Mental Health in Black, Indigenous, and People of Color (BIPOC) Communities

July 1, 2024

Mental health is a critical aspect of overall well-being, yet disparities in mental health care and outcomes persist among Black, Indigenous, and People of Color (BIPOC) communities. These disparities are influenced by a complex interplay of social, cultural, and economic factors. This article aims to provide a comprehensive overview of mental health issues and statistics among BIPOC populations, incorporating theoretical perspectives and research findings to offer a nuanced understanding of this critical issue.

Research indicates that 24% of people who reported experiencing discrimination exhibited greater levels of depressive symptoms, perceived stress, and anxiety.

Understanding the mental health challenges faced by BIPOC individuals requires a multi-faceted approach. Several theories offer insight into the unique stressors and experiences that contribute to mental health disparities in these communities.

Biopsychosocial Model of Racism

The heightened physiological and psychological responses caused by frequent racial discrimination can restrict access to resources, opportunities for advancement, and social mobility, further contributing to poorer mental health and well-being.

In recent years, movements like Black Lives Matter have brought to light the urgent need to address mental health issues among African Americans and those of African or Caribbean descent. Generational trauma, victimization, criminalization, and systemic injustice have significantly contributed to higher rates of physical and psychiatric disorders in these communities. Research shows a strong link between everyday discrimination and depressive symptoms in Black American men, regardless of their specific ethnicity. A study involving 1,271 African American men and 562 Afro-Caribbean American men found that lower self-esteem often accompanies higher depressive symptoms after experiencing discrimination. Interestingly, ethnic group membership appeared to protect Afro-Caribbean men from the negative impacts of discrimination on self-esteem. However, the differences in nativity and the amount of time spent in the U.S. made comparisons between African American and Afro-Caribbean men more complex. Another study highlighted how racial discrimination hinders personal growth, further exacerbating depressive symptoms. These findings emphasize the need for culturally sensitive, community-based interventions to support mental health in Black communities.

Cultural Assimilation Theory

The increased stress and loss of personal identity that can occur when immigrants encounter their new culture alongside their native culture. Immigrants often go through this process when they relocate to a new country.

When working with the Latiné community, it's crucial for providers to understand the unique cultural factors involved in diagnosing and treating depression. The immigration process brings many stressors, like adapting to a new culture, shifts in social identity, family dynamics, social status changes, and discrimination, all of which can lead to depression. Research shows that Hispanic immigrants, while generally less likely to suffer from mental illness than their U.S.-born counterparts, see an increase in mental health issues the longer they live in the U.S. A study of 581 Latiné individuals who immigrated before age seventeen found key differences between younger and older migrants in terms of acculturation, stress, social status, and discrimination. Younger migrants often faced more family conflict over cultural values, which worsened their depression. Additionally, Latiné women immigrants had higher rates of depression than men, due to stress from cultural adaptation, gender roles, limited access to resources, discrimination, and sociopolitical factors. It's essential for clinicians, educators, and family members to address these mental health risks to provide proper support for Latiné immigrants.

Immigrant Paradox

Despite experiencing higher levels of stressors like poverty and lower social status, immigrants have been found to have lower rates of mental health disorders compared to BIPOC individuals born in the U.S. This phenomenon recognizes the resilience and strength in adaptation among various immigrant groups.

​​Researchers found that foreign-born Asian American women tend to have lower levels of psychiatric disorders compared to their U.S.-born counterparts. This observation comes from a study involving 1,030 Asian American women, mostly Chinese, Filipino, and Vietnamese. While only 18% were U.S.-born, the rest had immigrated. The study found that U.S.-born Asian women had higher rates of depression (17.89%) and anxiety (12.13%) compared to those who immigrated before age 25 (10.75% and 10.46%) and after 25 (5.53% and 7.02%). 

The concept of the immigrant paradox suggests that immigrants often exhibit resilience and a strong ability to manage stress, leading to lower rates of psychiatric disorders. However, U.S.-born Asian women face unique challenges, including greater discrimination, family conflict, and lower family cohesion, which contribute to higher levels of depression and anxiety. These insights emphasize the importance of considering generational and cultural differences when developing mental health strategies for Asian American women.


Defined as, a comment, action, or incident that unintentionally or subtly discriminates against people from marginalized groups. Microaggressions are often indirect and can be so subtle that they may go unnoticed by others.

Considering the insights from various BIPOC groups, it's crucial to address mental health risks among multiethnic or multiracial individuals, especially the impact of microaggressions and discrimination related to their heritage. These daily slights can manifest as exclusion, objectification, mistaken identity assumptions, denial of multiracial reality, and pathologizing of identity. A study with 9 participants revealed that such microaggressions, particularly within families, lead to increased isolation, identity crises, and lack of support systems, negatively affecting their mental health. Educators and clinicians should use these findings to improve support and services for multiethnic and multiracial individuals, addressing their unique psychological and social challenges.

Minority Stress Theory

Mental health problems among minoritized groups are linked to their ongoing experience of social stressors, stigmas, and discrimination, in contrast to their non-minority peers.

While ethnic minority communities often face higher risks of depression due to factors like low socioeconomic status, discrimination, and acculturative stress, their cultural identities and traditions can offer some protection. In a study with 132 Native American students aged 13-19 from Northern Michigan, it was found that perceived discrimination was closely linked to cultural socialization. Native American youth had higher rates of suicide attempts and depressive symptoms compared to their White peers. Interestingly, while participating in cultural traditions didn't necessarily protect against depression, it was linked to higher self-esteem. These findings emphasize the importance for educators, clinicians, and policymakers to consider cultural factors when supporting the mental health and well-being of Native American communities.

Silencing the Self

Primarily observed in women, this theory proposes that social inequality and societal gender norms can directly influence one's thoughts and behaviors, increasing the risk of depression and other mental health disorders. Individuals are expected to prioritize others over themselves and conform to oppressive behaviors, which can reinforce negative self-perception, lower self-esteem, and lead to feelings of a loss of self. This theory is evident in cultures where women are expected to maintain traditional roles, such as child-rearing and household management, while men are the family providers. 

Studies have revealed a significant correlation between depressive distress and silencing the self (STSS) scores. For every one-point increase in STSS, there was a 3% increase in depressive distress. Ethnic group differences were noted, with certain groups being more vulnerable to self-silencing and consequently more at risk for developing depressive disorders.

Therapy & the BIPOC Community

According to a survey from Blue Cross Blue Shield Association, 54% of Black respondents and 47% of Hispanic respondents said that people with mental health conditions are “looked down upon” in their communities. Meanwhile, only 38% of White respondents shared the same stigma. Similarly, 65% of White respondents made an appointment with a mental health care provider while 43% of Black and 47% of Hispanic respondents decided to deal with their mental health challenges on their own. Respondents from Black and Hispanic communities relied more on help from friends and family, social media, and community groups rather than the mental health care workforce.

Not only does discrimination lead to a number of mental health challenges for BIPOC individuals, but there is also a pervasive stigma around therapy and distrust in many BIPOC communities, which prevents many from seeking the help they need. Part of the issue is due to the lack of diversity in the healthcare workforce with nearly 75% of mental health professionals in the U.S. identifying as White. At Tava Health, we’re proud to say that 7 of our top 10 performing providers on Zocdoc are members of the BIPOC community and that we’re continuing to cultivate a diverse pool of therapists.

Zooming in further, even when mental illness is present, Hispanic (40%), Black (38%), and Asian (36%) adults were less likely than White adults (56%) to receive mental health services. At Tava Health, only 0.97% of users cite “racial trauma” as one of their presenting challenges, which echoes this trend in BIPOC communities. The lack of diversity in the mental healthcare system presents real challenges for BIPOC individuals. In one survey, about 18% of Black adults and 12% of American Indian and Alaska Native (AIAN) adults report unfair or disrespectful treatment by healthcare providers due to their racial or ethnic background, compared to just 3% of White adults. Additionally, 29% of AIAN adults and 24% of Black adults experienced such treatment for any reason in the past three years, higher than the 14% reported by White adults.

Additionally, the need for mental health care isn’t being recognized at the same rate for BIPOC communities as they are for white communities despite having higher rates of suicide-related diagnoses. In one study, they found that children in black communities were 61% less likely to have a record of anxiety and 35% less likely to have a record of depression compared to children in white communities. Yet, they were 19% more likely to have a suicide-related diagnosis, and 40% more likely of underrecognition of mental health disorder.

Another barrier for BIPOC communities is accessibility and affordability. As of 2022, American Indian or Alaska Native (19%) and Hispanic (18%) people were more than twice as likely to be uninsured than White people (7%). Native Hawaiian or Pacific Islanders (13%) and Black (10%) individuals were also more likely to be uninsured than White individuals. The lack of insurance means mental health care isn’t an affordable option for many individuals. Furthermore, Black and Hispanic households have less net worth than White households.

The mental health challenges faced by BIPOC communities are deeply rooted in systemic inequalities and societal stressors. Theoretical perspectives and research findings highlight the unique experiences and resilience of these populations. Addressing mental health disparities requires a comprehensive approach that includes cultural competence, equitable access to care, and targeted interventions to mitigate the effects of discrimination and social stressors. By understanding and addressing these factors, we can move towards a more inclusive and supportive mental health care system for all.

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