Barriers to Black mental health: Part III

Historical trauma a factor in Black mental illness; self-medicating is common

Conclusion of a three-part story

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Barriers to Black mental health

Barriers to Black mental health: Part II

Jeffrey Harmon
Jeffrey Harmon

Rozenia Fuller, a member of the executive board of the Hennepin County Mental Health Advisory Council, explained the ways in which these race-based adversities in U.S. history affect African Americans today when they seek help for mental health issues.

“Historical trauma continues to manifest itself in each generation…[in] some kind of way, and I think one of the ways that it manifests itself historically is self-hatred,” Fuller said. “That leads to an identity crisis, and if you already have someone being bipolar or dealing with chronic depression or dealing with schizophrenia and you put that together with your mother, and your father, and your uncle, and your grandmother carrying this historical trauma and it’s not been treated, it’s kind of in your whole [self] as the norm and you don’t know what’s there or what’s really going on.

Cynthia Fashaw, director of Children’s Programs and Multicultural Outreach at the National Alliance on Mental Illness (NAMI) Minnesota, pointed out, “Most African Americans who do access mental health services get mental health services through the criminal justice system, meaning their mental health has gotten them involved in something where they end up in the courts, [and] they end up possibly in prison.”

Nearly half of all prisoners in the United States are African American, and prison inmates are at a high risk of developing a mental illness if they don’t already have one coming in. Fashaw argues that the likelihood that an African American will not begin to receive help until they are in the criminal justice system is the primary difference between White and Black Americans with mental illness.

“The huge thing about the African American community is that the number-one mental health service agency in this community are the jails and prisons,” Fashaw said. “So while African Americans who have mental health issues…get into the criminal justice system, or more accurately are put through the criminal justice system, European Americans with the same issue are more likely to be diverted to the mental health system.”

Although some African Americans do go on to get professional help through the mental healthcare system, there are many African Americans with mental health issues who self-medicate to alleviate their symptoms.

“I was just medicating my pain with anything,” said Jeffrey Harmon, a 52-year-old Minneapolis resident living with serious depression, anxiety disorder, and post-traumatic stress disorder since 2001 when someone came into his home and killed his wife and daughter. “Weed, marijuana, alcohol, crack, pills, it didn’t matter. Anything that would…take away my pain. I was medicating my pain, and I didn’t realize over those years that I was making myself worse.”

Nichelle Clater, a 53-year-old African American woman with schizoaffective disorder residing in West Saint Paul, said, “I believe a lot of Black people in my community, we self-medicate with drugs. You know, alcohol or illegal drugs. That’s our way of dealing with it.”

Despite the problems and barriers that African Americans face when pursuing help for a mental health issue, there are ways that they can get the treatment that they want and need. Fashaw argues that a good place to start is with a family doctor.

“If they have a family doctor that they trust, [they can] talk with their family doctor. Family doctors can handle some mental health issues, and they can check to see if symptoms the person is experiencing are due to a physical illness. Having a family doctor do an exam to check for physical causes of symptoms is the first step of an assessment.”

Due to socioeconomic disparities that affect the African American community, many individuals who need health care do not have health insurance. Fashaw recommends that individuals without healthcare explore coverage through the Affordable Care Act.

In addition, if a person is not certain they can afford health insurance, they can call NAMI to talk to a navigator who can walk them through the process, make an appointment to complete an application, or provide information about other options for healthcare coverage.

Fashaw also recommended that African Americans with a mental illness should look into resources in their community for education and support. “[They should] get educated about their illness and the best treatments and medications for their illness. There are many peer-to-peer support groups, educational trainings and advocates to help people identify and access needed informational and support services.”

While African Americans have to overcome many barriers to get treatment, Fashaw argues that getting help is nevertheless possible. “There are many resources available to support people in living full lives.”


To contact NAMI Minnesota, call 888-626-4435, email them at, or visit their website at

Daniel Abramowitz is an MSR journalism intern and a student at Macalester College. He welcomes reader responses to