Racism and Mental Health

1.0 Impact of Racism on Mental Health

The American Psychological Association has defined racism as a pandemic. This has prompted some associations of mental health professionals (for example, the Royal College of Psychiatrists, American Psychiatric Association, and Canadian Psychological Association) to take a stand against racism and to urge governments to respond to the impact of such events on the mental health of Black communities.

Among the consequences of racism, studies have documented psychological and emotional distress, post-traumatic stress disorder, depression, anxiety, obsessive-compulsive symptoms, low self-esteem, chronic stress, alcohol and substance abuse, increased school dropout rates, somatization (a mental illness that causes a person to have excessive physical symptoms that are not explained by a medical condition), high blood pressure, diabetes, heart disease, poorer physical health and increased body-mass index -BMI. An increased body-mass index (BMI) means that a person’s BMI value is higher than what is considered healthy for their height. An increased BMI, particularly in the overweight or obesity range, can be associated with higher risks of health issues such as heart disease, diabetes, and certain cancers.

Specifically with regard to police brutality, a study showed that the killing of each unarmed Black person in the USA increased the number of days of poor mental health among individuals from Black communities. Moreover, a systematic review showed that Black people were 2·3 to 2·5 times more likely than White people to be compulsorily admitted to mental health institutions.

Research has also shown that the main reasons for lack of access to care are not financial, but instead associated with negative perceptions of mental health services and professionals, self-stigmatization, and poor experiences with care services, including attitudes described as discriminatory and racist by young people and adults.

(Source: Jude Mary Cénat, “How to provide anti-racist mental health care”, November 2020, https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30309-6/fulltext).

Black Americans experience disparities in mental health that lead to unfavorable health outcomes and increased morbidity from mental illness due to centuries of racism. In order to achieve racial equity, historical factors such as European imperialism, enslavement, the myth of Black inferiority, and scientific racial classification have all perpetuated disparities, leading to the current underestimation, misdiagnosis, and inadequate treatment of mental illness in Black populations.

(Source: Courtney D. Cogburn, PhD., et al., “The impact of racism on Black American mental health”, January 2024, https://pubmed.ncbi.nlm.nih.gov/38101873/)

Mental Health, Violence and the Criminal Justice System

There is a well-established relationship between mental illness and criminal activity. Individuals with mental illness are significantly over-represented in local jails or state and federal prisons. More than one-third of inmates are diagnosed with a mental disorder prior to incarceration. On any given day, more than 1 million people with mental illness are locked up or on probation or parole.

(Source: Elisa Jácome, “How better access to mental health care can reduce crime”, July 2021, https://siepr.stanford.edu/publications/policy-brief/how-better-access-mental-health-care-can-reduce-crime).

Urban adolescents are exposed to a substantial amount of community violence exposure (CVE) which has the potential to influence psychological functioning. More than 85% witness some form of violence in their lifetime; and as many as 69% report direct victimization. Depression, anxiety, posttraumatic stress disorder (PTSD), and aggression have negative associations with CVE in urban adolescents.

Source: Catherine C McDonald, “The Relationship between Community Violence Exposure and Mental Health Symptoms in Urban Adolescents”, December 2008, https://pmc.ncbi.nlm.nih.gov/articles/PMC2821658/).

Research shows that exposure to community violence can lead to long-term mental health issues such as PTSD, anxiety, and depression. This trauma can perpetuate a cycle of violence, where individuals who experience or witness violence may be more likely to engage in violent behavior themselves. Exposure to community violence is an epidemic problem that causes debilitating effects on youth mental health.

Source: Andrew Foell et al., “Exposure to community violence and depressive symptoms”, December 1, 2021, https://pmc.ncbi.nlm.nih.gov/articles/PMC8635280/#:~:text=Exposure%20to%20community%20violence%20has,factors%20to%20influence%20depressive%20symptoms

Much research shows that exposure to community violence and crime negatively impacts health across the life course. Specifically, direct victimization or witnessing violence is traumatic, significantly increasing the risk of long-term mental health issues, such as posttraumatic stress disorder (PTSD), anxiety, and depression. Furthermore, indirect exposure to community violence has been linked to a higher incidence of sleep disturbances, asthma, hypertension, and reduced academic performance.

Source: Allison Lind, et al., “Carjacking and homicide in Minneapolis after the police killing of George Floyd: Evidence from an interrupted time series analysis”, October 2024, https://www.sciencedirect.com/science/article/abs/pii/S0277953624006816

3.0 Treating Mental Health Disorders

There is substantial research linking improved mental health services to violence prevention and reduction in homicide rates. For example, community-based mental health programs have been shown to reduce violence by addressing underlying issues such as trauma, substance abuse, and mental illness.

Source: Alisa B Biller, “The Roles of Trauma and Mental Health in Preventing Domestic Radicalization and Violent Extremism”, April 22, 2024,

https://nij.ojp.gov/topics/articles/roles-trauma-and-mental-health-preventing-domestic-radicalization-and-violent.

Making mental health care more accessible and affordable is widely considered a smart crime-reduction strategy, as research shows a strong connection between untreated mental health issues and criminal behavior, meaning addressing mental health can potentially lower crime rates by preventing individuals from engaging in criminal activities due to their mental state.

Source: Jennifer Doleac, “Why Crime Matters and What to Do about It”, November 2024, https://www.economicstrategygroup.org/wp-content/uploads/2024/11/Doleac_Executive_Summary.pdf

One form of mental health therapy – cognitive behavioral therapy, CBT- stands out in the criminal justice system. CBT assumes that most people can become conscious of their own thoughts and behaviors and then make positive changes to them. A person’s thoughts are often the result of experience, and behavior is often influenced and prompted by these thoughts. In addition, thoughts may sometimes become distorted and fail to reflect reality accurately.

Cognitive behavioral therapy has been found to be effective with juveniles and adults who have committed an offense; substance abusing and violent individuals; and people on probation, persons who are incarcerated and those on parole. It is effective in various criminal justice settings, both in institutions and in the community, and addresses a host of problems associated with criminal behavior. For instance, in most cognitive behavioral therapy programs, participants improve their social skills, means-ends problem solving, critical reasoning, moral reasoning, cognitive style, self-control, impulse management and self-efficacy.

“Becoming a Man in Chicago” which uses the principles of CBT has cut arrests of young men for violent crime in half and significantly increased graduation rates.

Source: Patrick Clark, “Preventing Future Crime through Cognitive Behavioral Therapy”, May 28, 2010, https://nij.ojp.gov/topics/articles/preventing-future-crime-cognitive-behavioral-therapy).

4.0 Black Americans and the Criminal Justice System

The distribution of crime is not random; violence is more likely to occur in communities of color and in disadvantaged neighborhoods. This inequitable distribution of violent crime extends to being a direct victim; for example, Blacks made up 14% of the population in the United States, but accounted for 52% of all homicide victims in 2019. These differences in exposure to crime and violence appear to be important drivers of health inequities.

Disparate Treatment of Black Americans by the Criminal Justice System

Police officers’ reliance on millions of minor traffic stops annually as a pretext to investigate drivers for criminal activity disproportionately impacts Black. Among those they pull over, police are more likely to search Black (6.2%) than whites (3.6%). But police are often less likely to find drugs or weapons among the Black that they search compared to whites.

Black and white Americans use illicit drugs at roughly similar rates, but about one in four people arrested for drug law violations are Black, although Black people make up 14% of the U.S. population.

Black Americans were 9.3 times as likely as whites to be homicide victims in 2020. Since homicide is generally an intra-racial crime, these figures correspond to higher rates of homicide offending among these communities of color, which is attributable to spatially-concentrated urban poverty resulting from longstanding and ongoing segregation, discrimination, and disinvestment.

Source: The Sentencing Project, “New Report on Racial Disparities in Policing and Crime from The Sentencing Project”, November 2, 2023, https://www.sentencingproject.org/press-releases/new-report-on-racial-disparities-in-policing-and-crime-from-the-sentencing-project/

Racial Disparities in Crime Victimization

As noted above, Blacks made up 14% of the population in the United States but accounted for 52% of all homicide victims in 2019.

Victimization rates for Black Americans increased 37% from 2022 and 2023, driven by a 79% increase in robbery, 47% increase in rape/sexual assault rates, and a 16% increase in aggravated assault.

Black Americans were more likely to be victims of violent crime than other racial groups in 2023. For instance, Black Americans were more than twice as likely to be robbed as White Americans.

Source: Thaddeus Johnson, “Violent Victimization is Decreasing – but Not for Everyone”, October 2024, https://counciloncj.org/violent-victimization-is-decreasing-but-not-for-everyone/

5.0 Carjackings

Carjacking—taking a vehicle by force or threat of force when the owner is present—typically takes place in a matter of seconds, most likely at or near a victim’s home, with the offender(s) usually armed and unknown to the victim. To succeed, the offender must coerce the victim into surrendering their car during this brief confrontation; this is typically done through instilling fear. Twenty-six percent of carjacking victims are physically injured, and afterwards the majority report high levels of stress and fear of revictimization, often changing their daily routines. The violent and frightening nature of carjacking has led to heightened concern in many communities, prompting some to establish “Carjacking Task Forces” in response to the perceived surge.

The relationship between carjackings and mental illness is complex and multifaceted. While not all carjackings can be directly attributed to mental illness, there are several factors that support the argument that many carjackings could be manifestations of underlying mental health issues:

Trauma and Stress: Individuals who have experienced significant trauma or stress, particularly during formative years, may engage in risky or criminal behavior, including carjackings.

Lack of Mental Health Resources: In some cases, individuals with untreated mental health conditions may resort to criminal activities. The lack of access to mental health care and support systems can contribute to behaviors like carjacking.

Youth and Developmental Issues: Many carjackings involve teenagers, whose brains are still developing. Impulse control and decision-making skills are not fully matured, and mental health issues can further impair these functions.

Source – Source: Sylvie McNamara, “What’s Behind in the Surge in Youth-Involved Carjacking?”, May 12, 2022 https://www.washingtonian.com/2022/05/12/whats-behind-the-surge-in-youth-involved-carjacking/

Source – Source: Clarissa Cowley, “Teen-carjacking: From the juvenile brain to youth detention to community solutions”, April 13, 2023, https://www.ksdk.com/article/news/crime/carjacking-st-louis-chicago-kia-hyundai-court-ymca-dream-builders-equity/63-1644108b-36a0-4505-b13e-188a8d7a7b07

MILWAUKEE, WI – The Milwaukee Police Department (MPD) is pleased to announce the launch of the first ever Operation Winter Guardian initiative. The objective of Operation Winter Guardian is to rapidly deploy extra uniformed personnel to saturate areas where a carjacking incident has just occurred in order to locate and arrest the offenders and prevent further incidents. Winter Guardian also prioritizes arresting wanted carjacking offenders, locating and recovering carjacked vehicles. Winter Guardian incorporates positive community interaction and constant feedback with enforcement.

Source: Milwaukee Police Department, Press Release, “Operation Winter Guardian”, December 20, 2024, https://www.facebook.com/groups/3312293715702027/posts/3854827174782009/?_rdr.