Getting mental health care is often considered a luxury in many BIPOC cultures. Because of this, college students who belong to minority communities are less likely to ask for help when burdened with symptoms of mental illness.
Growing up, many BIPOC children hear harmful sentences like “depression is all in your head” and “suicide is a cowardly act.”
I have heard them countless times in India from my relatives, as well as from a few peers. Not to mention the list of self-help books that quickly started to feel like broken records. It went hand-in-hand with the "mind-over-matter" theory.
It was only as a post-adolescent that I learned these kinds of words can be triggers for depression victims.
Coping without professional care
An interesting phenomenon that takes place in majority-world countries is turning to religion to overcome mental and emotional fatigue. BIPOC communities cling more firmly to religion, usually in defiance to decades of foreign persecution — because that is usually the first part of a culture that is attacked.
I have received this kind of advice myself. Being raised in a Hindu family, I was taught about reward and punishment through the cycle of rebirth.
"All you have to do to be happy is do good deeds," was the general theory. "If your life is not going as you would like it to, it is probably as a result of what you did in your past life."
Other religions have similar theories, not always involving reincarnation. Both Christianity and Islam have the concept of afterlife where goodness is rewarded and evil is punished.
But as a non-religious person, I stopped finding comfort in spiritual theory after adolescence. I did not believe that my experiences coincided with the idea of a simple system of reward and punishment. I also did not see why I should have to follow an organized religion to be happy. But being agnostic or non-spiritual is not easy in a country like India. It is not even validated as a spiritual identity in most circles.
I do not claim that religion is an unhealthy coping mechanism. In fact, it is not even just a coping mechanism, definitely much more than that. I know several people who have found happiness in spirituality. But that should be left as a choice. Coercing an entire community to make do with praying for happiness is wrong.
Mental health struggles from cultural minorities in the U.S.
Haiyuan Wang, a junior with a double major in finance and business data analytics, said in China "few people receive mental health care because in Chinese values, mental illness is considered a failure, not a disease."
It is, then, no surprise that so many of them internalize this notion of guilt about seeking help. Even when they migrate to different countries, like the U.S., they hold on to these ideas. I have heard from other Indian students at ASU they could never condone suicide, arguing there are "other options."
Wang said people who come to the U.S. from China also refrain from seeking help due to this. They deal with mental health problems on their own.
"Chinese people traditionally reserve their emotions from others because they think expressing them is a compromise of privacy," he said.
Most BIPOC communities have different beliefs, norms and values, Wang said. Since a majority of counseling professionals are white, this usually creates a large cultural gap between the care provider and the patient, and often gives way to discrimination.
The second reason for not seeking aid is because mental health care is expensive.
"The basic health insurance policy that is mandatory for all international students does not cover mental health care," Wang said.
Bias within mental health care
Many underrepresented groups in the U.S. are wary of seeking care because of how the mental health care industry has responded to them historically.
Dr. James Bludworth, a psychology professor and director of the Counselor Training Center at ASU, said there are "disparities that exist between certain groups about who has access to mental health care, who’s able to afford that care and the quality of care – whether or not it is culturally competent."
Bludworth explained that even if a person is fortunate enough to be able to afford to see a counselor or a psychologist, or if they happen to get it at low cost like community counseling or psychological services, the next issue is whether or not those services are culturally responsive to a person’s ethnicity, race, gender identity or sexual orientation.
“And so, there are a lot of different factors to consider when we’re thinking about trying to provide mental health services to anybody, but particularly for people who happen to be in a marginalized group or hold a marginalized identity,” he said about accessibility of care and its cultural competence.
Sometimes, how a cultural group reacts to the idea of mental health care is related to how that group has been related to mental wellness and illness. As recently as the 1960s, being LGBTQ+ was "considered a pathology," Bludworth said.
"Although, in our diagnostic system, that’s generally no longer the case, there are still some diagnostic categories that suggest pathology, which really serves to further marginalize an already marginalized group," Bludworth said.
He explained that, historically, there has been a lot of racial bias in diagnosis. For example, African American men are often over-diagnosed with certain diagnostic categories, which is very likely inaccurate, Bludworth said.
He said many disparities in access still exist such as technology for virtual Zoom counseling sessions as many have moved online due to COVID-19.
Bludworth said the stigma is more evident in BIPOC cultures as it results from a lack of sensitivity education in both adults and children. Because these communities face problems, like poverty, illiteracy and lack of access to basic health care, that are ostensibly more pressing than mental wellness, it is not prioritized.
This dismissal of the importance of mental wellness has long-term repercussions on the future of those communities. Harmful clichés about depression being "all in your head” minimize the seriousness of mental health.
Reach the reporter at abhilasha.mandal@asu.edu and follow @AbhilashaMandal on Twitter.
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