Racism and Mental Health

The outburst of Black Lives Matter protests this year was directly triggered by the unjust murders of many – too many – African Americans. Recall the distress you felt watching a video of police brutality or when reading that another black person has been unjustly killed. Now imagine these feelings of distress, fear, and hopelessness at the same constancy, extended to the duration of your entire life, and amplified into a sense of immediate fear that the same could happen to you or those around you – whether you are jogging in your neighbourhood or sleeping in your bed. Add on a lifetime of slurs, microaggressions, racial profiling, and systemic discrimination towards yourself. This is racial trauma – prolonged, constant, intergenerational and a daily reality. 

These wounds of racial trauma were recently reopened (in the week after the Floyd video went public, African Americans showing clinically significant signs of anxiety or depression increased from 36% to 41%, meaning 1.4 million people), but in fact have existed for generations. The late civil rights leader John Lewis wrote: 

Emmett Till was my George Floyd. He was my Rayshard Brooks, Sandra Bland and Breonna Taylor. He was 14 when he was killed, and I was only 15 years old at the time. I will never ever forget the moment when it became so clear that he could easily have been me. In those days, fear constrained us like an imaginary prison, and troubling thoughts of potential brutality committed for no understandable reason were the bars.

John Lewis

Any discussion of racism and mental health must begin with writer and psychiatrist Frantz Fanon. His works ‘Black Skin White Masks’ (1952) and ‘Wretched of the Earth’ (1961) explored the effects of racism on the psychopathology of the colonised. Fanon used the experiences of his psychiatric patients to study the effects of colonial racism, arguing that it fosters feelings of alienation and inferiority, and cultivates psychopathological tendencies. 

Similarly, Monnica Williams has based some of her understanding of racial trauma on her experience as a clinician. In a 2015 New York Times article, Williams laid out the symptoms of what she labels as ‘race-based stress and trauma’: 

  • Depression 
  • Intrusion 
  • Hypervigilance 
  • Anger 
  • Loss of appetite 
  • Apathy 
  • Avoidance symptoms 
  • Emotional numbing 

Williams states that these symptoms are extremely similar to those of post-traumatic stress disorder, although while PTSD tends to be a singular incident, racial trauma is ongoing and involves constant reexposure. 

Here are some terms to further introduce key concepts within this field. 

1. Vicarious trauma: Indirectly experienced racism, witnessed in person, through the media or through storytelling that causes psychological trauma (enhanced by social media proliferating the spread of videos, stories, etc.)

2. Intergenerational trauma: Traumatic event(s) from the past affecting how the current generation understands and deals with trauma through storytelling and behaviour. 

  • A form of vicarious trauma 

We are exposed to different kinds of racism historically, collectively, institutionally, systemically, interpersonally and generationally — we inherit a lot of this… The children of parents who have been exposed to racial trauma become more sensitive to it.

Lillian Comas-Diaz

3. Post Traumatic Slave Syndrome: A theory addressing the impacts of generations of slavery

  • Transgenerational effects of the unhealed trauma of slavery, Jim Crow, police brutality, etc. 
  • Results in adaptive survival behaviours
  • Vacant esteem (hopelessness, depression, self destructive outlook) 
  • Propensity for anger and violence from extreme suspicion 
  • Racist socialisation and internalised racism 
  • Caused by multigenerational oppression, indoctrinated inferiority, and institutional racism 

The very systems which cause racial trauma then create obstacles to addressing it. Minorities are less likely to receive quality mental health care, four times more likely to be detained under the Mental Health Act in the UK, and underrepresented in professional services. In Hong Kong, the Equal Opportunities Commission found racial discrimination to be apparent in various services, including medical services. Since racial trauma lacks widespread recognition, psychiatrists and therapists are less likely to identify it within their patients. The lack of black therapists also means that the reality of racism and racial trauma might be dismissed, creating a barrier towards treatment – research shows high early therapy dropout rates amongst African Americans. 

Racism is not a distant reality for us, either. 

  • In the Hong Kong Unison “Racial Acceptance Survey Report” (2012), less than half of respondents accepted Africans, Nepalis, Pakistanis, Filipinos and Indians in their personal lives
  • 6 in 10 Hong Kongers believe there is prejudice against ethnic minorities 
  • Ethnic minority youth suffer from poorer mental health, with higher depression, higher anxiety, higher suicidal ideation, or higher suicide attempts compared to their ethnic majority counterparts 

This is only a brief introduction to racism as a mental health crisis, and educating ourselves is only the first step. It is important to support those immediately around us, support communities around the world, challenge our beliefs and unconscious biases, and stand up against injustice. 

Important links 

Black Minds Matter UK 

One Way To Be An Ally Right Now? Support Black Mental Health  

Racism is A Mental Health Crisis. Here’s How To Fight It.

Key references

This Is What Racial Trauma Does To The Body And Brain 

Racism’s Psychological Toll

Black Minds Matter: confronting racism as a mental health crisis

Can Racism Cause PTSD? Implications for DSM-5

A Racial Trauma Therapist Breaks Down The Black Lives Matter Protests

The Trauma of Racism

Racism in HK 


New study shows that depression among African Americans skyrocket after George Floyd’s death, protests

What Fanon still teaches us about mental illness in post-colonial societies

Racial trauma: Theory, research, and healing: Introduction to the special issue.

The legacy of trauma


Opinion | John Lewis: Together, You Can Redeem the Soul of Our Nation 

Arat, G., Jordan, L. and Wong, P., 2019. “Exploring the culturally specific factors of mental health in South Asian minority students in Hong Kong” European Journal of Social Work, pp.1-14.

Editor’s note: Coolminds spoke to youth in Hong Kong regarding their experience with stigma and discrimination in relation to mental health and what they’re doing to combat these issues. See our ‘Voices of Youth’ booklet here.