Self | Carolyn Todd
Every time a celebrity opens up about their own experience with something like anxiety or depression, they’re adding their voice to a vital conversation about mental health. And when somebody as influential as Jay-Z speaks up, it’s exceptionally powerful. The hip-hop legend is, much like his wife, a true American icon. When Jay-Z talks, people listen—and what he had to say in a recent interview on CNN is extremely important for everyone to hear.
The 50-year-old artist had a conversation with CNN’s Van Jones about the stigma surrounding mental health care in the black community. "Mental health, trauma, PTSD is so rampant in our community," Jones said, joking that "as scared as black folks are of the cops, we're even more scared of therapists." Jones asked Jay-Z how he moved past that barrier to enter therapy, something the father-of-three spoke to the New York Times about last November.
"Yeah, it's a stigma," Jay-Z agreed. "As you grow, you realize the ridiculousness of the stigma attached to it. It's like, what? You just talk to someone about your problems."
"I think, actually, it should be in our schools," he continued. "Children have the most going on…social anxiety and all these things are happening to you, and you don't have the language to navigate it."
His remarks regarding the glaring need for normalization of mental health care in communities of color are spot-on, Richard S. Schottenfeld, M.D., chairman of the Department of Psychiatry and Behavioral Sciences at the Howard University College of Medicine, tells SELF. "Mental health issues have been stigmatized in many societies and communities, and remain that way," Dr. Schottenfeld says. "And we know that that stigma has been very prominent in the black community."
Although the roots of this stigma are complex, experts say two major factors play a significant role: a lack of access to care and an aversion to openly discussing mental health.
"There are clearly big disparities in many black communities where there are fewer mental health services available," Dr. Schottenfeld says. "Compared to white Americans, black Americans not only have less access to mental health care—they’re substantially less likely to receive treatment."
Additionally, according to data from the American Psychological Association, the vast majority of therapists in the U.S. are white. In 2013 (the most recent year available) only 5.3 percent of therapists were black. Of course, a black patient does not have to see a black therapist, but everyone deserves access to a counselor who understands the daily struggles they deal with—including what it's like to exist as a person of color in this country.
The other component, the sense of personal shame associated with talking about mental illness, is an issue that people struggle with regardless of race. But, as SELF previously reported, this notion may be especially prominent in the black community. "In the black community, there is often a sense that unlike other illnesses, this is a personal failing, a moral failing. And that’s really misunderstanding the nature of mental disorders," Dr. Schottenfeld explains. "People are often ashamed if they’re feeling bad. There’s a reluctance to show that you’re hurting."
This can be especially prevalent among teenagers, as Jay-Z pointed out. "It’s particularly hard for young people to seek help in cultures and communities, and often in black communities, where how you appear to others—being strong, invulnerable—is so important that people hide what they’re feeling," Dr. Schottenfeld says, something Jay-Z also mentioned previously. Consequently, "people delay seeking treatment for much longer."
As with virtually any health issue, the longer you ignore the signs and symptoms of a mental illness without seeking professional help, the more serious and difficult-to-treat the problem can become.
"The stigma and avoidance of care plays a big part in how persistent and disabling these disorders are," Dr. Schottenfeld says. The earlier people get treatment, "the more successful you can be in helping people regain their ability to function well before they’ve suffered consequences."
That’s why he strongly agrees with Jay-Z’s assertion that young black people need better mental health care. Identifying and treating things like anxiety and depression early on can reduce kids' distressing symptoms and help prevent them from making harmful choices as a means of coping—dropping out of school, lashing out at someone they love, turning to drugs or alcohol.
"Some people, their cry for help is to do something self-destructive or destructive to others—they act out in anger because they’re frustrated," Dr. Schottenfeld explains. "But if they can get a chance to talk about it, they can get relief. [They can] learn what the effects of stress and trauma are, to see that it’s understandable to have these feelings, and that there are things we can help them do [to manage] those feelings," like introduce them to healthy coping mechanisms. "They end up both avoiding trouble and succeeding."
As Jay-Z said, young people developing a "language to navigate" what’s going on in their lives highlights a key benefit of therapy: Simply learning how to put what you’re feeling into words.
"That’s the essence of what so much of treatment is about," Dr. Schottenfeld says. "When you’re drowning, you don’t know what’s happening to you, and you flail. But if you can use your thinking to begin to understand what’s happening—and then, yes, develop a language for understanding that—that’s our greatest tool as human beings."
The idea of making therapy accessible in schools is a great one, says. Dr. Schottenfeld. But for some people, bringing up mental health concerns may feel more natural and less intimidating in general health settings—like a doctor's office or school clinic—which proves how necessary it is to have trained staff on hand to handle those issues or point you in the direction of resources. "Sometimes in that setting, mental health issues—'Yeah my sleep is terrible, I’m anxious all the time, I have nightmares'—can be a little bit easier to talk about," Dr. Schottenfeld says. Plus, for those who could benefit from medication, this setting makes the referral process to a psychiatrist a bit easier.
While there is still a lot of work to to be done toppling the barriers that keep so many people from the care they need, the most encouraging thing is the fact that getting help actually works. "These are actually treatable disorders, and people get better," Dr. Schottenfeld says. "This is an area where’s there’s just terrific evidence that if you can get people in for treatment, you can make a huge difference." Having access to a therapist can be incredibly beneficial even for those who don't have a diagnosable condition.
And the effectiveness of mental health care really puts the power of Jay-Z’s comments into perspective. "It can get people to say, 'I can get help for that'," says Dr. Schottenfeld. "'It’s helping Jay-Z. Why couldn’t it help me?'"