Say the acronym “PTSD,” and an image will probably emerge in your head. Most likely of a veteran. Most likely of someone who’s White.
And though trauma studies began with White soldiers in WWI’s aftermath, trauma is not racially exclusive.
Or is it?
PTSD: A Historical Overview
Though historical accounts of nightmares following ancient battles and the Hundred Years’ War contained humanity’s first records of PTSD, trauma studies didn’t officially begin until the early 20th century, upon the introduction of the term “shell shock” into medical literature.
Born after researchers observed emotional disturbances in WWI veterans, shell shock acted as a predecessor diagnosis for PTSD until the 1970s, when mental health professionals and social workers began documenting widespread psychological problems in Vietnam War veterans and Holocaust survivors. And though shell shock mimicked PTSD’s symptoms, PTSD itself wasn’t added to the Diagnostic and Statistical Manual of Mental Disorders (DSM) until 1980.
Black History and the Legacy of Collective Trauma
While it takes a clinical license to assign a PTSD diagnosis, it doesn’t take a psychology degree to notice a pattern in PTSD’s history – that up until the 21st century, trauma studies were very, very white.
So white, that the results can lead the uninformed to an incorrect conclusion – that non-White people, such as the US’s second-largest minority, African Americans, cannot get PTSD.
However, an examination into Black history reveals all the trappings of collective trauma and a PTSD diagnosis to match.
To understand why, all you have to do is examine the mechanics and legacy of chattel slavery.
Imagine 400 years of torn apart families, of children ripped from their mothers, of fathers sold at auctions. Imagine 400 years of dismantled identities, where native African languages, religions, and traceable lineages were ground into dust. Imagine 400 years of systemic dehumanization, of abuse and violence and rape at the hands of White perpetrators and the governments that enabled them, centuries of collective trauma, used to justify colonialism and white supremacy.
Add another 150 years on top of slavery’s 400… Emancipation, or the illusion of it anyway… Over 150 years of conscious and unconscious sovereign efforts to diminish Black autonomy… Of voter suppression, Jim Crow, redlining, and mass incarceration.
Add 400 years of slavery and over 150 years of its legacy together, and you get a recipe ripe for Black PTSD, a recipe so potent that researchers have coined a name for the distinct experiences that come part and parcel with being Black in America – racial trauma.
As an umbrella term applying to exposure to discrimination, racial trauma comes in three forms:
- Direct, such as through police harassment, verbal attacks, and racially motivated violence.
- Indirect, such as through the effects of witnessing discrimination and racism.
- Transmitted, such as inherited intergenerational traumatic stress.
These forms, identified by Mental Health America, lay the groundwork for psychological distress, such as clinical depression, anxiety, and emotional dysregulation. I, for example, navigated all three forms of racial trauma throughout my adolescence in a majority White high school. Access to advanced classes was a constant struggle, as was stereotype threat, where administrators, classmates, and athletic coaches automatically assumed my race made me less capable than my non-Black peers.
According to a 2019 study from Pew Research, my personal experiences are only a small part of America’s broad, pervasive, and systemic pattern of racial trauma: 69% percent of high school-educated Black Americans have been subject to at least one instance of racial discrimination, a number that jumps to an alarming 81% for Black Americans with college degrees.
Barriers to Mental Health Care in the Black Community
Race and racial trauma alone, however, do not increase susceptibility to PTSD.
A combination of race and risk factors associated with it, on the other hand, does.
And the most important of said risk factors, risk factors that include societal isolation and increased exposure to complex trauma, is less access to mental health care, access that influences whether or not one develops PTSD after trauma.
The reasons why mental health care is inaccessible for African Americans are threefold.
The first, being cost.
It’s no secret that health care in the US is expensive, especially for mental health services. Many therapists opt-out of insurance networks. For therapists who opt-in, tales of months-long new-patient waitlists abound, if an in-network therapist accepts new patients at all. The health insurance network conundrum is exacerbated by dismal health insurance rates in the Black community, where up to 12% of African Americans are uninsured.
The second reason is a dearth of diversity in mental health care of both therapists and patients. According to the American Psychological Association, less than 2% of its members and associates are Black, meaning finding a Black therapist is a tall, often impossible, order for Black patients. As in the history of PTSD, mental health care’s foundations are also very, very white. Also, the failure of the DSM (Diagnostic and Statistical Manual of Mental Disorders) to account for cross-cultural values enables a narrow view of how to recognize and treat mental illness in Black populations.
Stigma, related to how the Black community views mental illness and a history of mistreatment and unethical experimentation by White doctors, is the third and most difficult barrier to Black mental health care. “Just go to church” and “depression is for White people” are common verbalized retorts, retorts that I’ve experienced firsthand, retorts that trace back to slavery when beliefs that slaves were immune to mental illness were commonplace.
The Long Road to Dismantling Black Mental Health Care Barriers
Barriers, however, do nothing to change the truth – that Black people can and do develop PTSD.
In fact, Black people are more likely to develop PTSD after a traumatic event, thanks to the combined effect of collective and racial traumas. And until America’s systemically racist power structures are demolished, Black people will remain at increased risk for PTSD, increased risk mental health professionals can accommodate for by considering the following:
- Reform the DSM. Set mental health professionals up for increased and diversified success by including culturally sensitive diagnostic and treatment criteria.
- Push for more Black therapists by introducing and funding Black scholarship programs in the psychological sciences.
- Advocate for universal health insurance coverage so all Black Americans have access to quality mental health care.
- Continue working to dismantle mental health stigmas in the Black community by building Black trust in the health care system and providing education about what is and isn’t therapy.
Therapy means putting in the work, as does dismantling longstanding barriers to Black mental health care. And with a bit – or a ton – of hard work, the past 550 years don’t have to mean 550 more years of untreated racial trauma.
About the Author: Alicia Michelle is a blogger, freelance writer, and mental health advocate. Her serial memoir and podcast, Do You Speak Georgian?, chronicles her travels in the Republic of Georgia as a Black woman on the autism spectrum.
Laurel House, Inc. and www.rtor.org are committed to the advancement of racial equity and social justice, and to making mental health services accessible to all. Help us in this commitment by taking out User Poll on Racial Trauma and Barriers to Mental Health Care in the Black Community.Take Poll
Resources to Recover and Our Sponsor Laurel House Celebrate Black History Month
February is Black History Month, a time for celebrating the outstanding achievements of Blacks and African Americans and their central role in US history. It is also a time to recognize the struggles Black people have faced throughout the history of this nation and give tribute to the strength and resilience of generations of Black Americans who have risen above adversity.
Black History Month originated from an idea by Harvard-educated historian Carter G. Woodson, who wrote the Journal of Negro History in 1916 to herald the achievements of overlooked African Americans in US history and culture. In 1926 he led an effort by the Association for the Study of Afro-American Life and History (ASALH) to officially declare the second week of February as “Negro History Week.” These dates align with the birthdays of two crucial figures in Black American history: Abraham Lincoln (February 12, 1809), who signed the Emancipation Proclamation officially ending slavery in the United States, and the Black American abolitionist and author Frederick Douglass (February 14, 1818), an escaped slave who is widely considered the most influential civil and human rights advocate of the 19th century. In 1976, President Gerald Ford gave official governmental recognition to the observance by declaring February “Black History Month.”
Without the contributions of Blacks and African Americans to more than 500 years of US history, culture, entertainment and the arts, science, athletics, industry and the economy, public service, and the Armed Forces, we would not be the country we are today.
The opinions and views expressed in any guest blog post do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in the article or linked to therein. Guest Authors may have affiliations to products mentioned or linked to in their author bios only.
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