Hardships and Hope: Mental Health in Underrepresented Students
Fast Facts about Mental Health in Underrepresented Students
All postsecondary students face challenges when entering this new phase of life, but students from underrepresented groups must meet even greater challenges, including in the realm of mental health.
Today, a wide variety of underrepresented students attend postsecondary schools. In this article, we’ll discuss those who identify as Black, Indigenous, or people of color (BIPOC), immigrated to the United States, speak English as a second or additional language, or observe religions that are less commonly practiced in the U.S.
Every person can help underresourced students—and populations at large—to maintain better mental health and receive treatment when issues arise.
Terms to Know
- First Generation Immigrants: Those living in the United States who were not born on U.S. soil
- Second Generation Immigrants: Those born with U.S. citizenship to at least one immigrant parent
- Third Generation Immigrants: Those with both parents being born in the United States, but not all grandparents were
- AAPI: Asian American and Pacific Islander (including Hawaiian)
- BIPOC: Black, Indigenous, and people of color (meaning anyone who doesn’t identify as strictly white)
- ESL: English as a second language
- ELL: English language learner
- Hispanic: Spanish-speaking, regardless of country of origin
- Latinx: Gender-neutral term for people from Latin America
- Underrepresented: Communities with small populations compared to the general population
How Diverse Are Colleges and Trade Schools?
Postsecondary schools in the United States are becoming more diverse. For instance, in 1996, 29.6% of undergraduate students were people of color; as of 2016, that amount had risen to 45.2%. However, the level of diversity doesn’t quite reflect that of the general population.
Below, we explore recent statistics related to students enrolled in U.S. postsecondary institutions.
How Racially Diverse are Colleges Compared to the Overall Population of the United States?
When added together, BIPOC groups as a whole comprise a larger percentage of the college population than they do of the general population—barely. But this hides the underrepresentation among certain BIPOC groups, and—as you’ll see in a subsequent section—enrollment doesn’t necessarily lead to degree attainment.
|Group||Overall Population (2019)||Undergraduate Students (2018)|
|Native American/Alaska Native||1.3%||0.72%|
|Native Hawaiian/Pacific Islander||0.2%||0.3%|
|Two or More Races||2.8%||3.9%|
It’s important to note that while college professors have become more racially and ethnically diverse over the past several years, the percentage of professors identifying as white (76%) is higher than the percentage of the general population identifying as white (60%), let alone among the population of undergraduates.
How Many Immigrants Are Enrolled in U.S. Colleges?
As of 2018, immigrants made up 13.7% of the overall U.S. population, and first-generation immigrants comprise 8.9% of the undergraduate and graduate student population in colleges and universities. However, when we include second and third generations from immigrant families, the number leaps to 28% of the overall postsecondary population, up from 20% in 2000.
The majority of immigrants in the U.S. are documented, with 45% being naturalized citizens; only 23% of immigrants are undocumented. Approximately 454,000 college students are undocumented immigrants, including traditional and adult college students, which accounts for 2% of the overall postsecondary population. Of these students, nearly 50% arrived in the U.S. at ages 12 or younger.
How Many Postsecondary Students Speak English as a Second Language?
As of 2018, 21.9% of the U.S. population spoke a language other than English at home, 45% of whom were born in the United States. Of these speakers, 38% say they speak English “less than very well.” This, combined with the fact that many colleges require a certain level of proficiency, could help explain the disparity between the number of second-language speakers in the overall population and college students—though the number of English language learners in colleges is growing.
The number of ELLs attending postsecondary schools is further affected by the number who graduate from high school. Nationwide, 63% of ELLs graduate from high school, compared to 82% of the overall student population, and only 1.4% of ELL graduates take college entrance exams.
This is where the statistics get murky. While ESL students comprise 10.1% of the overall public school population, the percentage of 12th graders in ESL programs is 4.6%. Factors contributing to this lower number (the highest numbers are in early elementary school) include testing out of ESL programs and dropping out of school before graduation.
A recent study reported that, of those identified as ELLs, only 53% enrolled in college within two years of graduation. Further, only 18% moved on to attend four-year programs.
Even if we assume all 4.6% of those 12th graders graduate, cutting that nearly in half to reflect ELL college enrollment means only about 2% of the overall college population would be officially considered English language learners according to K-12 education standards. And small numbers can sometimes mean forgotten numbers.
How Religiously Diverse are U.S. Colleges?
There isn’t a straightforward answer to the question of how many college students practice any particular religion. However, some statistics can help us make educated guesses.
For this purpose, we’re going to compare those who are college-aged (18 to 29) with those most likely to be their parents’ ages (50 to 64), using Pew Research data from 2019. This could give us an idea of what religions this age group was raised in compared to how they self-identify.
|Religion||Aged 18-29 in This Community||Aged 50-64 in this Community|
|Other Non-Christian Faiths||3%||2%|
|Nothing in Particular||25%||14%|
Except for those who identify as Muslim, young adults statistically follow religions other than those practiced by people their parents’ ages. In particular, the number of those who practice Christianity has dropped drastically, and the numbers of those identifying as atheist, agnostic, and “nothing in particular” have shot up.
Practicing a non-Christian (or less-common Christian) religion can be, to say the least, socially isolating. Leaving the religion of one’s parents can cause even more challenges.
Do Students of Different Background Graduate from College at Different Rates?
Students from different racial, religious, and linguistic backgrounds or of varying immigration statuses graduate from college at different rates, and these rates don’t reflect the original enrollment numbers.
BIPOC College Graduation Rates
Postsecondary degree attainment rates for every group within the BIPOC communities are lower than those of white students, except for Asian students.
|Community||Complete Four-Year Programs Within Four Years||Complete Four-Year Programs Within Six Years||Complete Two-Year Programs Within Three Years|
|Native American/Alaska Native||23%||39%||27%|
|Native Hawaiian/Pacific Islander||31%||51%||34%|
|Two or More Races||39%||60%||25%|
Data from the National Center for Education Statistics (NCES), last updated February 2019. The three- and six-year data include those who graduated in the traditional time periods. Two-year program data may seem low in part because they don’t count students who move on to four-year programs as “graduated.”
Immigrant College Graduation Rates
The number of immigrants with bachelor’s degrees is on the rise, and those who finish their bachelor’s degrees are more likely to later earn advanced degrees than those born in the United States.
However, this number includes those who earned their degrees in their home countries (i.e., those who arrived with their college educations completed).
Further complicating the issue is that the majority of immigrants who complete college report fluency in English. Those who aren’t fluent (or don’t consider themselves fluent) are less likely to finish college.
ELL College Graduation Rates
It was reported that only 12% of ELLs enrolled in college had earned bachelor’s degrees within eight years of graduating from high school. This is starkly different from the 32% of native English speakers and 25% of English-proficient students who come from homes where their families speak other tongues (also called language minority, or LM, students) who had enrolled in college.
College Graduation Rates and Religions
Degree attainment varies by religion, but the rates of degree-holders by religion may surprise you.
These numbers don’t represent the overall number of degree holders, but the number of college graduates within individual faiths:
- Hindu: 77%
- Jewish: 59%
- Buddhist: 47%
- Atheist: 43%
- Agnostic: 42%
- Muslim: 39%
- Nothing in particular: 24%
The majority of the U.S. population is Christian, though many individual faiths fall under this umbrella. Using these statistics, it would be nearly impossible to determine the number of Christians with college degrees, though Unitarian Universalist comes second in degree attainment.
Unique Mental Health and Treatment Challenges for Underresourced Students
In 2017, an estimated 18% of adults in the United States were living with diagnosable mental health issues, with 4% having serious mental illnesses. However, only 43% of those with mental illnesses received treatment. This includes those of all backgrounds. Members of underresourced communities live with these issues at different rates than the overall population and often experience different outcomes.
Members of underrepresented communities encounter mental health treatment barriers their white, religious-majority, U.S.-born, and English-speaking peers don’t.
As we go through this section, one thing needs to be made clear: After hundreds, if not thousands, of years of practicing certain cultural norms and experiencing systemic oppression, it’s understandable that people from these backgrounds have barriers others don’t. People from outside these communities must work to understand the history and societal issues correlating to barriers and choices and not jump to conclusions or judgments.
All information comes from studies and statements from people within underrepresented communities.
Common Mental Health and Treatment Challenges in Underrepresented Groups
Unsurprisingly—and unfortunately so—discrimination is a major cause of mental health issues at the college level. While already undergoing the challenges all college students experience—transitioning to a more independent life, managing classes and social pressures, etc.—underrepresented students also contend with biases from their peers, professors, and administrators.
Additionally, particularly in mostly white college settings, BIPOC students often report “imposter syndrome,” which means they feel they aren’t supposed to be there.
All of this can be incredibly stressful, and stress directly links to various mental and physical health concerns.
Some common stressors and treatment barriers members of these groups face are:
- Being first-generation students: Students who are the first in their families to attend college are less likely to live on campus than students who aren’t in this category, and BIPOC learners are more likely to be first-generation than white students. This means mental health resources on campus aren’t as easy to access because these students frequently commute to campus and simply don’t have extra time to seek out campus resources.
- Lack of health insurance: BIPOC, immigrants, and English language learners disproportionately lack health insurance, particularly in states where Medicaid hasn’t been expanded.
- Low-income backgrounds: Additionally, many underrepresented students come from low-income backgrounds and often work while attending college, resulting in their having to choose between work and medical or mental health visits.
- Professors and faculty who don’t understand their needs
- Religious and cultural taboos
- Issues with mental health services providers:
- Conscious and unconscious biases
- Minimal training in culturally responsive treatment
- Few providers from underrepresented backgrounds (only 14% identify as BIPOC) or who speak languages other than English
- Even fewer practitioners who identify as both BIPOC and LGBTQ+
- Physicians being less likely to recognize the severity of mental health issues in BIPOC students
- School mental health services: Non-white students are less likely to obtain mental health services within their schools before college.
This section will further expand on these barriers and how they apply to different underrepresented groups.
Mental Health and the Black Community
Members of the Black community are 20% likelier to have mental health problems than the population at large. The challenges have risen over the last several years:
Fast Facts about Mental Health and the Black Community
These rates of mental health concerns may be skewed. Men in this community are significantly more likely to be diagnosed with schizophrenia than their white peers, often without cause.
In addition to the general challenges above, Black students also experience mental health treatment barriers thanks to their unique history of oppression, societal expectations, cultural norms, and costs.
To begin with, according to Mental Health America, “the historical Black and African American experience in America has and continues to be characterized by trauma and violence more often than for their White counterparts and impacts emotional and mental health of both youth and adults.”
A long history of dehumanization and other forms of oppression and violence have turned into systemic and casual racism, and this can result in daily trauma—whether or not the individual affected is always conscious of the trauma at the moment.
The history of the Black experience with the mental health field is, to say the least, unsavory:
- In 1851, two “disorders” were invented—draeptomania and dysaesthesia aethiopica—to claim enslaved people were mentally ill if they ran away or wanted to “avoid hard work.”
- That same claimant said Black people were inherently incapable of complex emotional processes and therefore didn’t need thorough or effective mental health treatment.
- From the 1930s to the 1970s, hundreds of Black men participated in the Tuskegee Experiment. They were told they were being treated for “bad blood,” in this case meaning syphilis, when they actually received no treatment. Syphilis can result in neurosyphilis, which manifests in personality disorders, dementia, psychosis, and more. Many of these men ended up with this comorbid disease, as well as other health problems like blindness, often leading to early deaths and other heartbreaking endings.
- Even after the Civil Rights Act, segregation in medical facilities, including mental health facilities, was deemed “medically necessary.” Many of these facilities had forced labor for the patients, and the doctors were often unlicensed.
- In the 1970s, certain medications were prescribed to Black people to keep them “under control.”
- To this day, mental illness is criminalized through all populations—but this is especially true for the Black community.
This history, understandably, can cause Black people to hesitate before seeking medical or mental health treatment.
An article in The Wall Street Journal states, “Living in a predominantly white society has often led Black Americans to be hypervigilant about the images they presented to the wider world.”
The article quotes Dr. Annelle Primm, who adds, “Being an African-American carried its own negative stigma… To willingly step forward to seek out mental-health services and potentially be labeled as also having a mental illness in a society that also looked down upon people with that label is certainly something that people would want to avoid.”
In short, when you feel like you’re already being judged, you may take steps to avoid further judgment.
Additionally, many Black and African American communities hold long-lasting stigmas regarding mental health, especially among men, and the need to handle problems on your own.
A lack of healthcare resources furthers these feelings of stigmatization and judgment. The Black community has historically been and continues to be treated differently by the healthcare system than its white counterparts.
Many Black families spend as much as 20% of their household incomes on healthcare premiums, compared to 11% for families in general. The cost is part of the reason for the Black community being disproportionately uninsured. With the Affordable Care Act (ACA) so frequently challenged and Medicaid being slow to expand, it’s no wonder many feel stressed about healthcare, if not completely unable to access it due to financial concerns.
With insurance covering little to no mental health treatments and out-of-pocket costs being exorbitant, it isn’t hard to understand why many Black community members don’t seek help—even if they otherwise would.
But it’s not just about insurance: Black people statistically have poorer outcomes than white people when seeing medical professionals, including higher infant mortality and pregnancy-related death rates.
When we look at mental health specifically, things get even more complicated. According to verywellmind.com, in addition to being misdiagnosed with schizophrenia, “Black Americans are also less likely to be offered treatment for their mental health issues. Research has also shown that Black teens are less likely to be asked about eating disorder symptoms than white teens, even though they’re about 50% more likely to show bulimia behaviors.”
Frighteningly, Black children are diagnosed as psychotic more often than white children but are less likely to be given treatment. If these children go to college, they face additional challenges due to their unchecked mental illnesses (if the illnesses exist; as we see with the aforementioned unwarranted schizophrenia diagnoses, they may not).
And as for medication, white people die of opioid overdoses at double the rate of Black people, but Black people are more likely to be given drug tests and have their prescriptions taken away.
When Black people seek mental health assistance, like many other BIPOC individuals, they tend to begin within their faith communities—though those diagnosed with depression self-report being more willing to seek help than the general population.
Mental Health and the Indigenous and Native American Community
Indigenous and Native American people experience mental health issues 2.5 times more often than the overall population in any given month. They experience alcohol and drug abuse younger and more often than any other ethnic group.
Frighteningly, while the community’s overall suicide rate is similar to that of white people, it’s nearly twice as high for Indigenous teens between 15 and 19.
For Indigenous and Native people, gaining access to therapists, online or in person, is especially challenging.
Firstly, poverty is rampant among this population, making treatment financially inaccessible.
Additionally, Indian Health Service hospital staff are most likely to understand their needs, but most of these hospitals are on reservations, while only 22% of this population live on tribal lands.
Further, 67% of Indigenous/Native people have high-speed internet access, compared to 82% of other U.S. residents, making online therapy harder to access.
Beyond logistical challenges, there are cultural factors at play in seeking mental health treatment. Factors may vary by tribe; these are general observations from Mental Health America:
- Encouragement to seek help from spiritual or other healers rather than mental health professionals is common.
- If treatment is sought, Indigenous and Native people may discuss or present symptoms in unique ways, potentially making the challenges hard for professionals to recognize as specific conditions.
- Belief systems often identify mental and physical health issues as one and the same, and their causes are understood through a unique lens.
- Many Native cultures believe connectedness with others and nature can serve as protection against mental health challenges.
- Over 200 languages are spoken within Indigenous communities, and language is an essential part of each culture. However, not many providers speak those languages.
Mental Health and the Hispanic and Latinx Communities
Mental health problems appear to have increased among the Hispanic and Latinx communities over the last several years. That said, it’s not clear whether it’s the rate or the reporting that’s increasing.
Fast Facts about Mental Health and the Hispanic and Latinx Communities
Poverty and lack of insurance are major factors in Hispanic and Latinx students having access to mental health treatment, but barriers go beyond that. As mentioned, providers who speak languages other than English are hard to find. Importantly, it’s been discovered that health issues are reported very differently in Spanish versus when only-English paperwork is provided.
When Latinx and Hispanic people seek medical treatment, they’re more likely to focus on physical health issues than mental health ones. For both mental and physical issues, these individuals are undertreated when compared to white people.
However, seeking treatment in the first place can be hard to do. Many don’t even know where to begin, and if there has been discrimination or other poor treatment a previous experience, returning is unlikely.
Cultural factors also play a role in receiving mental health treatment. MHA and Falgas, et al. report:
- Faith is often a critical part of these communities, which can both provide comfort and increase stigma because some behaviors can be interpreted as negative choices.
- Some community members believe having a mental illness—or even discussing the possibility of one—could bring shame to the family.
- Self-reliance is an essential part of many people’s identities, leading to them wanting to handle such concerns independently.
Mental Health and the Asian American and Pacific Islander (AAPI) Community
AAPI mental health has been incredibly under-studied when compared to research into other groups. However, some information has been discovered through a few studies.
As with other communities, it’s difficult to determine whether the numbers of mental health problems are on the rise or the willingness to report is increasing.
Fast Facts about Mental Health and the AAPI Community
A small-scale study[i] of 19 AAPI parents of public school students revealed they recognized both their children’s and their own resistance to seeking mental health services within their schools. They stated the hesitation was caused by knowledge, attitudinal, structural/practical, and relational barriers, all of which were intertwined with cultural factors.
Just over 42% of these parents said their cultures don’t emphasize mental health and, for many, their countries of origin had few resources available. They also said there are cultural stigmas and a tendency to turn toward faith leaders over mental health professionals. One mother, Huifen, who came from China, said, “[People] would rather go to their Buddhism religion and pray in front of the Buddha. They think if they are labeled with [a] mental illness, their whole life is ruined.”
Of course, the cultural issues don’t exclusively come from within. For years, Asian Americans have been forced to wear the title of “the model minority,” putting a huge amount of pressure on them to succeed. Their parents said this could cause their children’s mental health struggles to go unnoticed—more than their white peers, the APPI children often feel they need to focus more on academic skills than socioemotional ones.
On a related note, the parents reported their children felt embarrassed about being seen going to the schools’ mental health staff. Further, the parents feared such visits or any diagnoses would appear on their children’s school records, making them less appealing to colleges.
This may demonstrate that school administrators haven’t been abundantly clear about student privacy rules or fully gained these parents’ trust, which is something to be aware of if you work in public school settings.
Like other groups, AAPI parents also reported having poor prior experiences with mental health providers. While some perceptions related to cultural issues, others said they felt professionals gave the same basic advice as good friends and family. They also were concerned about the overprescribing of mental health medications and their potential side effects.
Importantly, they also reported many of these negative experiences involved receiving treatment from practitioners who “don’t understand our culture…They are not trained…Definitely, cultural competence will be, is the barrier,” as one Chinese mother, Grace, put it.
Because of the lack of culturally responsive training, many parents felt mental health practitioners judged them. For example, Grace shared that a young woman she knew sought assistance from a school counselor. The girl left feeling she needed to defend her parents from accusations of abuse due to their culturally informed parenting style rather than feeling like she was on the road to better mental health.
Mental Health and Immigrants and English Language Learners
Immigrants and English language learners who identify as BIPOC or religious minorities share those same struggles and then some.
While not all ELLs are immigrants and not all immigrants are ELLs, the two groups are often combined in most studies of immigrant healthcare. Additionally, many studies tend to group second language populations with Hispanic/Latinx, even though not all people who speak English as an additional language are native Spanish speakers or from Latin America.
This section addresses immigrants and ELLs together, and more information on the latter can be found in the above section on Hispanic and Latinx mental health issues.
For immigrants—both documented and undocumented—immigration policies play a major role in mental health. “Current immigration policies can create vulnerabilities, including fear and mistrust, discrimination, limited access to services, parent-child separation, and poverty. These experiences increase poor mental health outcomes and may exacerbate prior exposure to trauma in the home country (e.g., violence) and during migration (e.g., extortion),” states a 2018 study in American Psychologist.[ii]
This is due to a daily lack of certainty and legal inability to access services or even have jobs. If every day feels unsafe in some way, mental health could be negatively affected.
Of course, many people who immigrate to this country overcome these political challenges to varying extents. But, politics aren’t the only barriers immigrants face.
In her article for the National Alliance on Mental Illness, Katherine Ponte says, “my quintessential hard-working immigrant success story still does not address a very important factor: I live with bipolar disorder. The mental health challenges that immigrants face are the part of this story that need to be told.”
Ponte goes on to say that not only are challenges like discrimination and language barriers faced, but there’s often an increased sense of isolation and being separate from others because immigrants frequently move into communities comprised primarily of other immigrants from the same area.
She also brings up immigrants’ underemployment, which often leads to a lack of health insurance, money, and time to get healthcare treatment.
“Coping with these challenges can lead to mental health issues or mental illness, particularly for those with a pre-existing biological vulnerability to a mental illness,” Ponte says.
And, like other groups, there is often stigma involved. People may come from cultures with limited educational opportunities, particularly when it comes to instruction about mental health, and (like many Americans, admittedly), there is often a dismissal of “women’s problems” and a strong belief that men can’t show weakness.
When there’s a language barrier, things get much harder. Being unable to communicate with a medical professional is frustrating to everyone, but getting treatment can feel impossible when the practitioner literally speaks a different language. Thus, people who don’t speak English as a first language often are unlikely to seek out healthcare.
Even if someone is reaching English fluency, medical terminology is practically a language of its own. If someone doesn’t understand what they’re told, they don’t know what questions to ask.
Additionally, the underemployment and language barriers often result in a stereotype that immigrants and language learners aren’t as educated or capable as those born in the States. It doesn’t matter if someone holds a doctorate—the stereotype can persist. And those who defy this stereotype sometimes distance themselves from their communities so they can try to avoid being identified by those misconceptions. A lack of community can lead to mental health challenges.
Mental Health and DACA
We would be remiss if we didn’t talk about the Deferred Action for Childhood Arrivals (DACA) program. When introduced in 2012, DACA permitted some undocumented immigrants who arrived as minors to stay in the country without fear of deportation for two years with the possibility of renewal.
A 2017 study from the Journal of Immigrant and Minority Health[iii] discovered DACA has both positive and negative effects on eligible young people’s mental health and wellbeing (MHWB).
Positive Effects of DACA:
- Feeling like they could be more immersed in society
- Experiencing less fear of discovery
- Increasing self-esteem
Stressful Effects of DACA:
- Renewal only lasts two years and isn’t guaranteed.
- DACA recipients are often responsible for family needs because it’s easier for them to get jobs and drivers’ licenses.
- They increasingly worry about their families’ safety because of these responsibilities.
The list of pros and cons for DACA as it relates to mental health (though, as the journal puts it, “…DACA is a positive first step”) goes on and on. But this study was published in 2017, and it was conducted before DACA was rescinded in September of that year.
Since then, DACA has been a bit like Schrödinger’s cat: Both there and not there at the same time. Though applications are accepted at the time of this writing, there remains a lot of confusion about who is eligible and has this status.
The fact that DACA is frequently in jeopardy causes stress, anxiety, depression, and more, leading to or exacerbating mental health issues.
Mental Health and Religious Minorities
Religious minorities experience mental health issues those in mainstream Christian religions—the ones comprising the majority religious group in the country—don’t. This is the case regardless of race, language, or immigration status, though those factors can further affect their lived experiences.
While there aren’t many statistics related to mental health and religious minority communities, there have been studies relating to surrounding issues that may affect emotional and mental wellness.
Being a member of a faith community can benefit mental health. However, religious discrimination correlates with much higher rates of all common mental illnesses—even when considered separately from race, ethnicity, or suspected paranoid traits.
Firstly, it’s important to address what can happen when one leaves their parents’ religion, which is the case among an increasing number of young people.
Loren D. Marks and David C. Dollahite of Brigham Young University and Katy Pearl Young of Utah State University[iv] surveyed 198 religiously diverse families from across the country—66% of whom were from Jewish, Muslim, or minority Christian backgrounds—about the unique hardships they encounter.
The challenges most commonly seen by the religious minority groups surveyed were related to:
- Difference and minority status: Biases from other people, sometimes leading to isolation, exclusion of non-Christian religions from the mainstream (e.g., Christmas decorations everywhere), struggling to find common experiences with friends from other backgrounds
- Other religious people: Beliefs forced upon them, feelings of betrayal or contention within their own communities
- Misunderstandings and ignorance: Others not understanding religious restrictions (e.g., days people can’t work), mistrust after events like 9/11
- Demands of the faith community: Pressure to conform and excel within their faith, fear of disappointment or separation from a deity
- Animosity and rejection: Hate crimes, employment discrimination and unlawful termination, intentional hateful comments, microaggressions (e.g., others saying they’re “worried about their soul”), loss of friendships
Further, college students are increasingly pulling away from religion. A study from Psychology of Religion and Spirituality[v] showed students who have experienced this struggle more than their classmates who haven’t left or reconsidered their faiths. This includes having increased feelings of being “immoral,” feeling judged or abandoned by members of their former communities, and experiencing a lack of sense that there’s a greater meaning in life—possibly for the first time.
These issues can contribute to mental health struggles. For instance:
- Social isolation can lead to depression, anxiety, difficulty sleeping well, and engaging in unhealthy habits.
- The pressure to practice one’s faith “correctly” and fear that a deity may abandon a person have been correlated with higher rates of depression.
- Hate crimes are often connected to PTSD, anxiety, depression, and general psychological distress.
- Existential crises—thoughts that life may have no meaning or that the meaning is unclear—can include feelings of anxiety and depression. In extreme cases, people may experience existential crisis obsessive-compulsive disorder (OCD).
There’s also an unofficial diagnosis related to leaving one’s religion: Religious Trauma Syndrome (RTS). The DSM-V doesn’t recognize this syndrome, but according to Restoration Counseling, “Religious Trauma Syndrome is in the early stages of research and is gaining traction as a legitimate diagnosis.”
RTS occurs when someone decides to leave their faith and is especially common among those “who have escaped cults, fundamentalist religious groups, abusive religious settings, and other painful experiences with religion.” Symptoms are like those of complex PTSD, and a significant symptom is feeling like you’ve lost your community—which may include parents or other family.
When it comes to how people from different religions address mental health issues, we’re entering murky waters. What some of us would consider “barriers” others would consider “opportunities.” Interpretation may need to depend more on outcomes and individual circumstances.
A variety of faiths encourage members to open up to their faith leaders instead of, before, or in addition to pursuing mental health treatment. This isn’t restricted to minority religions, either—mainstream Christian sects often go this route. Underserved populations who are members of churches may be more likely to seek help from religious leaders because they’re familiar, often from the same backgrounds, and don’t have language barriers.
However, while guidance from within one’s faith is undoubtedly helpful for many people, not all religious leaders are trained mental health professionals. Moreover, diagnosing illnesses and prescribing medications are generally outside of their legal rights. So, those who would typically go to their faith leader for assistance may not get the help they need if they feel they can’t pursue outside treatment.
People from religions outside the mainstream may also not pursue help because they feel their challenges are a moral failing or punishment from God. They may experience shame as a result and feel they need to keep quiet about their struggles.
How to Help Yourself
There are ways underresourced students can help themselves get mental health treatment, but it takes some legwork.
The first thing to know: Your mental health care is private. If you’re a college student, your provider can’t ring up your parents to tell them you’ve been visiting, as they’re bound by doctor-patient confidentiality.
However, if you’re using your parents’ insurance to attend therapy, the bills and explanations of benefits (EOBs) may be sent to them. Choosing a counselor on your campus or using online therapy without insurance (often a full month costs about the same as a single in-person therapy session) may be better options if you want to ensure your family doesn’t know.
This isn’t to say therapy is shameful. It isn’t. But, hopefully, knowing doctor-patient confidentiality applies to mental health treatment alleviates some worries, and understanding your parents could receive EOBs and bills can help you plan accordingly.
When seeking out a therapist, it may be incredibly hard to find a practitioner who shares your background. As you’re looking for one, you should assume positive intent—most therapy providers went into the field out of a desire to help. But, be open about your needs. Do you want them to be of a certain religion or race? That’s fine! Do you want to see someone who speaks your primary language, even if you’re fluent in English? That makes perfect sense!
Some counselors offer pre-counseling consultations, and they should gladly provide you with information about their backgrounds before you make your first appointment. You can ask these questions of professionals outside your school and at your campus’ counseling center.
Some questions to ask include:
- What race/religion are you? Are you an immigrant? (These questions may seem rude, but many counselors give this information on their websites and understand why you’re asking.)
- Do you speak a language other than English (if relevant)?
- What training do you have in working with clients of my background?
- What professional experience do you have working with people of my background?
- Have you sought additional training in culturally responsive practices? If so, tell me a little about that.
- If I bring up something you don’t know enough about, will you be up-front about it? What will you do to rectify this for future visits?
- Do you believe in white privilege? What about institutional racism?
- How do you define discrimination/racism?
If their answers don’t satisfy you, ask if they know any other professionals you could call.
It’s probably difficult to ask people these things, but these are professionals and are used to being asked probing questions.
Additionally, the vast majority of mental health workers want to assist you, whether that means inviting you to their practice or referring you to someone better fitting your needs.
No matter how qualified a counselor is, you may find you don’t “gel” with them. In this case, you can change. You don’t even need to give them an explanation, though feedback is usually appreciated if you feel comfortable offering it.
If you’re on campus, your counselors may rotate as they’re often graduate students. When one isn’t a good fit for you, tell the front desk to try to avoid pairing you with that person again.
If you can’t find counselors in your area who meet your needs, check out online therapy. Ask them those same questions. These are professional counselors and want you to find a good fit as much as in-person counselors do. Check out our resources at the end of this article for some online therapy options.
How to Help Others
Whether you’re a member of an underrepresented group or not, if you want to help others, there are ways you can do so.
What You Can Do as a Mental Health Professional
Mental health professionals may have the highest level of responsibility for ensuring underresourced populations have access to mental health services.
A study by the Journal of Clinical Psychology in Medical Settings[vi] states, “Incorporating cultural perspectives into mental health treatment has been deemed a moral and ethical responsibility of providers because factors related to culture have significant potential to impact recovery and rehabilitation,” particularly if working with people who have (to use the journal’s term) severe mental illnesses.
The first thing to do is take a good look at your own conscious and unconscious biases. Identifying them is essential to overcoming them.
While there isn’t a magic button a mental health provider can push to become perfect at working with cultural and linguistic differences, there are some actions you can take:
- Survey the local community regarding their needs.
- Determine the level of cultural competency of everyone in your practice (from administrative staff to practitioners).
- Conduct case study reviews and interact with patients—including surveying patients to determine satisfaction levels.
- Pursue continuing education courses regarding various cultures and ensure other staffers do as well.
- Read books and articles by experts in culturally competent mental health treatments.
Additionally, activities you should engage in include learning a language commonly spoken in your community and participating in active and passive methods of immersing yourself in cultures (e.g., attending cultural events, watching YouTube videos, etc.) regularly.
What You Can Do as a Faith Leader
For every group in this piece, many people go to their faith leaders before or instead of mental health professionals for assistance. This means religious leaders—whether in mainstream faiths or not—need to be aware of their roles in supporting their congregants’ mental health.
In her piece for NAMI, Ponte stated, “some faith leaders, when presented with emotional concerns, guide their followers to prayer or to ‘pray it away’.”
While many, of course, find prayer a great source of comfort and an important part of their mental health routine, faith leaders need to seek mental health training. If you’re a faith leader, this may help you recognize when prayer and meditation are sufficient versus when something needs to be addressed from additional angles.
Faith leaders should take this education and use it in the right ways, particularly in determining when they can help and when they need to find outside resources for those who seek help.
While those who aren’t legally permitted to do so shouldn’t try to provide diagnoses, they should strive to recognize the differences between, for example, stress, nerves, and anxiety. Stress and nerves are generally temporary; anxiety can be a mental health issue or indicative of one.
They should also always take suicidal statements seriously. It can be extremely difficult to overcome years of being told—perhaps even trained—that suicide is a mortal sin. No one should argue this is easy. But, reframing the conversation from morality to preventing the act can save someone—perhaps in more ways than one, depending on your belief system.
These leaders can also turn their communities into places not just of worship but also of education and advocacy. Finding reputable mental health resources, including practitioners and informational packets and websites, as well as distributing this information and making it accessible to community members can go a long way.
What You Can Do as a College Administrator
Postsecondary administrators likely don’t get to know their students well—not due to a lack of care, but due to their jobs’ demands. But it’s also their job to ensure their students feel safe on campus and can learn effectively. Not doing so can have devastating consequences.
One such consequence was the 1995 murder-suicide of Trang Phuong Ho and Sinedu Tadesse, a pair of immigrant roommates at Harvard University. Tadesse had, in hindsight, sent out red flags before the tragedy, including in a letter directly to the school’s health center.
This brought into sharp relief the understaffing of the school’s counseling services and new rules regarding how to handle appointments and emergencies, among other changes. The university also had to deal with a lawsuit from Ho’s family and bad press.
To this day, the tragedy raises an important question, not just at Harvard but at all postsecondary institutions: Are we serving our students, particularly those from underresourced backgrounds, effectively?
Administrators know they have a responsibility to their students, not just to prevent lawsuits and grow and maintain enrollment but to ensure their students are mentally and physically safe, have positive experiences at school, and can enter the world as well-adjusted and successful adults.
The question is, of course, how? It isn’t easy to know what to do—especially since the overwhelming majority of high-ranking school officials, from provosts to athletics administrators, are white.
One answer is training. Attending seminars, workshops, and conferences on multicultural issues, culturally responsive education, and other similar topics can make a huge difference in how you understand and interact with your student population.
This isn’t just training for you as an administrator, either. Make this kind of instruction a part of your staff’s professional development and be open to funding their attendance at independent development events.
Another route involves getting input from the students themselves.
- Hold formal meetings and informal meet-and-greets so you can have a dialogue with learners.
- Visit student groups during meetings and listen to what they have to say.
- Send out anonymous surveys to get an idea of how students perceive school culture—and act on the responses.
- Take student complaints seriously, whether they’re in-person statements, published in the school paper, or posted online anonymously.
You don’t have a lot of free time. You know that. But, proactive steps could be time-savers later—and good for public relations.
What You Can Do as a Professor or Teaching Assistant
If you’re an instructor at a postsecondary institution, from a graduate aide or teaching assistant (TA) to a tenured professor, you’re likely to encounter students from all sorts of backgrounds.
As only 24% of postsecondary school faculty don’t identify as white, which is significantly less than the number of students who identify as BIPOC, professors have some extra homework to do.
When it comes to graduate students—not all of whom are TAs—as of 2016, 44% identified as BIPOC. This is slightly less than for undergraduate students. Additionally, knowing students from wealthy families are more likely to graduate from undergraduate programs, it’s reasonable to extrapolate that many graduate students are from higher-income backgrounds. This is statistically less common for students from underresourced backgrounds, meaning their experiences growing up may not have been the same as the undergraduate students with whom they work, regardless of any other aspects of their lives. So, there’s homework to be done on this subject area as well.
Professors have opportunities and barriers their TAs don’t.
Their opportunities include the ability to:
- Pursue professional development regarding diversity, from lectures and conferences to reading relevant books and articles
- Engage in conversations with colleges and administrators about how to improve instruction and school culture
- Take student concerns seriously, addressing them swiftly and transparently
However, professors may have hundreds of students in a single class. While all teachers, from Kindergarten through college, know building relationships with students is essential, it can be a literal impossibility to connect with every student. This is where they need to lean on their TAs, whom they should train in diversity issues before TAs’ small group instruction begins.
Like professors, TAs have specific opportunities and barriers to providing culturally sensitive education.
Opportunities can include:
- Small-group instruction allowing for relationship-building
- Potentially being closer in age and less removed from the undergraduate experience, allowing for more empathy
- When possible, taking classes related to diversity in their fields
The biggest barrier is, of course, a lack of school-work-life balance. Graduate students are busy. Over three-quarters of graduate students work, and one-quarter work full time. Almost one-fifth have children. All this is while taking heavy course loads, performing independent research, and, of course, performing all their assistant duties. This may mean they have no time to learn best practices in education and study culturally responsive methods.
Whether you’re a professor or TA, it’s essential to acknowledge conscious and unconscious biases, address them, and work to overcome them.
In addition to pursuing opportunities to improve instruction of underrepresented students and working to overcome barriers to that instruction, there are some (relatively) simple steps to take inside the classroom. Inside Higher Ed offers some suggestions:
- Acknowledge the existence of microaggressions, and interrupt and address them immediately. Follow up with students who frequently commit these microaggressions.
- Find overt and subtle ways to show support. On day one and throughout the semester, you can state your commitment to diversity, discuss any training you have in the area, and concede you have areas for improvement—including telling students to call you out. You could also consider putting up posters showing your support for causes.
- Bring people and works from diverse backgrounds into your curriculum. Those who teach literature can purposefully use pieces by authors of different backgrounds, while those in the sciences can highlight the work of experts from underresourced backgrounds, for instance.
- Ensure your teaching and grading practices are equitable, recognizing students have different backgrounds, speak different languages, and have different life experiences. This isn’t about lowering standards—it’s about meeting students where they are. For instance, a student who speaks English as an additional language may not write “perfectly,” and you can cut them some slack and use it as an opportunity to help them improve their writing through meaningful, respectful feedback.
- Check your grades for patterns. Are students from certain backgrounds consistently receiving lower scores? And don’t just use names for this—you can’t tell race, religion, etc., from names alone. If your school has a class demographics program, use it. If not, look at your students’ records—either as a whole or from a reasonably sized sampling—and compare. If you notice students from other countries, different languages of origin, or with certain racial backgrounds are consistently scoring lower, ask yourself “why?” and work to rectify the situation.
- Get to know your students as people. Whether you’re a professor with a small class or a TA, speak to students about their lives and struggles. When students ask for meetings with you, ask questions beyond the materials to find out who they are and how that can affect their work. If you have a large class, you can still observe your students, see those who look like they’re confused or struggling, and pull them aside to talk—you don’t know if there’s an issue if you don’t ask. This is especially important for students from underresourced backgrounds, as they often don’t live on campus and work a great deal, meaning visits during office hours are difficult to arrange.
What You Can Do as Part of a Community
Communities at large can play significant roles in improving mental health and college outcomes for underresourced students.
As with all others, the first thing to do is check yourself for unconscious and conscious biases and take steps to address and rectify them. You can seek mental health assistance to help navigate these waters if desired.
Then, look into community organizations, charities, and other groups focusing on issues directly affecting underresourced communities. Find out how you can get involved, whether through volunteering, donating, or attending meetings, so you can better learn how to improve your community.
Additionally, look at your community versus the people in charge. Are all voices being heard? If your community’s youth population is 45% Hispanic/Latinx, for instance, and your school board is all white, it’s worth investigating why the board doesn’t reflect the student body. Even if every member has the best intentions and functions as an ally, it’s simply not possible to understand the community’s needs thoroughly through an all-white lens, and change may be needed.
Also, think critically about your workplace, whether you’re an owner or an employee. Questions to ask include:
- Are you adequately serving underresourced communities?
- Are the employees especially suspicious of shoppers of color?
- Does the staff represent the community?
- Have you had anti-bias training?
If you’re a decision-maker, address any bias or service issues you see. If an employee comes to you with a concern about the company’s biases or behaviors, take it seriously. As a general rule, at least five people expressed this same concern elsewhere before someone got up the nerve to talk to you about it.
If you’re an employee and feel safe doing so, bring up any concerns with your boss.
Have open discussions with your children. Discrimination is hard to talk about, especially if you were raised in the “I don’t see color” generation—overcoming years of instruction from parents, teachers, and society at large isn’t easy, but it’s necessary. According to Alanna Nzoma, MD, “Avoiding the conversation may be more comfortable but this only allows your child to absorb society’s racial stereotypes, which will likely shape negative views of people of color.”
Remember, parents of underresourced children have had to engage in these discussions since their children were very young—often for their protection from everything from mean words to full-on violence.
Nzoma recommends incorporating books and other media featuring people from all backgrounds as positive protagonists. Further, she says immersing oneself in cultures, even with simple measures like going to authentic restaurants, can go a long way.
As kids age, they learn about underresourced populations and histories in schools—discuss these topics at home, especially as they only hear part of the story in the classroom.
Mental Health Resources and Further Readings
This online therapy program allows you to message your counselor as often as you want, any time, day or night. They’ll generally get back to you within 24 hours on the days they work. Talkspace costs $260 to $396 per month. You’ll often receive a discount for your first month (displayed at the top of the page), and they accept many insurance plans.
In addition to being the preeminent mental health information resource in the United States, this publication maintains an extensive list of therapists you can search. Click “Find a Therapist” at the top of the home page. You first search by location, and then you can further narrow it down by gender, ethnicity, sexuality, language, and faith(s) they either identify as or serve.
This site lets you search for therapists in your area who may fit your needs, including languages spoken, low-cost services available, and level of cultural knowledge.
Mental Health America (MHA)
MHA is a nonprofit organization striving “to protect the rights and dignity” of those who’ve experienced mental illness and allow their voices to be heard. In addition to various types of support available on the site, it contains a page dedicated to BIPOC mental health.
Therapy for Black Girls
This site seeks to break stigmas preventing Black girls and women from seeking mental health treatment, provide resources regarding mental health, and help find therapists who can meet your needs.
Therapy for Black Men
Therapy for Black Men strives to connect members of this community with therapists capable of understanding and caring for them.
Some of the sources used in this piece aren’t freely available online and aren’t linked above:
[i] Wang, C., Do, K.A., Frese, K. et al. Asian Immigrant Parents’ Perception of Barriers Preventing Adolescents from Seeking School-Based Mental Health Services. School Mental Health 11, 364–377 (2019). https://doi.org/10.1007/s12310-018-9285-0
[ii] Torres, S. A., Santiago, C. D., Walts, K. K., & Richards, M. H. (2018). Immigration policy, practices, and procedures: The impact on the mental health of Mexican and Central American youth and families. American Psychologist, 73(7), 843–854. https://doi.org/10.1037/amp0000184
[iii] Siemons, R., Raymond-Flesh, M., Auerswald, C.L. et al. Coming of Age on the Margins: Mental Health and Wellbeing Among Latino Immigrant Young Adults Eligible for Deferred Action for Childhood Arrivals (DACA). J Immigrant Minority Health 19, 543–551 (2017). https://doi.org/10.1007/s10903-016-0354-x
[iv] Marks, L. D., Dollahite, D. C., & Young, K. P. (2019). Struggles experienced by religious minority families in the United States. Psychology of Religion and Spirituality, 11(3), 247–256. https://doi.org/10.1037/rel0000214
[v] Exline, J. J., Van Tongeren, D. R., Bradley, D. F., Wilt, J. A., Stauner, N., Pargament, K. I., & DeWall, C. N. (2020). Pulling away from religion: Religious/spiritual struggles and religious disengagement among college students. Psychology of Religion and Spirituality. Advance online publication. https://doi.org/10.1037/rel0000375
[vi] Maura J, Weisman de Mamani A. Mental Health Disparities, Treatment Engagement, and Attrition Among Racial/Ethnic Minorities with Severe Mental Illness: A Review. J Clin Psychol Med Settings. 2017 Dec;24(3-4):187-210. doi: 10.1007/s10880-017-9510-2. PMID: 28900779.