In recent times, there has been greater awareness of Black History Month. Dr Chuks Nwuba, a speciality doctor in eating disorders, argues that this should be leveraged to improve the mental health stigma endemic in the Black community.
Whilst working as an inpatient doctor in eating disorders, I have come across only a handful of fellow Black clinicians in the specialty, which is a shame. However, a larger disappointment is that after nearly three years’ work in this field, I have treated less-than-a-handful of Black patients. This is desperately sad. Not because I have a strong desire to treat members of my community, but because evidence suggests that there are large numbers of Black people with difficult relationships with food that would benefit from medical support, particularly in relation to binge eating disorder and bulimia nervosa (1). Which means there must be many suffering in silence.
One can maybe argue the reason for not encountering many Black patients is that the inpatient service predominantly focuses on the treatment of more immediately life-threatening cases of anorexia nervosa, which exist in greater numbers in the White population (1). But such an explanation would still fail to explain why the many clinicians working in the eating disorders community services — that I speak to — also highlight a lack of Black patients amongst their respective caseloads.
Research suggests the causes of this are manifold. However, they primarily include a lack of confidence in seeking help (2) due to the significant stigma endemic in the Black community (3). Unfortunately, unspoken struggles in the Black population are present across the whole of mental health (4), not just eating disorders. There is still a ubiquitous dearth of Black engagement with issues surrounding mental health and wellbeing.
Black History Month
It was around this time last year that David Olusoga wrote a brilliant piece in The Guardian describing the well-established presence of October’s Black History Month (5). He highlighted that “millions of people have engaged with ideas of race and racism as never before”. Indeed, Black History Month has emerged as an avenue via which past Black experiences are annually revisited through the eyes of the present. Great efforts from people like political activist, Lawrence Westgaph, recently transforming the National Museums Liverpool in an attempt to acknowledge the city’s links with slavery (6), have helped with the October publicity.
And yet again, this month is set to shine an intense spotlight on the Black journey. But this time is different. Across society, the destructive effects of the COVID-19 pandemic are starting to settle in (7), with its psychological and psychiatric aftershocks disproportionately — and more concerningly, not yet fully — realised by the Black community (8). So now presents a critical window to forge renewed efforts to destigmatise mental health in the Black community to minimise any potential negative long-term impacts. It is a fresh opportunity to encourage greater openness and discussion to embolden greater numbers to access care.
Black History Month is a uniquely opportune season to harness the energies of Black legends. However, in the past, amidst the commemoration, we have often failed to acknowledge the mental health challenges of such individuals, and in doing so have missed opportunities to be inspired by the fearlessness with which their stories were shared. For example, we can be encouraged by the frankness with which Audre Lorde, famous writer and activist, spoke openly of her mental health turmoil (9); the transparency with which writer and support of the British abolitionist movement, Olaudah Equiano, spoke of his depression (10) and through the openness with which Rosa Parks, well-known activist in the civil rights movement, informed the public of her difficulties with dementia (11). We ought to also be inspired by the candour with which Ukawsaw Gronniosaw, the first Black author to be published in England, made known his depression in the throes of slavery (12), and with which Marsha P Johnson, gay liberation activist, opened up to having severe mental health issues (13).
Also, learning about the struggles that living, well-known, Black individuals have had with their mental health could further play an important role in empowering others to be more open with theirs. This year, actor David Harewood released his stunning memoir (14), Maybe I Don’t Belong Here, painting a graphic picture of his experiences with depression, using brutally honest brushstrokes. David, as well as other famous people within the Black community, opening up about their mental health challenges (for example, Dave in his latest album We’re All Alone In This Together) (15) might further inspire members of the community to reach out for mental health assistance when necessary.
We Are All In
As a society, we all have a responsibility to secure the future of Black mental health. This summer, we saw glimpses of such unity in action when people from across the country rallied together to safeguard the mental health of Black footballers Marcus Rashford, Jadon Sancho and Bukayo Saka (16).
This Black History Month is a good opportunity for everyone — not just Black people — to reignite race-related learning, discussion, and growth, collaboratively combating the mental health stigma that weighs heavy on the Black community. And we can leverage the powerful stories of our Black heroes along the way.
The last eighteen months have been a whirlwind, and mental health challenges over this period have worsened. The need is more acute than it has been in a long time, but this is a golden opportunity to turn the tide.
For more information and support, please visit Breaking Mad (17), Black Minds Matter UK (18), Black Thrive (19) and BLAM UK (20). These are just a few of the many UK-based organisations engaging in brilliant work around Black mental health.
Dr Chukwuemeka “Chuks” Nwuba works as an eating disorders doctor in London. He was voted on the list of Powerful Media’s Top 10 Black Future Leaders 2017-18. He is a member of the Association of Black Psychiatrists.