By Dr. Nicole Monteiro
Most people are aware of or at least recognize the importance of maintaining good mental health, yet mental illness continues to be a taboo topic plagued by stigma within Black American and Muslim communities. There is often a double stigma for Black American Muslims struggling with mental health challenges. Many of us would have little problem recommending that an acquaintance seek help for their problems, but would hesitate to seek treatment if a close friend, family member or even ourselves experienced emotional or psychological problems.
By all accounts Muslim communities are not immune from increasing rates of psychological and mental health problems. Muslims are vulnerable to significant levels of stress as a result of Islamophobia, the pressures of maintaining work-life-family balance in a fast-paced society, managing uncertainty about financial and job security, and bridging the gap between Islamic and Western lifestyles. Moreover, Black Muslims experience a unique set of stressors – i.e., racism, discrimination, marginalization, individual and community trauma, and the intergenerational effects of racial terror in the U.S. – that may put them at risk for problems such as depression, anxiety, posttraumatic stress disorder, behavioral problems, eating disorders, etc. Other illnesses, such as Bipolar Disorder and Schizophrenia, have a strong genetic component, which means that several members of the same family may be at risk for these disorders and they may be exacerbated by stress and lack of access to proper care.
Yet, Black Muslims are often the most hesitant and reluctant to seek professional counseling or any other mental health treatment. There are a number of historic reasons for mental health stigma among Black Muslims. There have been concrete examples and experiences of Black – and other marginalized groups – being exploited by medical researchers and government institutions. In the Tuskegee Syphilis Experiment, the United States Public Health Service recruited Black men to study the progression and effects of untreated syphilis. The men were not informed of the true purpose of the study, but instead were told they were receiving free health care. Furthermore, they were denied treatment with penicillin even after it became a widespread and proven treatment for syphilis. This history of government deceit and disregard for Black lives has left a legacy of mistrust and avoidance of medical institutions.
The mental health care system is often seen as an extension of institutionalized and systemic oppression of Black Americans. Many school activists have critiqued the over- diagnosis of Black boys with ADHD. There is also growing recognition of implicit (unconscious) racism and bias within health fields that result in some medical professionals; perceiving African American patients as feeling less pain; assessing them as more aggressive; under-diagnosing their trauma related symptoms; or concluding that they are less psychologically insightful. In the field of psychiatry, research has shown that, presenting with similar symptoms in psychiatric hospitals, Black patients have been more likely to receive more severe diagnoses such as schizophrenia than their white counterparts who tended to receive diagnoses of depression or anxiety for the same symptoms. Research with Black-American counseling clients indicates that they may drop out of therapy early because they fear the counselor who is racially or culturally different does not understand their lifestyle and may pathologize or over-diagnose them. Furthermore, the intersecting experiences of being Muslim and Black add to the sense of being marginalized and misunderstood by mental health professionals in a society that denigrates both Black Americans and Muslims.
Another significant reason that Black Americans often reject professional mental health treatment is their iman, their faith. Islam is a complete way of life and it is believed that the Qur’an and the Sunnah of the Prophet Muhammad (peace be upon him) provide the remedies for all ailments. Many Muslims cope with hardships by using prayer, patience, reading Qur’an, going to the mosque and practicing other forms of Islamic worship. But others – more than would openly admit it – suffer in silence and bear a great sense of guilt and shame because they can’t just pray their depression and anxiety away, or they still experience the racing thoughts and poor judgment that characterize Bipolar Disorder, or they struggle with eating disorders like bulimia or binge eating, or they are haunted by voices in the midst of a psychotic episode, or they consider suicide because they are survivors of abuse and struggle with the aftermath of psychological trauma, or they have a child with developmental delays or learning problems.
Historically, Black American Muslims have prided themselves on having a strong sense of community. The conditions under which many Black American Muslims accepted and practiced Islam were adversarial and challenging and required a great deal of commitment, determination and faith. As a result, Black American Muslims have a great deal of resilience. But resilience alone does not treat mental health problems any more than it cures diabetes or high blood pressure. What is needed now is greater mental health awareness among Black Muslims and willingness to unmask the secrecy and suffering around mental illness and emotional/psychological distress.
As a Black Muslim mental health professional who has done a lot of work in the African diaspora exploring both traditional and modern approaches to treating mental health problems, I have gleaned a lot of wisdom from the power of community to address collective and individual suffering. While I have noticed that mental health stigma is an almost universal phenomenon, one noteworthy observation I have made is that the involvement of family and close social groups is essential to help people recover from mental illness. Communal support and ensuring that people suffering are integrated into and not isolate from their communities, particularly their religious community, gives people permission to seek help from a variety of sources, including mental health professionals.
How can this approach be applied to Black Muslims? One is to open the lines of communication and to broaden networks of support within our communities. That means: educating religious leaders about mental illness and encouraging them to work collaboratively with counselors and other mental health professionals; supporting Black and Muslim mental health professionals who are trying to bring awareness to our communities and educate the mainstream mental health establishment about Muslims; and guarding against an insular and judgmental mindset that pushes people to isolate and hide in their greatest times of need. It is also important for Black Muslims to recognize that seeking professional mental health treatment does not preclude them from also using religious and spiritual coping mechanisms. Contemporary mental health treatment is increasingly holistic and inclusive. Finally, seeking help is not a sign of weakness, instead it is a sign of courage and respect for oneself, one’s family and one’s community. The Ummah only becomes stronger when we attend to the whole person – spiritual, physical, AND mental.