Overlooking Racism May Lead to Undiagnosed Mental Health Disorders

Mental health professionals may be missing at least five novel mental health problems because the impact of racism is not considered when determining mental health, a new report suggests. 

Tony N. Brown, Vanderbilt University assistant professor of sociology, asserts in the report that standard mental health criteria may fail to capture a true picture of problems across racial groups. 

That failure in turn, leads to some psychological problems going unclassified and undiagnosed. "We don't know what is deviant if we don't know what the norm is and the norm is dictated by society's beliefs, which vary across racial groups.

For example, the black community may question the sanity of blacks who bleach their skin or blacks who 'hate being black,' but these lay definitions of poor mental health are ignored by mental health professionals," Brown said. 

"Combining lay and clinical definitions and considering racism's impact on mental health could offer a more complete picture of mental health disorders," Brown added. 

The report, "Critical Race Theory Speaks to the Sociology of Mental Health: Mental Health Problems Produced by Racial Stratification," appears in the September edition of the Journal of Health and Social Behavior published by the American Sociological Association. 

Mental health research has hinted that a complex relationship between racism and mental health exists but the link has not yet been fully explored. The conventional wisdom in the field of mental health is that the more stress a person is exposed to, the more likely it is that he or she will suffer from poor mental health. 

However, community epidemiological studies conducted during the past 20 years indicate that blacks, relative to whites, exhibit about the same, or in some cases lower rates of psychiatric disorder despite blacks' stress levels being compounded by racism.

Brown believes racism's not being factored into the mental health equation accounts for some of the disparity. In the report, Brown proposes five mental health problems related to racism that he believes are the most prevalent and impairing. He focuses on these five because available evidence offers strongest support that these problems exist. They are: 

*Nihilistic Tendencies - self-defeating attempts to survive in a society that systematically frustrates normal efforts for natural human growth. According to the report, this mental health problem is likely to affect blacks that, finding the doors to legitimate survival blocked, have chosen destructive means to achieve immediate needs and desires out of an urgency to survive. 

*Anti-self issues - a mental health problem that describes how blacks feel estranged from their racial selves and seek to escape their blackness and any connection to other blacks. Estranged blacks have internalized negative notions about being black that result in disdain for their racial group and their trying to create social and physical space between themselves and their group. 

*Suppressed Anger Expression - denial of anger and aggression that leads to false affability, passivity, resignation and ultimately withdrawal or inward self-destruction. In social or workplace settings, blacks may feel they are denied the liberty of expressing anger about racial issues which can build up over time to detrimental effects. 

*Delusional Denial Tendencies - a mental health problem that can affect both blacks and whites. In response to racism, blacks may repress unpleasant or painful ideas from reaching the conscious level and ultimately generating disability. Researchers have also theorized that whites are socialized to believe that they do not benefit from racial oppression and that they do not need to consider the role race plays in their lives. 

*Extreme Racial Paranoia - a mental health problem typically affecting whites who hold illusions of exaggerated self-importance based on race and who experience unreasonable discomfort at the thought of having an interpersonal interaction with a black person. Brown cites research that has called extreme racial paranoia (Nerophobia) among whites a serious mental illness. 

Brown suggests that more research is needed to verify these mental health problems and to explore the relationship between racism and mental health across all racial groups. He also cautions against the acceptance of standardized concepts of mental health because the dominant group in society often defines normalcy and disease. 

He cites the example of white psychiatrists in the 19th century who claimed black slaves suffered from "drapetomania" a "psychiatric disorder indicated by a desire to run away from slavery."

Psychological Responses to Racism Similar to Trauma Symptoms Study Finds

November 16, 2012

For Black American adults, perceived racism may cause mental health symptoms similar to trauma and could lead to some physical health disparities between Blacks and other populations in the United States, according to a new study published by the American Psychological Association.

 

While previous studies have found links between racism and mental health, this is the first meta-analysis on the subject focusing exclusively on black American adults, according to the study published online in APA’s Journal of Counseling Psychology^®.

“We focused on black American adults because this is a population that has reported, on average, more incidents of racism than other racial minority groups and because of the potential links between racism and not only mental health, but physical health as well,” said lead author Alex Pieterse, PhD, of the University at Albany, State University of New York.

Researchers examined 66 studies comprising 18,140 black adults in the United States. To be included in the analysis, a study must have been published in a peer-reviewed journal or dissertation between 1996 and 2011; include a specific analysis of mental health indicators associated with racism; and focus specifically on black American adults in the United States.

Black Americans’ psychological responses to racism are very similar to common responses to trauma, such as somatization which is psychological distress expressed as physical pain; interpersonal sensitivity; and anxiety, according to the study.

Individuals who said they experienced more and very stressful racism were more likely to report mental distress, the authors said. While the researchers did not collect data on the impacts on physical health, they cite other studies to point out that perceived racism may also affect black Americans’ physical health.

“The relationship between perceived racism and self-reported depression and anxiety is quite robust, providing a reminder that experiences of racism may play an important role in the health disparities phenomenon,” Pieterse said. “For example, African-Americans have higher rates of hypertension, a serious condition that has been associated with stress and depression.”

The authors recommended that therapists assess racism experiences as part of standard procedure when treating black Americans, and that future studies focus on how discrimination is perceived in specific settings, such as work, online or in school.

Article: “Perceived Racism and Mental Health Among Black American Adults: A Meta-Analytic Review,” Alex L. Pieterse, PhD, University at Albany, State University of New York; Nathan R. Todd, PhD, DePaul University; Helen A. Neville, PhD, University of Illinois at Urbana-Champaign; and Robert T. Carter, PhD, Teachers College, Columbia University; Journal of Counseling Psychology, Vol. 59, No. 1.