a threat that should be feared. The basic fear of the “Other” is a central aspect in all parts of our society and therefore also affects relationships within MH services between black service users and professionals” (440). Xenophobic attitudes have been explicitly displayed publicly towards African Americans in terms of coercive force, racial slurs, and treatment of African Americans by respected institutions such as the police.

    Unconscious bias is applied towards them in everyday life, so they fear any institutions capable of judging them or are connected to death. There is often an “air of secrecy” between black people and MH (mental health) professionals, who are scared to talk about race and culture due to the fear of saying the wrong thing that could produce aggressive behavior in black clients (Keating and Robertson 445). This hinders the ability of professionals to build relationships and trust with their clients, thereby builds on the ambiguity of the clients illness. This results in a misdiagnosis, a product impaired professional decision making stemming from the lack of knowledge of the illness. African Americans refusal to disclose information to professionals due to the fear of losing control and not knowing the outcome, delays treatment and worsens their conditions or those of their loved ones. This reiterates the vicious circle of fear thats is produced through combining layers of “fear of black people, fear of mental illness and fear of MH services” (Keating and Robertson 440&446).

    The fear of being the deviant controls the attitudes of African Americans towards mainstream MH services. There is also the notion of being “strong” which is valued, due to the traumatic history witnessed by many African Americans in the nation. They believe that because their ancestors were able to survive the horrors of slavery, they too believe that they can endure personal struggles of inner pain by themselves without placing it out in the open, which was viewed as weak. This narrative of being weak affects all persons, young or old in the black community. Gaston et al quotes Ward et al 2009 who states,

    African- American women were not seeking help because of their belief that Black women “had to be strong,” or because they believed that they could handle it on their own. Women were relying on their informal support groups, religious coping, reading, normalizing mental health problems, and/or denying mental health issues altogether (686).

    Black women were taught from birth that there is no room for vulnerability, as they should bite back their tears, swallow their pain, put on a brave face and keep it pushing for their families. This pre-existing narrative of seeking help was a distinct sign of weakness, has forced them to suffer in silence while their mental states detriotes. Mental health was dealt within the family that encourage faith based methods to suppress mental illnesses. Black men were also held to a high standard, and ridiculed for displaying certain emotions such as crying, otherwise they would be labeled as weak and incompetent. Robinson et al states, “Masculinity norms also mitigated African American men’s help-seeking” (Robinson et al 2007). Black males were regarded as the head and protector of the family. They were expected to take everything life throws at them without having support networks such as a wife or friend to prevent him checking out of reality. This absence of support results in isolation, as they become shallow shells, incapable of feeling or showing sympathy.

    The African American culture is deeply rooted in the church, as the church became the center of cultivating a cultural identity during the time of slavery. Kranke et al quotes an African American youth, a participant in the study,who states, “My culture is like “Ha, i dont like medication, who does?..Black cultures think they are a little too good to take medication..Like certain Black cultures think they’re like..too god-like..too high and mighty..” (62). Black culture believe that they are immune to certain diseases and characterize certain illness, like mental illness as a “white people illness”. They view mental illness as a sign of weak relationship with god and believe that through prayer, the burden will be gone. This misconception is harmful to the new generation of adolescents, who are more inclusive of MH services and view it as a helpful tool rather than a sign of giving up, which highlights the sharp contrast between the children and the adults.

    The adults are largely a product of a culture that always told them to “take it to God in prayer.” This idea has become ingrained in them and they would rather suffer than seek help. The attribution of certain illness to specific races has also caused an inability for adults to understand the need for help in treating mental illnesses. Mental illness has been attributed to “white people” as those are the people seen in the commercials, walking on fields and describing medicine that helps. Kranke et al states “Numerous youth believes that adherence to medicine and treatment was acceptable because it was created by god..whereas adults believed mental illness is curable through religious intervention” (65). This unwillingness to seek treatment for their illness further solidifies African Americans’ inability to believe in something that they cannot see– with an exception to God.

    Mental illness, unlike physical illness, does not present itself in rashes or sickness. Instead, it is seen through behavioral traits that are too often brushed off. Those adults that do accept its existence believe it to be “curable through religious intervention.” In contrast, the younger generation is more susceptible to help as they are more open-minded. While the adults dismiss their complaints, the children seek help rather than suffer in silence. In this, it is clear that with time has come progress.

    The Black church is the only support network that can resonate with the black community and pave the way for collaboration between Mh service professionals and african american individuals. The pastor is the only individual other than immediate family members that congregants reveal their mental health issues to. Robinson et al quotes Evans et al 2011 and Hooker at al 2012, who state, “HIMM…may aid the Black Church with promoting healthy Black male mental health. The HIMM theoretical framework endorses a life course application and may intersect well with Black males of all ages” (1100). When the topic of mental health id brought out into the open through conversation, the black church can “confront the elephant in the room of Black men’s mental health and overcome the taboo of mentioning or addressing the reality of the plethora of mental health problems” (Robinson et al 1101).

    In addition to the the black church, forums and plethoras of other organizations can help promote mental health exposure through trusted outlets. Robinson et al states, “Black church leadership can design..mental health screening and prevention strategies..can be deployed using..traditional outlets and barbershops”(1101) when traditional outlets are used, they are viewed as safe havens to african americans because a setting of familiarity is created which enables vulnerability and bravery to lay out their skeletons before their peers. They are more accepting of help, because it comes from their own people yet deployed through mental health service professionals.

    Psychoeducation diminishes the ignorance of mental health stigmas and cultural stereotypes. Briggs et al states, “African Americans could have benefited from additional psychoeducation on different types of mental health disorders..repeated education on mental illness may contribute to increased use of mental health services” (12). When a person is educated, they gain the knowledge that they lack and are able to assimilate new information into their pre existing narratives. Psychoeducation has the ability to suppress public stigmas, hence ushering the inclusion of mental health as a real illness that can affect anybody no matter their race, age, or sex.

    Mental illness has always been prevalent in all cultures, some more than others. The African American community has suffered in silence with mental illness, which has been culturally denoted as an “invisible illness”, due to fear, stereotypes, and stigma. Research fails to show how mental illness stigmas have progressed over time, especially during adolescence to adulthood. For example how would the results differ if the child was biracial?, would the parents comments change if they are members of the wealthy black elite? The call to action for Black Church to assume a massive role in suppressing the taboo associated with the illness will resonate with the community. The Church is not only responsible for their congregation spiritually, but also to their mind and body. Through psychoeducation forums, barber shop setting talks, and program collabs with MH service professionals the black community will slowly become comfortable with revealing “inner demons”, they’ve been battling with. This will bring mental health, into a new light of inclusion, acceptance, and support.

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    Normalizing the “Invisible” Illness . (2022, Nov 26). Retrieved from https://artscolumbia.org/normalizing-the-invisible-illness/

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