By: Sandra C. Melvin, DrPH, MPH,CEO, Institute for the Advancement of Minority Health | July 23, 2026

Jackson, Mississippi–  For generations, many Black families have survived by being strong. Strength helped us endure poverty, racism, grief, discrimination, violence, and systems that too often failed to protect us. But somewhere along the way, strength became confused with silence. We learned to keep going, keep praying, keep working, keep parenting, and keep showing up, even when we were exhausted, anxious, depressed, or carrying trauma we never had the space to name. Mental health stigma in the Black community is not simply about refusing help. It is rooted in history, survival, mistrust, and limited access to culturally responsive care. Many people have been taught that therapy is for other people, that depression is weakness, or that family business should stay inside the family. Others worry they will be judged, misunderstood, mislabeled, or treated unfairly by providers who do not understand their lived experience. The numbers show why silence is dangerous.

In 2023, only 15.1% of Black adults received mental health treatment in the past year, compared with 27.0% of White adults, according to the Substance Abuse and Mental Health Services Administration. Among adults with serious mental illness, the treatment gap is also clear: in 2022, 52.3% of Black adults with serious mental illness received mental health treatment, compared with 71.4% of White adults. These disparities are not abstract. They show up in families, schools, churches, workplaces, and neighborhoods. Women suffer in silence. Mothers carry emotional burdens while caring for everyone else. Young people learn to hide pain instead of expressing it. Families normalize stress until crisis becomes the first point of intervention. The urgency is even greater when we look at suicide data. From 2018 to 2023, suicide rates increased significantly among non-Hispanic Black people by 25.2%, while rates declined among White people during the same period, according to the Centers for Disease Control and Prevention. Earlier CDC data also found that suicide rates among Black youth ages 10 to 24 increased by 36.6% from 2018 to 2021. These numbers should force a public conversation about access, stigma, prevention, and culturally grounded support. Addressing stigma requires more than telling people to get help.

We must make help feel safe, familiar, and accessible. Mental health conversations should happen in trusted spaces such as churches, schools, community centers, barbershops, beauty salons, maternal health programs, and neighborhood organizations. We need culturally responsive providers, peer support circles, community health workers, and programs that honor both clinical care and lived experience. Cost and access also matter. A 2023 KFF analysis found that Black adults reporting fair or poor mental health were less likely than White adults to say they received mental health services in the previous three years: 39% compared with 50%. The same analysis found that adults who had unfair or negative experiences with a provider were twice as likely to go without needed mental health care. Stigma is therefore not only personal; it is structural. It is shaped by whether care is affordable, respectful, available, and trustworthy. Language matters. Instead of asking, What is wrong with you, we should ask, What happened, and what support do you need? Instead of framing therapy as weakness, we should present it as a tool for healing, parenting, leadership, and long-term wellness. Practical support is also essential. Transportation, childcare, flexible scheduling, and affordable services are not extras; they are access points. Confidentiality must be clearly explained so people understand how their privacy will be protected. Stories of healing should be shared without shame. Black women deserve spaces where they are not expected to be endlessly strong, but fully human. Mental health is not separate from community health. When we reduce stigma, we strengthen families. When we support healing, we interrupt generational trauma. When we make room for honest conversations, we give people permission to live beyond survival.

The Black community has always known how to care for one another. Now we must expand that care to include mental wellness, not as a luxury, but as a right. Silence may have helped us survive, but healing requires voice, access, trust, and collective action.

Stigma reduction begins by normalizing mental health care as part of whole-person wellness rather than treating it as a sign of crisis or weakness. Community-based programs can frame counseling, support circles, and education as tools for managing stress, strengthening families, and building resilience. This approach helps shift the message from shame to care. Trusted messengers are also critical. Peer facilitators, community health workers, faith leaders, educators, and women with lived experience can help make mental health conversations feel safer and more credible. When support is offered in familiar spaces by people who understand the community, participants are more likely to engage and return. Programs should offer low-barrier entry points such as wellness workshops, listening sessions, support circles, and resource navigation before or alongside clinical care. These settings allow people to receive information, build trust, and connect with services without feeling labeled. Staff and providers should receive ongoing training in culturally responsive, trauma-informed, and stigma-sensitive engagement so that every interaction reinforces dignity and respect. Finally, stigma cannot be separated from access. Transportation, childcare, flexible scheduling, affordable services, and clear confidentiality practices help remove barriers that often keep people from seeking support. Anonymous stories of healing and resilience can further replace silence with hope, connection, and permission to ask for help.

Stigma reduction should be treated as a public health strategy, not a communications add-on. Policies should invest in community-based mental health models that bring services into trusted local spaces and integrate clinical support with peer support, prevention education, and resource navigation. Such models are especially important in communities where mistrust, cost, transportation, and childcare barriers limit access to traditional mental health care. Policy makers can strengthen access by funding transportation and childcare supports, reimbursing group-based and peer-support services, expanding culturally responsive workforce development, and requiring behavioral health systems to collect and respond to patient-experience data. Mental health equity will require more than awareness campaigns. It will require sustained investment in the conditions that make care accessible, respectful, and safe.

References

Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2023 National Survey on Drug Use and Health.

Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2022 National Survey on Drug Use and Health.

Centers for Disease Control and Prevention. Notes from the Field: Differences in Suicide Rates, by Race and Ethnicity and Age Group – United States, 2018-2023. Morbidity and Mortality Weekly Report.

Centers for Disease Control and Prevention. Notes from the Field: Recent Changes in Suicide Rates, by Race and Ethnicity and Age Group – United States, 2021. Morbidity and Mortality Weekly Report.

KFF. Black and Hispanic Adults with Fair or Poor Mental Health Are Less Likely Than White Adults to Say They Received Mental Health Services, Reflecting Cost Concerns and Other Barriers to Care.