Perhaps the most famous depiction of a Black man in therapy is in a film about a suburban cabal of white supremacists. In Get Out, Chris (Daniel Kaluuya) is coerced into a hypnotherapy session that pries him open at the seams. He sinks, on command, through the floor and into the “sunken place”: the repressed consciousness of society’s most marginalised voices. Here, a Black man is in therapy against his will, screaming soundlessly into the void.
“Let’s not act like therapy isn’t institutionally racist,” Will* tells me. “Being a young Black man, you’re taught that vulnerability is a weakness that can be used against you.”
Men from African and Afro-Caribbean origin are disproportionately sectioned under the Mental Health Act – legislation that treats people for mental illnesses without their consent – but are rarely granted access to timely psychological intervention. This year, University College London’s COVID-19 social study reported that thoughts of suicide and self-harm were significantly higher among Black, Asian and minority ethnic Brits than their white counterparts.
Will, 22, tried therapy for the first time as a student, after a weekend when anxiety and depression made him unable to perform basic tasks. But the experience, as university therapy often is, felt half-arsed and hostile. After a lengthy sabbatical, he started Cognitive Behavioural Therapy with the NHS earlier this year.
“In general, healthcare and medical practices have been historically horrible for people of colour. There’s a deep distrust between systematic support and minorities,” Will says. “And so, there’s a stigma against mental health support, especially including taking any type of antidepressants or anti-anxiety pills. I don’t think I’ve ever told another Black man that I’ve taken antidepressants.”
This stigma surrounding mental illness can be found in many parts of the Black community.
“The community at large are very reticent about therapy,” says Michael Opoku-Forfieh, a counsellor based in south east London. “There’s a firm idea of what it means to be a man from this kind of cultural background. Recently, there’s been an uptake in regard to the amount of Black people who are engaging in therapy. I’m seeing Black men become more willing to at least have a conversation with me about starting therapy.”
David*, 29, started therapy in February this year after hitting a particularly low point. “Being Black, you’ve got this cultural expectation of bravado,” he says. “With me, there was a lot of pressure, it felt like everyone was relying on me. That eats away at you. And then, you kind of forget about yourself.”
“I never used to talk about how I felt,” David continues. “I just got on with it and buried my head in the sand. But then I started drinking all the time. When I had a tough day and that, I’d have one, and then one leads to another, and it’s just a downward spiral. What do they call it? Binge-drinking. I’d just drink myself silly.”
Alcohol can be a crutch for those who struggle with mental health issues, perhaps even more so during the pandemic. A recent study from the University of Glasgow found that adverse alcohol use rose across almost all age groups during the first lockdown, compared to figures from 2017-2019.
Ismael, 45, muses about why his dad went to the pub every Sunday, “It’s a place where men can talk, and just express themselves. Men can only really express themselves if they’re drinking or smoking something. They need something in their hands.”
Ismael’s weekly counselling sessions began in July, prompted by watching a fellow youth worker display signs of a nervous breakdown during a Zoom conference.
“It’s seen as: you’re going crazy or you’re going soft. You aren’t man enough, you need to man up. Black men especially, we don’t like to talk about our issues,” Ismael says. “But therapy has helped me with coping strategies and honest reflection. The counsellor encourages me to have more boundaries. When I’m talking about the issues, I feel them rising up in my throat and coming out of my body.”
Caught between archaic notions of masculinity and entrenched cultural stigmas, Black men are often expected to endure and prosper in silence.
“Being Black, or being in any marginalised group, you come from parents and a culture of survival and overcoming. And the narrative is that you have to strive and overcome and that nothing else is acceptable.” Will explains. “The people who don’t make it – we just don’t talk about them. They don’t fit the mindset of hope. It’s almost a coping mechanism, it’s avoidance. And it’s protecting, even, against structural racism.”
But this rejection of therapy as another covert means of oppression, is perhaps the very reason why Black men are in dire need of mental health support. Opoku-Forfieh says that his clients are relieved to discuss racial injustices with someone who inherently understands: “It’s one of the first things we talk about. They see somebody that looks like them, that perhaps has a perspective on this life that they are living. And they can open up about things that have been damaging to them for a long, long time.”
When Ismael was five, his dad was wrongfully mistaken for a local gangster in South Kilburn and detained for two days. Upon his release, a policeman offered him a complaint form and a blatant threat – “Look, we know you’ve got children” – for his troubles. Ismael’s childhood is littered with memories of being stopped and searched, running from the police, and once, being violently restrained by an officer. In 2006, David says that he was stopped and searched 12 times in one day, when a policeman targeted him in an elaborate show of power. Will is tailed by security every time he enters a store. He hates not buying anything because that means he has no receipt or bag to adequately prove his innocence when he walks out.
“I almost feel an obligation as a Black man to prove that I’m friendly.” Will says. “To prove I’m non-threatening and make the people around me feel comfortable.”
When the world erupted at the murder of George Floyd earlier this year; Ismael, David and Will were weary. The story of brutality and inequality was all too familiar. The shared trauma of the Black experience in the West has been perpetual and unrelenting.
“This isn’t new. It’s what Black and brown people have been saying for centuries. It’s been in the music, in the arts, for a while,” says Opoku-Forfieh. “It’s only that, now, certain groups have decided to listen.”
Get Out eventually ends with Chris narrowly escaping the clutches of the eugenics cult, with its members lying bloodied and contorted in his wake. But when police sirens blare, and he lifts his hands in automatic surrender, we are quickly reminded that there is no absolute freedom from the racism that pervades society itself, and the very institutions it is comprised of.
“Therapy and rehab – institutional help and support, is a narrative that is very common in white storytelling and white media,” Will says. “And they are considered positive things, healthy things. While I feel like in the Black community, it’s like, ‘You should’ve never gotten there in the first place.’ Which is a shame. I think we should always operate in the mindset of being able to find solutions, rather than never having problems.”
*Names have been changed.