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Why is mental health more stigmatized in minority communities?

On a sunny Sunday morning this past August, 18 young people of different backgrounds, ethnicities, and gender identities—many of whom had never met before—gathered in New York City’s Bryant Park for an art therapy session and picnic led by art therapist Ingrid Mellor and illustrator Laura McGinley.

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The event was hosted by Sad Girls Club, a mental health awareness and discussion community for millennials. Each of the attendees, from 17-year-old high school student Emily Odesser to 24-year-old model Kristin Kagay, found out about the free mental health event through social media. Many of them also identify as people of color who have felt let down by the current support system for mental health and come from communities where mental health treatment can be stigmatized. Elyse Fox, a 27-year-old New York native, founded Sad Girls Club as a simple in-person group therapy session for young women of color. Fox sought treatment for depression, but soon realized she could not afford private therapy sessions and felt that the Caribbean-American community she grew up in preferred to keep mum about mental health issues. Her friend, 18-year-old singer and Art Hoe Collective curator Alia Kadir, empathizes: “I know I’m not the only one here with immigrant relatives who don’t understand that depression is not just something I can get over,” she said at the picnic, relating struggles during high school which her family mislabeled as laziness. Like Fox, Kadir has found an alternative support system and resources for depression through Instagram communities like Art Hoe Collective and Sad Girls Club.

There is no singular explanation for why and how mental health is stigmatized in American communities of color. For example, Asian-Americans report pressure to live up to a “model minority” stereotype—a unique barrier when seeking mental health treatment; some Asian-Americans report feeling incorrectly viewed as fully integrated into mainstream American culture. A 2001 Surgeon’s report found that only 20 percent of Latin Americans with mental illnesses spoke with their doctors about it. A study published in 2008 found that only one-quarter of African-Americans seek mental health treatment, compared to 40 percent of nonminorities. Other possibilities for which American communities of color may face difficulty accessing support include lack of convenience or transportation, discrimination in treatment settings, language barriers between providers and patients, affordability and health insurance coverage, lack of education about mental health, and the prevalence of a culturally homogenous mental health care system that may ignore or misunderstand cultural norms of minorities. Also, not everyone can or would like to sit on a couch and talk about feelings or take prescription pills. (For example, Womankind, a New York-based nonprofit organization and social service agency, serving gender-based violence survivors offers acupuncture as a form of therapy treatment.) When racial minorities do seek care, studies have shown access to be lower and quality of care to be poorer.

Read more: If going to therapy sounds scary, this might be an alternative

Though stigma can be shared and learned, it can also be internalized individually, which makes changing perceptions of mental health issues and treatment particularly complex. Public stigma, which describes discrimination and biases held by members of the public, such as journalists or medical practitioners, can be experienced personally and perpetuate internalized stigma. Though Instagram is often cited for fueling feelings of anxiety and inadequacy, young people like Fox are using social media to create authentic and honest conversations in new ways amongst their own communities. “Instagram is a great place to meet likeminded people and I think a lot of the stigma of Instagram being anxiety-ridden, it’s true if you let it be, but we also control the images that [show on our feeds],” she explained. “It’s all us putting these images out there, so if you want to see more real, we have to be that representation and take that first step.”

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