Unique Challenges Facing BIPOC Mental Health Patients

July is BIPOC (Black, Indigenous, Persons of Color) Mental Health Awareness Month.

For BIPOC communities, racial trauma, or race-based traumatic stress (RBTS) is a common, yet often overlooked, factor that can complicate the clinical presentation. Symptoms can look very similar to post-traumatic stress disorder (PTSD) and can include depressed mood, hypervigilance, low self-esteem, and/or somatic symptoms such as headaches, GI distress, and insomnia. It is important to note that according to research from the American Psychological Association, unlike PTSD, RBTS is not a mental health disorder but rather a mental and emotional injury that can occur as the result of living within a racist system or experiencing events of racism.

As mental health professionals, it is imperative to be aware of the unique emotional health challenges that your BIPOC patients may bring into the treatment room.

Thinking in 3’s can help you become better equipped to address racial trauma in your clinical practice. These 3 factors are Context, Clarity, and Action:

Factor 1: Context

One of the best ways to help your patients is by educating yourself about the social, cultural, and systemic factors that influence wellness. This is not an instant fix, but a long-term commitment to self-study. Note that I said SELF-study. Although it may be tempting to ask your BIOPC patients to educate you about aspects of their culture that you are not familiar with, this really creates an added burden of emotional labor for individuals who are already in emotional pain. Your patients are coming to you for guidance in their most vulnerable moments—one of the best ways to honor them is by doing your own work.

Where to start: A great place to turn is Harvard University’s  Resources and Reading on Racial Justice, Racial Equity, and Anti-Racism published by the Institutional Anti-Racism and Accountability Project (IARA) at the Shorenstein Center. The US Dept of Health and Human Services also has a host of resources available.

Factor 2: Clarity

Continuously engaging in critical self-reflection is essential to understanding your own personal blind spots and how those blind spots may be impacting how you engage with clients from communities that have historically been denied equal access to power and opportunity. This self-reflection can be difficult at times because our brains are wired to seek consistency in thoughts, beliefs, and actions. Any conflict results in discomfort. Leon Festinger, an American social psychologist termed this tendency “cognitive dissonance.

Where to start: Rather than avoiding discomfort, try altering your beliefs toward the discomfort by asking yourself the following questions:

• Are my thoughts or beliefs about this topic productive?
• Is there any way that this thought can cause harm?
• Are my thoughts or beliefs about this topic factual?
• Are my thoughts or beliefs about this topic as important as I’ve made them out to be?
• What aspect of my identity is being threatened if I were to embrace a new belief or point of view?

If hearing words like “white supremacy,” “structural racism,” or “privilege” triggers feelings of anger or extreme discomfort, ask yourself why and be willing to understand the source of the dissonance.

Factor 3: Action

Become an agent of change. One key aspect of critical self-reflection is really getting clear about your values. Once you are clear, the next question to ask is “Am I moving through the world in a way that is in alignment with those values?” If you notice tension, that’s generally a pretty good indication that some bit of dissonance is present.

Where to start: Rather than running away from the discomfort, examine it, challenge it, and when it’s necessary, have the courage to change.

About the Author: Reba Peoples, MD, IFMCP, Amen Clinics Atlanta

Dr. Reba Peoples is a functional psychiatrist at Amen Clinics who delights in appreciating those unique traits and qualities that make each of us who we are. She is board-certified in psychiatry and functional medicine and specializes in creating personalized treatment plans that are aimed at optimizing emotional health and well-being. Find out more about our services at AmenClinics.com.