Black people aren’t resistant to mental health treatment. We’re resistant to framing it as a cure
What healing might it offer all of us to always look at our pathologies—both real and projected—with understanding and care?
I was stressed. I was broke. I’d just confronted my parents with my queerness, and they responded by refusing to support my education. And since enrolling at NYU’s film school, my film-maker dreams were eroding in the face of structural barriers erected by white supremacy. I was bouncing to and from mental health crises.
Everything seemed to be burning, and yet, I had no desire to go to therapy. It wasn’t about the money. There were free mental health services to those who had insurance through the school, which I did.
But Black people are, the story goes, historically resistant to treating their mental health. The more generous tellers of this story will grudgingly admit that this resistance stems at least in part from anti-Blackness within the mental health industry, and the larger eurocentric medical model in general. We have been burned by Tuskegee experiments and Drapetomania diagnoses, and so we avoid the fire, even when we might need its heat as the world around us freezes over.
I wouldn’t have been able to name it then, but I know now that my reason for avoiding therapy at the time was deeper than that. It laid within the implicit understanding that our mental health issues shouldn’t always be “problems” that need “fixing”. This conflicted with the messages I’d heard constantly around mental health: People have disorders that need to be ordered. I never believed that’s how the world works. Or, I never believed that’s how it should.
We don’t need cures for every trauma and disability. We need a world that doesn’t make living with our traumas and our disabilities unbearable (although, of course, medications can and should help make living manageable). And maybe the issue is that Black people have always known this better than anyone.
In my ongoing attempt to wean myself off of the objectively horrible genre of exploitative true crime, I recently turned to the NPR podcast Invisibilia. Invisibilia explores the invisible forces that shape socialization. In the second season episode, “The Problem with the Solution,” co-host Lulu Miller visits a Belgium town called Geel, which she credits with setting a pioneering model for mental health treatment based on the rejection of the idea that mental health issues are problems that need to be cured.
At the heights of this social project, Geel placed several thousand people living with severe mental illnesses with foster families, for an average of dozens of years, rather than confining them to mental health institutions (today, there are a few hundred boarders living with foster families in Geel). Families aren’t told what each boarder has been diagnosed with. They accept them into their home and support them throughout their life regardless.
“In the families where it works, they aren’t really trying to fix the problem,” Miller explains, and by most accounts the model has been transformative. The lesson, according to Miller, is that “the solution to healing a person with mental illness is to not seek a solution.”
In 1983, Ellen Baxter created the housing development project Broadway Housing Communities (BHC)* in New York City after Geel’s model. In an interview with Miller, Baxter explained that she was met with significant resistance in bringing the model to the states, as much the American identity is rooted in fixing problems (though this resistance, in contrast to Black folk’s to resistance to mental health treatments, is rarely pathologized). Still, Miller has since found success rejecting the idea that mental health issues are problems that need to be cured in the U.S. too.
In the particular BHC housing complex featured in the podcast, 40% of the residents have a severe mental health issue and they live among neurotypical people who receive subsidized housing—not without problem, but certainly, it seems, with agency and relative prosperity.
That these communities seem to be thriving while rejecting the idea that mental health issues are problems that need to be cured was not surprising to me. I don’t credit Geel with pioneering this model.
What struck me most is how Miller and Baxter, who are both white, describe the neurotypical people who live among those with severe mental health issues in BHC. Baxter says that she goes to great lengths not to mention those living with severe mental illness to the neurotypical residents upfront, lest she scare them off. And as she interviews those residents, Miller is noticeably surprised that they live alongside those dealing with severe mental health issues so willingly and seemingly without contention.
But the neurotypical residents, who mostly seem to be Black, Latinx poor and working class people, offer another perspective. “I know people in my personal life who suffer from mental illness, so it’s not like a big shocker or something new,” explains resident Sherice Dickerson. Another resident tells Miller, laughing in her face, that “everybody has a touch of mental illness, everybody.”
Blackness is incompatible with the idea that there is always a need to always “solve” mental health problems, and has always been. In Blackness, everybody has a touch of something that the world has told them they needed to fix. And we know implicitly that fixing ourselves isn’t the answer, because respectability politics and other individualistic solutions haven’t ever saved us. How much faster could we progress as a society if we looked at Black understandings like this to lead us, rather than looking at them with condescension and skepticism?
My grandmother was diagnosed with bipolar disorder when I was very young, and she went untreated for most of my life. In her most unmanageable moments of crises, I saw her dragged by police across the lawn to be strapped up and institutionalized against her will.
They said it was for her own good, but I couldn’t believe that. Even as a child, I knew that didn’t look like love. And while it was never a walk in the park, when my mother invited her to move in with us for the last seven years of her life, that did. We wanted her to take her medicine, yes, but we also wanted her to feel seen and supported even if she couldn’t have been fixed. She never was, but she did love me more than anyone ever has since.
It’s not that I needed to de-stigmatize talking about mental health. It’s that I needed to talk about mental health on my own terms. Without the need to fix myself, but instead with recognizing the very Black need to show care and to heal. My current therapist, whom I’ve been seeing productively for over a year (and who is also Black), does not approach mental health as something that needs to be fixed.
But towards the end of my last semester at NYU, when I truly thought I’d hit rock bottom, I finally dragged myself into the therapist’s office, despite my very clear reluctance. I had finally internalized all of the messages that my hesitation was pathological, and forced myself to go. She was a white woman. She wanted to fix me. She couldn’t. And all I took from her was that I was broken.
Thank god for the community of Black friends who reminded me it was okay not to return. Who knew it was more important to be seen and supported than to be fixed.
After 500 years of slavery and its afterlives, and the global economy slavery built and still sustains, there are always more generous ways to tell Black stories. It’s easy to pathologize Black people for our shortcomings, and we are always presented with more examples of them. Our supposed special brand of homophobia. Our kids’ supposed propensity to bully those that aren’t sufficiently Black.
But what if “shortcomings” like the fact that Black people are resistant to mental health treatment have never been problems that need fixing themselves? What healing might it offer all of us to always look at our pathologies—both real and projected—with understanding and care?
*Ellen Baxter and Brooklyn Housing Communities did not respond when reached out to for comment