A Growing Push to Treat Racism’s Impact on Mental Health

There’s an accelerating push by psychologists and psychiatrists to identify stress and trauma caused by racism—and develop interventions to address it.

The move comes out of a growing recognition that the impact of racism on the mental health of Black people has often been ignored. This has led many patients to be undiagnosed, misdiagnosed or not adequately treated for their distress, doctors and therapists say. The most recent efforts are being led by a new generation of Black psychologists, psychiatrists and mental health advocates.

Research has found a link between racism and psychological distress, anxiety, post-traumatic stress disorder and depression among Black people. “If you are not thinking about societal, structural racism when it comes to Black mental health, you are missing a big part of it,” says Sarah Y. Vinson, an associate professor of psychiatry at Morehouse School of Medicine in Atlanta.

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Monnica T. Williams, a clinical psychologist, created the UConn Racial/Ethnic Stress & Trauma Survey in 2017 because therapists “are not asking about the experiences of racism; people are usually not volunteering it. It ends up getting missed,” says Dr. Williams, who is now an associate professor of psychology at the University of Ottawa. She says this can lead to inadequate treatment.

“You have to understand how the person is traumatized to help them. People of color may go to one or two therapy sessions, will feel like the therapist doesn’t understand them, they won’t come back and end up not getting treated. Or they’ll keep going but won’t talk about what is really important to them.” Dr. Williams’ survey includes questions like, “Have you tried to avoid activities, places, things, or situations that remind you of the racism-related experiences you have had?”

Dr. Williams and colleagues have created an intervention for race-based stress and trauma for veterans of color. In the group program, members share their early experiences of racism and learn strategies to build resilience such as cognitive restructuring to “recognize that acts of racism are not caused by the victim, but rather the perpetrator is responsible,” she says. “I think the focus on the experience of race and racism is the important thing,” says Dr. Williams. “One of the biggest problems is people have been invalidated so much, people feel a lot of self-loathing.” The support from other people who have had similar experiences is also key, she notes.

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