‘The lowest of the stack’: why black women are struggling with mental health
Andrea, 25, had turned up at a police station confused and disoriented. She had one question, and kept repeating it: “Please can you help me look for a job?” I was the “responsible adult” when she was sectioned later that day. The police had come to Andrea’s house to let her mother know, but she was away. I was visiting my mum, when an officer knocked on the door. Having grown up with Andrea, I offered to go to the station.
“I’m really tired,” she told me, when I saw her. “You’re not the only one,” I thought. I am on Prozac and antipsychotics; one of my closest friends takes a high dose of Venlafaxine. Two girls I grew up with have been sectioned, one on multiple occasions. A further five are on antidepressants and my sister regularly has panic attacks. Another old friend, I’ve heard, has schizophrenia. Aside from mental health problems, we all have one thing in common: we are all black women in our 20s and 30s, and we can all testify to being “tired”.
According to the Mental Health Bulletin, nearly 5,000 “black” or “black British” people per 100,000 accessed mental health services in 2014-2015; 12.7% of those in contact with mental health and learning disability services spent at least one night in hospital that year. That’s more than double the percentage in the white population.
Do black women face an increased risk in terms of their mental health? “The simple answer is “yes’”, says Marcel Vige, head of equality improvement at Mind. “The figures around black men are high, but they are also very high for black women too.” I started a WhatsApp group called “HELP!” and added all the black women I know. I wanted to find out what was driving us insane. Situational circumstances can often trigger depression in people of any background, but are there cultural and social issues that can induce poor mental health in black women in particular? I wanted the group to help me understand what was going on.
I was immediately inundated with messages: “Why do I have to change who I am so that people don’t find me intimidating or aggressive?” wrote Michelle, a 27-year-old teacher. “It’s tiring to have to always conform to get ahead.”
“I can’t embrace who I am, fully,” typed Grace, a 24-year-old PA. “I need to make sure people are always comfortable with me.”
“I have to prove that I can do the same thing as a white person,” messaged Naomi, who is 31 and works as a marketing executive in the city. “Often what I say will be ignored, then someone who is not black will say it and all of a sudden it makes sense!”
Zoe, a 27-year-old pharmacist, wrote: “I am treated like I’m odd just for being myself and doing the things I like to do. I’m always viewed through the eyes of people’s narrow-minded expectations.” And Maya, a 25-year-old events manager told us: “I would say, being treated like I should be grateful for everything – because I am black and a female, the lowest of the stack. Therefore anything positive I have achieved is not based on my academic or physical ability – but through help and compassion shown to me. I’m expected to be forever grateful; and, in return, be willing to be a slave to the man. White or black.” Each of these women are educated to degree level or more. Each have confessed to “playing a part” in order to get a job and be accepted while there. As a result, they feel they deliberately diminish what they perceive to be their “black self” in order to progress. “For black women, I think it’s about showing a proxy-self,” says clinical psychologist Anu Sayal-Bennett from the British Psychological Society. Playing a role is fun if you’re an actor, I suppose, but constantly bending to how others feel you should be must affect your psyche.
One of the girls in the “HELP!” group told a story of how she’d had a heated argument with a colleague; both of them had raised their voices but because she was gesticulating, her colleague told her to “stop being aggressive.” She explains how, “I had forgotten who and where I was. I was deeply disappointed that I got tagged with one of the most popular terms associated with black women and I have not argued a point since.”
The fact that black women face struggles with perception every day can often mean that the constant fight seems normal. It became clear that these women were resigned to their fate. As a black woman you are scary, inadequate, ugly or hyper-sexualised – and you just have to accept it.
“I don’t talk to people who say they have mental health issues,” says Dr Victoria Showunmi, a lecturer at the UCL Institute of Education. “I talk to black women in particular and, after speaking to them in a discussion group, say, they will then acknowledge the fact they have been suffering from issues related to bad mental health.”  She speculates that these might be “the need to be strong, resilient, [and] fear of being called an angry black woman.”
Research from the Mental Health Foundation suggests that African-Caribbean people living in the UK are more likely to be diagnosed with severe mental illness than any other ethnicity in the UK. This may be because they are reluctant to engage with services, so are much more unwell by the time they do. Mental illness is a stigma within the black community and, because of a lack of participation with mental health authorities, experts admit there is a huge gap in statistics for this growing problem.
“Little is known about black women and mental health as these individuals have been largely absent from research,” says Josefien Breedvelt, research manager at The Mental Health Foundation. “The majority of the research has looked at ethnic minorities as a whole, rather than providing a focus on the challenges faced by black women.”
I asked my mum what she thought when I first told her I had been diagnosed with depression. She said the family were all united in their sympathy for me, but wondered what I had to complain about. “I didn’t understand,” she said. “To us, you were brought up with more than your parents and other children left in Ghana. To us you have everything – what do you have to be sad about?” Their tone has since changed – I’m fortunate to have a loving family who researched depression and did everything they could to understand me.
From the messages I received on WhatsApp, guilt was a common theme. “There is a consciousness that follows you around,” said Grace. “If you feel blue or sad, you have to remind yourself that a family member somewhere else might be going hungry.” From experience, if you don’t remember, your family will be sure to remind you. Where everyday survival is the necessity, mental health will not necessarily be a priority. But that guilt is often deeply ingrained.
Between episodes in hospital, one of Andrea’s main worries was that I would tell her mother that she was unwell. Even through the confusion that she felt, she was very clear that she didn’t want her mother to know what was going on. Andrea is still sectioned under the Mental Health Act. The last time I went to see her, the majority of women in the unit were black.
All names have been changed.