Black, Indigenous, People of Color

According to 2023 population estimates, Black, Indigenous, and People of Color (BIPOC) account for about 60 percent of the Texas population.1 When examining this figure by race and ethnicity, 39.67 identify as Hispanic, 11.86 percent as Black/African American, 5.2 percent as Asian American, and 2.42 percent as non-Hispanic other (i.e., two or more races, American Indian, Pacific Islander, or some other races).2 BIPOC individuals experience rates of mental health disorders similar to those of White individuals; however, these mental health challenges are more likely to persist over time and have a long-term impact on behavioral health and well-being in BIPOC communities.3,4 Mental health is often undertreated for BIPOC individuals. For instance, 52 percent of White individuals with a mental illness received services within one year, compared to 37.1 percent of Black individuals and 35 percent of Hispanic individuals.5 Not only are people of color less likely to seek out mental health resources and services, but they are also often:

  • Less likely to have access to mental health resources and services;
  • More likely to receive poor-quality care; and
  • More likely to end services early.6

These trends can be attributed to societal and cultural barriers. Data from 2023 indicates that BIPOC individuals in Texas have less access to insurance coverage, with 27.5 percent of Hispanic Texans, 15 percent of Black Texans, and 19.6 percent of Native American Texans without coverage.7 Additional factors contribute to their disproportionate undertreatment, such as community stigma, racism, poorer quality of care, language and cultural differences, and shortages of ethnically and racially diverse providers.8 For example, over 80 percent of the Texas behavioral health workforce surveyed in 2023 identified as White.9 Moreover, Hispanics make up 39.6 percent of the Texas population; yet only 17.6 percent of surveyed providers identified as Hispanic or Latino.10,11

Highlighting BIPOC Communities

Behavioral health and substance use touches the lives of all people regardless of race and ethnicity, yet it may present differently as languages, cultures, and traditional values describe these experiences through a unique lens.

Communities of Indigenous American Descent

In Texas, there are three federally recognized Native American tribes: the Alabama-Coushatta Tribe of Texas, the Kickapoo Traditional Tribe of Texas, and the Ysleta del Sur Pueblo of Texas.12 Apart from these, data indicate that American Indian Texans identify with over 40 different tribes.13 However, census data historically has not completely encapsulated all indigenous identities, making it difficult to report specific demographics in Texas.14

Mental health is woven into the culture of communities of Indigenous American descent in ways that differ from current Western models of mental health.15,16 Words such as “depressed” and “anxious” are not found in some native languages.17 Instead, expressions like “ghost sickness” or “heartbreak syndrome” are utilized to embody distressing psychological symptoms.18 Moreover, this community holds a holistic view of well-being that values physical, emotional, spiritual, and community impact in the healing process.19 Indigenous persons experiencing mental health challenges often seek informal help from friends, family, and traditional and spiritual healers rather than clinical treatment.20

Indigenous/Native Americans have reported significant mental health challenges. Although specifics vary by tribe, suicide rates among this group consistently surpass those among all other racial and ethnic groups.21,22 The leading cause of death of Native American youth is suicide, and these youth are dying four times as often as youth in the general U.S. population.23 Elevated risk factors are influenced by communities living in poverty, historical trauma, alienation, acculturation, discrimination, community violence, and mistrust of mainstream services.24,25 Further mental health and substance use information about Native Americans as of 2022 reveals that:

  • 19.6 percent of adults experienced any mental illness within the past year;
  • 7.3 percent of adults experienced a serious mental illness within the past year; and
  • 11.6 percent of adults received mental health treatment within the past year.26

Black and African American Communities

Mental health conditions are often overlooked within the Black community. Attaining professional support is difficult, and African Americans face disparities in the mental health care system. Historical adversity must be considered when discussing barriers to adequate mental health support.27 Slavery, sharecropping, segregation, and race-based exclusion from health, educational, social, and economic resources have resulted in socioeconomic disparities for the Black community.28 This has permeated American medical research, education, and practices that are inevitably ill-suited to provide evidence-based services to this community.29 Other barriers include stigma, cultural mistrust, lack of representation, distorted perceptions of strength, and religion as a replacement for clinical treatment.30

Unfortunately, these factors lead to lower rates of treatment among this population, despite mental health conditions being present and pervasive. In 2022, suicide was the third leading cause of death for Black or African Americans ages 10 to 24, impacting more males than females.31 Rates of illicit drug use among the African Americans is slightly higher than the national average at 12.4 percent.32 Moreover, the 2022 SAMSHA National Survey on Drug Use and Health states that, within the past year:

  • 19.7 percent of Black and African American adults have experienced a mental health condition;
  • 4.7 percent of Black and African American adults have experienced serious mental illness; and
  • 15.3 percent of Black and African American adults with a mental health condition have received mental health treatment.33

For more in-depth information, read this Black Indigenous and People of Color (BIPOC) Mental Health Fact Sheet.

Communities of Arab Descent

Communities of Arab descent are underrepresented in mental health research.34 One reason for this is that Arab Americans are not identified as an ethnic group on national census tools.35 This, along with minimal cultural and ethnic representation among mental health professionals, has led to an inability to adequately identify and provide for Arab mental health needs.36

Despite challenges with robust reporting mechanisms and academic research, this population has voiced a few behavioral health trends within their community. After 9/11, discrimination against Arab and Muslim individuals significantly increased throughout the nation.37 As a result, Arab Americans reported an increase in psychological distress, lower levels of happiness, and declining health statuses.38 In addition, 60 percent of Arab American participants screened positively for depression in a 2021 study.39

Yet, Arab Americans tend to harbor negative attitudes towards seeking help for mental health issues for cultural and religious reasons.40 In the culture, mental illness is shrouded by stigma and shame, teaching individuals that symptoms of depression are “shameful” and “lazy.”41 These issues are viewed as private family matters, often turning to the extended family to provide support on issues like abuse and domestic violence.42 Seeking outside treatment could be interpreted as circumventing the family structure and is considered incompatible with cultural norms and values.43,44

Conclusion

The intersection of culture, tradition, and systemic disparities profoundly shapes the mental health experiences of BIPOC communities. Cultural values influence how BIPOC individuals perceive mental health and their decisions to seek – or not to seek – help from community, family, or professionals. These factors, along with historical and societal barriers, can limit access to resources and must be considered when examining the mental health landscape of Texas.

References

  1. Texas Demographic Center (2023). Estimates of the Total Populations of Counties in Texas  
    By Age, Sex, and Race/Ethnicity for July 1, 2023. Retrieved from https://demographics.texas.gov/Estimates/2023/  ↩︎
  2. Ibid. ↩︎
  3. Anxiety & Depression Association of America. (2024). BIPOC Communities. Retrieved from https://adaa.org/find-help/by-demographics/bipoc-resources  ↩︎
  4. Leblanc, D. (2022). Black Indigenous and People of Color (BIPOC) Mental Health Fact Sheet. Resources to Recovery. Retrieved from https://www.rtor.org/wp-content/uploads/2023/01/rtor_bipoc_fact-sheet_2023-web.pdf  ↩︎
  5. Ibid.  ↩︎
  6. Perzichilli, T. (2020). The historical roots of racial disparities in the mental health system. American Counseling Association. Retrieved from https://www.counseling.org/publications/counseling-today-magazine/article-archive/article/legacy/the-historical-roots-of-racial-disparities-in-the-mental-health-system  ↩︎
  7. Kaiser Family Foundation. (2023). Uninsured Rates for People Ages 0-64 by Race/Ethnicity. Retrieved from https://www.kff.org/uninsured/state-indicator/people-0-64-uninsured-rate-by-raceethnicity/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D  ↩︎
  8. Holman, A. (2023). BIPOC Mental Health: Barriers and Ways to Support. Lyra. Retrieved from https://www.lyrahealth.com/blog/bipoc-mental-health/  ↩︎
  9. Texas Behavioral Health Executive Council. (2023). Texas Behavioral Health Executive Council Workforce Study Survey Data. Retrieved from https://bhec.texas.gov/workforce-survey-and-data/ ↩︎
  10. Ibid.  ↩︎
  11. United States Census Bureau. (2023). Quickfacts: Texas. Retrieved from https://www.census.gov/quickfacts/TX  ↩︎
  12. Texas Demographic Center. (2023). American Indian and Alaskan Native Heritage Month 2023. Retrieved from https://demographics.texas.gov/Visualizations/2023/NativeAmerican/  ↩︎
  13. Wong, K. (2022). Data Brief: Indigenous Peoples Day. Every Texan. Retrieved from https://everytexan.org/2022/10/10/data-brief-indigenous-peoples-day/  ↩︎
  14. Ibid. ↩︎
  15. Mental Health America. (n.d.). Communities of Indigenous American descent. Retrieved from https://mhanational.org/indigenous ↩︎
  16. Anxiety & Depression Association of America. (2023). Native and Indigenous Communities. Retrieved from https://adaa.org/find-help/by-demographics/native-indigenous-communities#How%20Heritage%20&%20Culture%20Impacts%20Mental%20Health%20Care%C2%A0  ↩︎
  17. Ibid. ↩︎
  18. Ibid. ↩︎
  19. Mental Health America. (n.d.). Communities of Indigenous American descent. Retrieved from https://mhanational.org/indigenous ↩︎
  20. American Psychiatric Association. (2022). Indigenous Populations Face Unique Barriers to Accessing Mental Health Help. Retrieved from https://www.psychiatry.org/news-room/apa-blogs/indigenous-populations-barriers-to-help  ↩︎
  21. Anxiety & Depression Association of America. (2023). Native and Indigenous Communities. Retrieved from https://adaa.org/find-help/by-demographics/native-indigenous-communities#How%20Heritage%20&%20Culture%20Impacts%20Mental%20Health%20Care%C2%A0 ↩︎
  22. Stone D, Trinh E, Zhou H, et al. (2022). Suicides Among American Indian or Alaska Native Persons — National Violent Death Reporting System, United States, 2015–2020. Center for Disease Control. http://dx.doi.org/10.15585/mmwr.mm7137a1 ↩︎
  23. Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication No. PEP23-07-01-006, NSDUH Series H-58). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2022-nsduh-annual-national-report  ↩︎
  24. American Psychiatric Association. (2022). Indigenous Populations Face Unique Barriers to Accessing Mental Health Help. Retrieved from https://www.psychiatry.org/news-room/apa-blogs/indigenous-populations-barriers-to-help  ↩︎
  25. Anxiety & Depression Association of America. (2023). Native and Indigenous Communities. Retrieved from https://adaa.org/find-help/by-demographics/native-indigenous-communities#How%20Heritage%20&%20Culture%20Impacts%20Mental%20Health%20Care%C2%A0 ↩︎
  26. Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication No. PEP23-07-01-006, NSDUH Series H-58). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2022-nsduh-annual-national-report ↩︎
  27. Starks, S. (n.d.) Working with African American/Black Patients. American Psychiatric Association. Retrieved from https://www.psychiatry.org/Psychiatrists/Diversity/Education/Best-Practice-Highlights/Working-with-African-American-Patients ↩︎
  28. Ibid. ↩︎
  29. Ibid. ↩︎
  30. Holman, A. (2023). BIPOC Mental Health: Barriers and Ways to Support. Lyra. Retrieved from https://www.lyrahealth.com/blog/bipoc-mental-health/ ↩︎
  31. Office of Minority Health. (2024). Mental and Behavioral Health – Black/African Americans. U.S. Department of Health and Human Services. Retrieved from https://minorityhealth.hhs.gov/mental-and-behavioral-health-blackafrican-americans ↩︎
  32. Division of Diversity and Health Equity. (2017). Mental Health Disparities: African Americans. American Psychiatric Association. Retrieved from https://www.psychiatry.org/getmedia/bc6ae47f-b0aa-4418-b045-952ede06757f/Mental-Health-Facts-for-African-Americans.pdf  ↩︎
  33. Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication No. PEP23-07-01-006, NSDUH Series H-58). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2022-nsduh-annual-national-report ↩︎
  34. Mental Health America. (n.d.). Arab mental health: Quick facts. Retrieved from https://mhanational.org/arab-mental-health-quick-facts ↩︎
  35. Atieh, N. (2022). Barrier to Mental Health: The Middle Eastern Experience. National Alliance on Mental Illness. Retrieved from https://www.nami.org/education/barriers-to-mental-health-the-middle-eastern-experience/ ↩︎
  36. Ibid.  ↩︎
  37. Padela, A. I., & Heisler, M. (2010). The association of perceived abuse and discrimination after September 11, 2001, with psychological distress, level of happiness, and health status among Arab Americans. American journal of public health, 100(2), 284–291. https://doi.org/10.2105/AJPH.2009.164954 ↩︎
  38. Ibid. ↩︎
  39. Suleiman, A. R., Afify, O., & Whitfield, K. E. (2021). The Effect of Stress, Acculturation, and Heritage Identity on Depression in Arab Americans. Journal of community hospital internal medicine perspectives, 11(4), 433–438. https://doi.org/10.1080/20009666.2021.1929050 ↩︎
  40. Elshamy, F., Hamadeh, A., Billings, J., & Alyafei, A. (2023). Mental illness and help-seeking behaviours among Middle Eastern cultures: A systematic review and meta-synthesis of qualitative data. PloS one, 18(10), e0293525. https://doi.org/10.1371/journal.pone.0293525  ↩︎
  41. Atieh, N. (2022). Barrier to Mental Health: The Middle Eastern Experience. National Alliance on Mental Illness. Retrieved from https://www.nami.org/education/barriers-to-mental-health-the-middle-eastern-experience/ ↩︎
  42. Ibid. ↩︎
  43. Ibid. ↩︎
  44. Elshamy, F., Hamadeh, A., Billings, J., & Alyafei, A. (2023). Mental illness and help-seeking behaviours among Middle Eastern cultures: A systematic review and meta-synthesis of qualitative data. PloS one, 18(10), e0293525. https://doi.org/10.1371/journal.pone.0293525  ↩︎

Updated on December 13th, 2024



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