Therapy

Music: Breaking or Bringing Stigma Towards Therapy?

Musicians may influence mental health use in the African American community.

Posted Jul 27, 2018

Written by guest co-author DéLon Isom, Ph.D and Erlanger A. Turner, Ph.D.

Jupiter images/ Getty
Source: Jupiter images/ Getty

Mental health disparities in access to treatment have been discussed for decades. In the African American community, there is a long history of under-use of treatment and stigma towards seeking mental health services. Part of the reluctance about seeking mental health treatment is related to historical mistreatment by medical and mental health professionals. As a result, many prefer to cope with other methods. One of those methods may be through the use of the arts and music.

It is a known fact that “music and art reflect life.” Within the African American community, some may speculate that music has always reflected mental health issues through its sad and sultry tones often topped with stories of heartbreak and forced resiliency. Though subtle, the lyrics of mental health challenges are often popular, embraced, and normalized in ways that may contribute to a collective understanding that pain is inevitable. Furthermore, African Americans often prefer to cope by seeking social support from peers who have seemingly become professionals at suppressing the emotions tied to their difficulties.

Stigma around seeking treatment has improved, but many African Americans are reluctant to take their child to therapy or seek treatment to cope with their own personal life stressors. Approximately 1 in 5 children (CDC, 2013) and 1 in 5 adults (NIMH, 2016) in the United States experience mental health issues that meet criteria for a diagnosis in a given year. The rates of receiving treatment for mental illness vary among ethnic groups (see Figure 1). Data often indicate that African Americans are less likely to seek treatment. Given the disparity in treatment use, it is necessary to understand what can be done to change perceptions about treatment.

SAMHSA (2016)
Source: SAMHSA (2016)

How can music break the stigma around mental health?

Several musicians have utilized their international platforms to address mental health through interviews, catchy lyrics, and gripping narratives. Over the last few years, there has been increasing attention to mental health in the media and music. Some may wonder if this increasing attention has changed perceptions about going to therapy among African Americans. In general, research consistently reports that stigma is a barrier to African Americans seeking professional psychological services (Turner et al., 2016). With time it may be possible to better understand what relationships exist between help-seeking behaviors and discussions of mental health in music.

Currently, musicians from various genres have received attention for discussing mental health and substance abuse such as Demi Lovato and Kid Cudi. In the African American community, some artists seem to amass more attention from choosing to address such a stigmatized topic including Kid Cudi and Kanye West. These efforts either fall on deaf ears or may serve to perpetuate the stigma of help-seeking further as it relates to mental health within the black community.  While the artists mentioned above convey very positive experiences with mental health treatment, it is difficult to determine the impact of their disclosures on the understanding of mental health and perception of seeking treatment.

Although it is unclear if other artists are actively engaged in mental health treatment, specific musicians have utilized their platform to raise awareness about mental health in ways that listeners might better relate. Recently, a lot of attention was focused on Michelle Williams, of the super group Destiny’s Child. Michelle has previously discussed her battle with depression and recently posted on her social media about seeking treatment. Other artists have also been open about their mental health including Isaiah Rashad who detailed his struggles with depression in his work, and Lil Wayne who disclosed attempting suicide on Solange's latest album. While not a member of the African American community, Logic has promoted help-seeking for individuals with suicidal ideations through his song 1-800-273-8255. Other artists like Jay-Z (Shawn Carter) have openly discussed his involvement in psychotherapy and his struggles to find a suitable therapist (view video from The New York Times here). When moguls such as Mr. Carter speak to the difficulty in navigating the help-seeking process, one could only assume that those with fewer resources could either relate or were not inspired to navigate the process of seeking professional treatment, which may be complicated.

Other implications of music on coping with mental health

Artists may also unknowingly preserve or promote mental health when they promote virility and self-reliance instead of encouraging the use of professional psychological services to address stressful life events. This approach specifically and directly impacts the number of black males who engage in treatment. In the May 2018 issue of the Journal of Black Psychology, a study found that self-reliance and the belief in enduring difficulties was associated with stigma around seeking treatment. These messages have the potential to perpetuate the gender roles prescribed to men of color regarding the inhibition of emotional expression. As an example, the artist J. Cole released an album (KOD) brimming with personal stories of trauma, maladaptive coping, and mood symptoms. While listeners may relate due to their shared experiences, the album does little at highlighting the vices mentioned as a result of mental health issues and even less at creating a dialogue which supports or prompts others to engage in formal treatment. Similarly, artist Nipsey Hussle mentions mental health in his song I Don't Stress (Stressed Out). OutKast member, Andre 3000 also brings us coping in his music. Both artists have reflected on their challenges with stress and anxiety as they attempted to navigate their professional careers while dealing with stressors in their immediate environment. Each artist has discussed how they personally coped with challenges associated with their stress including substance use, natural remedies, religion, peer support, social withdrawal and a sustained sense of superiority employed to negotiate negative thoughts.

For some individuals within the African American community, music serves as a coping tool. Most utilize this art form as a distraction or to regulate their emotions. As such, it would seem that music could provide the perfect inroad for therapy in communities that are often less likely to seek professional mental health treatment. Mental health stigma does not only prevent African Americans from seeking treatment but this is a concern for many ethnic and racial groups. As mental health providers, it is interesting to see more musicians discuss mental health in their music and share their experiences with taking medications or going to therapy. However, some musicians take the opposite approach and reflect on living their lives without seeking treatment. In light of these circumstances, some might wonder how musicians discussing mental illness or mental health issues influence perceptions of seeking treatment among youth and their parents. It is our hope that more people will recognize the importance of mental health and seek appropriate treatment when necessary. If you have concerns about mental health, please visit the National Institute of Mental Health for more information and facts (https://www.nimh.nih.gov/health/topics/index.shtml).

Below are some suggested resources on locating mental health services:

  1. The APA (http://locator.apa.org/) and the Psychology Today Therapy Directory (https://www.psychologytoday.com/us/therapists)
  2. National Suicide Prevention Lifeline can connect you to a local crisis line (24 hours a day, 7 days a week). Call 1-800-273-TALK (8255) or visit www.suicidepreventionlifeline.org
  3. SAMHSA’s Treatment Referral Routing Service Helpline provides 24-hour free and confidential treatment referral and information about mental and/or substance use disorders, prevention, and recovery in English and Spanish. SAMHSA's National Helpline 1-800-662-HELP (4357) or TTY: 1-800-487-4889 Website: www.samhsa.gov/find-help/national-helpline
  4. For help locating African American providers, you can visit Melanin and Mental Health or Therapy for Black Girls

Copyright 2018 DéLon Isom, Ph.D and Erlanger A. Turner, Ph.D.

About the Guest Co-Author

DéLon Isom, Ph.D., earned his doctoral degree from Howard University and is currently a Postdoctoral Psychology Fellow specializing in Adolescent Medicine at the Children’s Hospital Los Angeles (CHLA).