Black population and mental health – 09/21/2023 – Public Health

For some time now, I have been carrying out studies and research that analyze the impacts of racism and its relationship with mental health. During the pandemic, the demand for mental health services grew dramatically and gained repercussions in different spaces. I can say that this is not a simple topic, as it is necessary to understand racial relations and their particular dynamics in Brazilian society, as well as the notion of mental health itself, which presents different theoretical and scientific conceptions.

According to the World Mental Health Report: Transforming mental health for all, published by the World Health Organization (WHO), most societies and health systems do not provide mental health care and do not have adequate specialized care for people who need it. This means that the lack of mental health care directly affects human rights. The report also indicates that social determinants are one of the main drivers of problems related to mental health, which requires radical transformations, including the protection of human rights.

Another point concerns the prevalence of psychological illness in conflict environments. In 2019, the magazine The Lancet published a study that analyzed WHO data on the impacts of conflict environments on the mental health of populations. Despite the heterogeneity of studies and data, it is necessary to highlight how natural disasters, public health emergencies, wars and contexts of human rights violations affect the psychological conditions of entire populations in the short, medium and long term.

Mental health is a collective and multifactorial issue

The challenges in understanding the relationship between mental health and racism are many. The first of these is understanding that mental health is not limited to an individual issue and involves different aspects of life. The guarantee of well-being is related to essential conditions such as: food, education, leisure, sport, health, housing, culture, among other needs for existence. This means that in order to have cognitive and intellectual development we need to have access to an adequate and balanced diet, guaranteed by food security. At the same time, access to education is necessary to stimulate the learning process, which is not restricted to the family environment, but is community and school-based. Likewise, having housing with basic sanitation and adequate environmental conditions is extremely necessary to guarantee good living and health conditions.

Social inequalities, racism and mental health

A second challenge that we need to clarify concerns the understanding that living conditions are related to the economic, social and political organization of our society. If on the one hand we have a history of unequal income distribution, at the same time work in Brazil exposes what is the basis of Brazilian social formation: racial relations. A country that grew and developed from the rape and torture of black bodies tends to deny, silence and erase the most cruel and violent facet of its history, justifying atrocities through the myth of racial democracy. Putting a finger on the wound is not an easy task, because it reveals the debt produced by the violation of human rights that subsidizes Brazilian existence.

In this way, the debate on the mental health of the black population needs to be carried out based on the recognition of how racism permeates ways of life and produces psychosocial illness in a significant portion of the Brazilian population. Which makes the problem collective and not individual. Although the individual is most interested in accessing mental health care, their well-being is not exclusive to them, but, on the contrary, is in interaction with the dynamics and interests of society.

Furthermore, the mental health issues of the black population cannot be seen as a problem exclusive to black people. On the contrary, it is a debate that touches on fundamental points, such as the right to health and the right to life. In this way, we defend a broad perspective on the topic, capable of revealing the structural problems behind the psychological suffering of black men and women and the way in which society perceives and responds to this historical and social problem.

According to the National Policy for Comprehensive Health of the Black Population, from the Ministry of Health, the lethality of black youth is one of the most alarming social determinants. If, on the one hand, young people are dying more and more, on the other hand, black women are those who are being highly medicalized. At the same time, diseases considered preventable, such as high blood pressure, type 2 diabetes, cardiovascular diseases, are prevalent in the black population, as is obstetric violence. These facts demonstrate how the promotion of well-being, health and mental health are related to a conception of society that may be permanently denying the basic principle of existence: the right to life.

Black movement and construction of the SUS

As a third and final question, it is necessary to highlight the relevance of popular participation in the construction of the Unified Health System (SUS) and the National Policy on Mental Health, Alcohol and Other Drugs. It is essential to emphasize that black and black women’s movements and collectives are important in the construction of the SUS. It is not new that black men and women are demanding attention to social determinants, the perpetuation of violence and its impact on health and mental health. However, in order to continue moving forward, we need to intensify popular participation in representation bodies. We can record the historic 17th National Health Conference, organized by the National Health Council and promoted by the Ministry of Health, with the theme “Guaranteeing rights, defending the SUS, life and democracy – Tomorrow will be another day!” and held in July this year. 4,000 people participated as delegates who were elected at municipal, state and free conferences.

In the case of mental health, in December, the V National Conference on Mental Health will take place – Domingos Sávio and during the month of September there will be several free conferences, such as the Free Conference on Mental Health of the Black Population and the Free Conference on Mental Health of the Peripheries . Popular participation is essential to combat health inequities, advance equity in access to mental health services and guarantee the right to life. Anti-racism needs to be a fundamental premise in the expansion and consolidation of mental health services, in the qualification of managers and professionals, in the mandatory adherence to the race/color issue in records and in mental health care technologies that must respect ethnic-racial diversity , cultural and territorial.

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Rachel Gouveia is a professor of undergraduate and postgraduate studies in Social Work at the Federal University of Rio de Janeiro (UFRJ) and specialized technical advisor at the Department of Mental Health of the Ministry of Health. Author of the book “In the sights of the rifle: mental health of black women in question”, published in 2023 by Editora Hucitec and Selo Diálogos da Diáspora.

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