Mental Health Through the Lens of Race: Cultural Challenges Facing BIPOC in Mental Health Systems

On May 31, 2020, Chase Leito, a 3rd-year Black-American college student, posted a resource guide for Black people experiencing racial trauma and everyone that wanted to take actions against racial injustice. Among all the information, he decided to put mental health resources at the top.



“It’s tough to watch Black violence constantly … but [due to the pandemic] there wasn’t really a place where people could find different resources to process [these] things,” Leito said.


All the 23 mental health service providers listed on the resource guide target minority groups and most of them center Black communities. Leito believes that although therapists, regardless of their races and ethnicities, try their best for their clients, the level of comfortability and understanding is higher when the patient has a therapist who shares some of their identities.


“For non-Black people it was certainly a time for re-learning, uncomfortability, and recognizing their privileges. Non-Black professionals might not have been best equipped to help a Black person process some of these thoughts and feelings, and they might not have felt like they were the right person to do so at the time,” Leito said.


But even though cultural connection is important for people with mental illness or unwellness, some BIPOC students at UChicago have found it difficult to find on-campus mental health services that would serve their identities well. Despite recent improvements, there remains much to be done by the university to support the mental health of BIPOC students.


Fanheng Ye, a 3rd-year Asian-American student, went to a therapist from UChicago Student Wellness in Winter Quarter 2019. When she called for an appointment at the end of Autumn Quarter 2018, the then Student Counseling Services (SCS) did not ask her if she would like to request a therapist with particular specializations. It was also hard for Ye to name a therapist who might be specialized in talking to Asian American students because the only therapist who seemed to understand Asian culture the most specialized in talking to Asian international students. Although she found the therapy to be helpful in other regards, her culture-specific concerns were not addressed.



“[When deciding what help you need,] you have to figure out your own balance in what you want more and what you want less. It was a lot of individual work,” Ye said.


Besides professional mental health services, some find that the access to health and wellness is not always easy and comfortable for BIPOC students.


4th-year student Ionie Banner served as the Health & Wellness Chair for the Organization of Black Students (OBS) last year. During her term, she organized a yoga and meditation workshop before finals week in Autumn Quarter 2019. Some participants told Banner that they would love to go to free classes at Ratner, but there was not a ready space and they did not feel comfortable with being the only Black person in the room.


“My biggest goal was creating space and allowing us to be free and be ourselves in that space, without having to code-switch or watch what we say,” Banner said.


The lack of accessibility to mental health services becomes an even more serious problem given the mental health challenges BIPOC people face in everyday life.


According to Leito, Black people, along with other underrepresented populations, are more susceptible to mental health issues due to “the added pressure to succeed and less room for error” in the social world, while a deep mistrust between Black people and doctors has contributed to “the mentality that you can rise above any problem through your family or through religion, and you don’t need a therapist or medical professional to do that.” Leito adds that this is part of the reason why he did not seek therapy before, even when he felt that he needed it.


Trauma can also factor into the decisions that BIPOC populations make about mental health. Alexander Joh-Jung, a 4th-year Asian-American college student and one of the organizers of this year’s Break the Silence (BtS) conference—an annual Asian and Asian-American mental health conference co-hosted by Asian cultural and mental health RSOs—believes that historical trauma such as the memories of fleeing war and surviving in the U.S. as an immigrant is another source of pressure and anxiety for minority groups.



“[Some BIPOC], especially older people, don’t want to go to doctors because [they have lived a very rough life] and they don’t want to be [an added] burden on their children,” Joh-Jung said.


There are also problems within BIPOC communities of openly discussing mental health issues. According to Ye, for people from Asian cultures where mental health is not widely discussed, it is difficult for them to recognize the existence of mental unwellness, seek help, and stick with help.


In addition to external pressures, doctor-patient mistrust, and cultural stigma around mental health, Banner believes that the most significant mental health challenge that BIPOC people face comes when they try to seek help and advocate. “Everyone gets anxiety, but not everyone can find someone who understands their experiences.”


UChicago has made some progress in promoting diversity and cultural competence in its mental health services. Out of the 26 Counseling and Psychiatry staff members listed on UChicago Student Wellness’s website, less than half seem to come from diverse backgrounds. The new position of Associate Director for Diversity, Inclusion, and Outreach focuses specifically on diversity. The new Student Wellness Center leaves more space for SCS. Publicly available profiles of their therapists make it possible for students to decide whom they want to be staffed with.


However, students believe that this is far from enough. At UChicago, the question of availability comes even before the question of cultural competence. Rumors and stories on campus about long waiting time and lack of availability of UChicago’s mental health services discourage students from seeking help from Student Wellness.


For Leito, these rumors and stories create uncertainties around whether and when one will actually receive therapy. “Going to therapy is a new journey you’re embarking on for yourself, and [these uncertainties] make me feel like that journey might be unfinished. [This] doesn’t sit right with me,” Leito said.


In a response to Exploring Race’s information request, UChicago News told Exploring Race that “[d]uring Autumn Quarter 2020, students’ appointment times were typically within five days of their initial request.”


However, in Winter Quarter 2020, Banner’s experience became one of these rumors. Experiencing serious depression, she called SCS to schedule an appointment, only to be told that the next available slot would be 4-6 weeks later. It took her around 4 weeks to finally meet a white therapist from whom she felt disconnected.


Although diversity among mental health staff seems to be the next goal in line, some believe that it should not be the end of the game. Vicky Xie, a 2020 alum and one of the founders of BtS, believes that diversity among staff members, while necessary, should not be equated with cultural competence.



“I don’t think every single organization has to have a full-on diverse group of mental health practitioners. It could be an aspiration, but it’s actually a lot more nuanced than that,” she said.


Xie believes that the first question UChicago Student Wellness should ask themselves is who they are trying to serve, and that they should be honest with their answers and adjust their strategies accordingly.“If the direction is unclear, action won’t be clear, and for the people who receive the help, it won’t be clear to them either,” Xie said. She stressed that the university should better understand the student body, which is the first step to promote cultural competence.


Joh-Jung agrees that it is essential for medical professionals to understand their identities in relation with those whom they want to serve and use that as a starting point. “When you [as a doctor] put on the uniform and walk into your office, you [tend to] leave your identity at the door. But the reality is [that] you still have it,” Joh-Jung said. “If healthcare workers actually talk about them being white, I think it breaks some of the tension in the room where an old white guy wants to diagnose [a BIPOC person].”


Regarding UChicago’s diversity and inclusion staff training, UChicago News further wrote in the response that the “[the training] includes one all-day training session per quarter, which focuses on enhancing personal and interpersonal awareness, understanding student experiences, and building skills through reflection, experiential activities, group discussion, didactics, and expert speaker presentations,” adding “a multidisciplinary staff diversity committee meets throughout the year to plan the training initiatives.”


Another alternative to professional mental health treatment is collective healing, which has been gaining popularity as a community-based approach to promote cultural competence.


Joh-Jung sees collective healing as a more feasible way to achieve cultural competence than “making alterations to a system that is already damaging in a lot of ways.” The longer-term and more casual relationship between community members could make the healing process more continual.


While many see peer-led support groups as important mental health resources, few think that they should replace professional help.


Livia Miller, a former coordinator of Fair Budget UChicago and a co-coordinator of UChicago Student Action, agrees that receiving help from peer-led organizations, although helpful, is still different from visiting medical professionals. For example, one can only receive medication from a doctor and there are things that are very hard to process and talk about, in which cases well-trained professionals are more helpful. Miller was one of the organizers of Fair Budget UChicago’s student wellness campaign in 2018 and 2019.


Although Banner is grateful that OBS has the Health & Wellness Chair position, she does not think that it should be students’ responsibility to provide therapy for their peers.


“There were times where I felt like I’m barely holding on, but I have to keep going because I know there are other students who need to have this meditation event,” Banner said. She wants to see more events that are centered around minorities, which can take pressure off of student organizations.


“I sometimes wonder if [peer-led mental health services] exist because [it provides] something that people are unable to get [from professionals]. I wouldn’t want the burden of providing mental healthcare to fall on any student,” Miller said. “It’s very important that [peer-led mental health organizations exist] in addition to a robust and accessible mental healthcare system.”

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