Statement on Racism, Racial Trauma, and Access to Mental Health Care for BIPOC

California Association of Marriage and Family Therapists
June 6, 2021

The California Association of Marriage and Family Therapists (CAMFT) recognizes the historical, intergenerational, and ongoing racial traumas that Black, Indigenous, and People of Color (BIPOC) have experienced and continue to experience. Frequent and pervasive racism-related stressors and racial violence occurring in the United States include and are not limited to

• The murders of Black people by police and vigilantes and violent attempts at suppressing the voices of those protesting these murders,
• The building of oil pipelines through Indigenous people’s sacred land with the potential to contaminate drinking water and displace residents, and the surveillance and military-style intervention against those protesting the Dakota Access Pipeline,
• The reinforcing of stereotypes by the approximately 2,000 professional, college, or other school sports teams that use Native American names, imagery, logos, and mascots,
• The rise in hate crimes targeting Asian Americans in the wake of the COVID-19 pandemic,
• The separation of children from their families at the U.S.-Mexico border and xenophobic rhetoric targeted at Latinx individuals, and
• The racial profiling of and hate crimes against Arab, Middle Eastern, and North African Americans and others perceived as Muslim.

These systemic and social dynamics contribute to the race-based traumatic stress many BIPOC experience. All of these racial traumas occur against the backdrop of pervasive white supremacy and the enduring legacy of systemic racism in the United States.

Racial trauma, or race-based traumatic stress, refers to psychological and emotional injury and physical distress that is experienced in response to racism (Carter, 2007). The connection between experiences of racism and mental health symptoms among BIPOC has been well-documented. Several comprehensive research studies and meta-analyses have provided scientific evidence that experiences of racism are significantly associated with detrimental mental health outcomes for BIPOC individuals (Lee & Ahn, 2011; Paradies et al., 2015; Pieterse et al., 2012). Specifically, racism is associated with increased anxiety, depression, and trauma symptoms, as well as decreased psychological well-being and increased psychological distress and suicidal ideation (Abdullah et al., 2021; Brown et al. 2000; Hwang & Goto, 2008; Pieterse et al., 2010; Whitbeck et al., 2002). Researchers suggest that our society’s context of systemic racism and the pervasive nature of racism result in daily environments and experiences that can cause serious emotional and physical damage . Systemic racism is pervasive and inescapable, because “covert racist incidents form the social backdrop against which racially marginalized people must function day to day. The incidents are never far from one’s consciousness and require expenditures of cognitive energy, hypervigilance, and coping” (Bryant-Davis & Ocampo, 2005, p. 575).

CAMFT cautions therapists against pathologizing the natural and valid emotional responses BIPOC have to experiences of racial violence, stress, and trauma. The inability to understand and recognize symptoms of racial trauma are not just invalidating but damaging to the individual who is struggling. Pathologizing symptoms of racial trauma situates the problem in the individual experiencing oppression, as opposed to the individuals, systems, and societies that perpetuate and maintain the oppression.

Systems of oppression are interconnected (Collins, 2002), and BIPOC’s experiences of systems as interconnected may lead to a belief that they are likely to encounter racism in seeking mental health services similar to the ways they encounter racism in educational institutions, in their workplaces, in other health care settings, and in their daily interactions (Alang, 2019). This directly relates to the cultural mistrust, or adaptive suspicion, of mental health services that many BIPOC, particularly African Americans, understandably have developed in an effort to protect themselves from mistreatment and minimize their potential exposure to racism (Alang, 2019; Whaley, 2001). Given that BIPOC are often stigmatized and devalued in the U.S. as a result of their race, concerns about being further stigmatized for seeking mental health treatment or being diagnosed with a psychological disorder may prevent BIPOC from seeking needed mental health care.

Often, suggestions for reducing stigma and improving access to care are focused on things that BIPOC can do to reduce internalized stigmas or educational efforts to encourage BIPOC to seek mental health care. However, therapists must work towards making mental health care settings and the services we provide safer for BIPOC to engage in. CAMFT encourages all therapists, and White therapists in particular, to consider ways they can reduce barriers to care for BIPOC by:

• Engaging in anti-racism education and training on an ongoing basis,
• Continuously striving towards cultural humility and culturally responsive mental health care,
• Engaging in community-based, BIPOC-led efforts aimed at dismantling systemic racial oppression,
• Critically examining the institutions and workplaces they are affiliated with and advocating for changes to reduce potential for marginalization of BIPOC, and
• Advocating against and disrupting racism everywhere they encounter it, including in themselves, in their own families, in interactions with others, in their communities, in institutions, and in policies.

CAMFT is committed to advocating for racial justice and equal, fair, and culturally responsive mental health care for all.

This statement was created in collaboration with BARE Mental Health and Wellness, LLC, for publication at www.camft.org. Individual contributors to the development of this statement include

• Jessica Graham-LoPresti and Tahirah Abdullah-Swain, Directors of BARE Mental Health and Wellness, LLC
• Nabil El-Ghoroury and Holly Daniels, CAMFT Executive Staff
• Robin Andersen, Juan Gavidia, Maureen Houtz, and Lisa Romain; CAMFT’s Social Policy Task Force

Any correspondence or inquiries regarding CAMFT Social Policy Statements should be addressed to communications@camft.org.

The CAMFT Board of Directors has prioritized the publishing of Social Policy Statements to raise understanding and awareness about the impact of social and systemic issues on mental health and well-being, and to emphasize the importance of culturally responsive training for mental health clinicians.

CAMFT develops these positions and responds to social issues relevant to the practice of psychotherapy, mental health policy, and social concerns impacting the mental health of individuals, families, and communities in California in order to guide the profession, amplify the voices of marriage and family therapists, educate the public, and influence decision makers.

CAMFT is aware that social justice issues are dynamic developmental processes responsive to evolving social, political, economic, and other world circumstances, as well as clinical, ethical, and legal considerations. This statement is both a commitment on the part of CAMFT to address these issues and intended to provoke discourse and evolution in recognition of the realities of members of all communities.

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References

Abdullah, T., Graham-LoPresti, J. R., Tahirkheli, N. N., Hughley, S. M., & Watson, L. T. J. (2021). Microaggressions and posttraumatic stress disorder symptom scores among Black Americans: Exploring the link. Traumatology. Advance online publication. https://doi.org/10.1037/trm0000259
Alang, S. M. (2019). Mental health care among blacks in America: Confronting racism and constructing solutions. Health Services Research, 54(2), 346-355. https://doi.org/10.1111/1475-6773.13115
Brown, T. N., Williams, D. R., Jackson, J. S., Neighbors, H. W., Torres, M., Sellers, S. L., & Brown,
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Collins, P. H. (2002). Black feminist thought: Knowledge, consciousness, and the politics of empowerment (2nd ed.). Routledge.
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