Disclaimer: This article is based on research and insights from credible medical professionals, publications, and institutions. It is intended for educational purposes only and is not a substitute for professional diagnosis or treatment. If you believe you may be experiencing symptoms of bipolar disorder, please consult a qualified healthcare provider. 

Hey Black Bipolar Besties, come to the front real quick! First, I want to acknowledge that this month is National Suicide Prevention Month. I hope you’re taking care of yourselves — mind, body, and spirit. Over the next few weeks, I’ll be sharing content on how to recognize the signs of suicidal ideation and ways we can support ourselves and each other. Stay tuned and stay safe. 

In my article Therapy While Black: The Cost, the Gaps, and the Hope, I discussed the lack of representation and the deep mistrust many Black Americans face when searching for culturally competent therapists. But let’s be real—that’s just one piece of a much larger puzzle. The challenges Black people face when trying to access adequate mental health care in America run deep. Let’s dig deeper.

According to Katherine Keisler-Starkey and Lisa N. Bunch in their report Health Insurance Coverage in the United States: 2020, many Black adults in the U.S. lacked any form of health insurance (Keisler-Starkey & Bunch, 2021). During the height of the COVID-19 pandemic, the American Psychiatric Association reported that Black Americans faced an overwhelming surge in mental health issues—grief, financial strain, and isolation due to separation from loved ones, to name a few (American Psychiatric Association, n.d.).

When you’re worried about paying the bills, finding safe schools that teach your children their true history, and surviving systemic racism and the racial wealth gap, mental health often takes a back seat. It’s not just about money—it’s about survival. And that survival mentality often comes at the expense of emotional and psychological well-being.

Another major barrier to mental health care in our community is one that’s hard to say out loud: stigma. A National Library of Medicine study titled African American Men and Women’s Attitude Toward Mental Illness, Perceptions of Stigma, and Preferred Coping Behaviors found that among older African American adults, mental illness—particularly symptoms of depression (which can also indicate bipolar disorder)—was often perceived as a personal weakness (Ward et al.,2013). 

While I truly believe that Millennial and Gen Z Black folks are working to change that narrative by being more open about mental health, let’s keep it funky: many of us still feel like we have to keep our struggles quiet. It’s taboo. A family secret. I’ve even had an elder say, “Do you have to talk about this?” And my answer is always: yes. Yes, we do.

When I was in undergrad at Georgia State University, I had a beautifully diverse friend and associate group. Some of my peers came from African households, and mental health? Chile, forget about it. The idea that someone might need therapy or medication was so far outside the realm of possibility that it wasn’t even discussed. African American households weren’t much different—just like other family secrets, you didn’t talk about what you were going through with outsiders. Growing up, therapy and hospitalization were seen as “white people things.”

Fortunately for me, my parents—despite being born in the late 1950s—were a bit more progressive. They didn’t hesitate to get me therapy or help when I needed it. In fact, it was my mother who first suspected I had bipolar disorder. When I was hospitalized for the second time at 19, the doctors were convinced I was struggling with severe depression and anxiety. My mother, tears in her eyes, looked them in the face and said, “I think she’s bipolar.” And although she had no MD or OD behind her name, she was right. I was formally diagnosed at 26. A mother’s intuition is a powerful thing.

Even when we do gain access to mental health care, many of us face another harsh reality: provider bias and inequality of care. As I mentioned in my previous piece, Black people are often mistreated, misdiagnosed, or simply dismissed by the healthcare system. 

This is a widespread issue across the diaspora. The National Alliance on Mental Illness (NAMI) explains that many Black Americans have negative experiences with providers who lack empathy, cultural awareness, and compassion. According to NAMI, “Black individuals are more likely to receive a misdiagnosis of schizophrenia when expressing symptoms related to mood disorders” (NAMI, n.d.).

In so many areas of life, Black Americans sit at the bottom of the totem pole when it comes to receiving care, attention, or even basic decency. And when we cling to tropes like the “strong Black woman” or the “unbreakable Black man,” we unintentionally reinforce harmful narratives that suggest we don’t need help. But here’s the truth—we are strong, and that strength includes knowing when we need support.

Despite everything we’ve endured on this soil—our blood, our sweat, our tears, our trauma—we continue to rise. But we’re still human. We deserve to be treated with dignity and given access to competent, compassionate, and culturally relevant care. We deserve accurate diagnoses and treatment plans that lead to stability, not shame.

References: 

APA’s Council on Minority Mental Health and Health Disparities, & Paulsen, E. (n.d.). The Impact of COVID-19 on African Americans: Managing Stress and Mental Health (V. Watts Ph. D. & E. Yarbrough M. D., Eds.). American Psychiatric Association. https://www.psychiatry.org/File%20Library/Psychiatrists/APA-COVID-19-Mental-Health-Facts-African-Americans.pdf

Keisler-Starkey, K., Bunch, L. N., & U.S. Census Bureau. (2021). Health Insurance Coverage in the United States: 2020. In Current Population Reports (Report No. P60-274). U.S. Census Bureau. https://www.census.gov/content/dam/Census/library/publications/2021/demo/p60-274.pdf

National Alliance on Mental Illness. (n.d.). Black/African American | NAMI. NAMI. https://www.nami.org/your-journey/identity-and-cultural-dimensions/black-african-american/

Ward, E. C., Wiltshire, J. C., Detry, M. A., & Brown, R. L. (2013). African American Men and Women’s Attitude Toward Mental Illness, Perceptions of Stigma, and Preferred Coping Behaviors. Nursing Research, 62(3), 185–194. https://doi.org/10.1097/nnr.0b013e31827bf533