July 5, 2019

BY: ALEX PERSONS, SPA INTERN

July is National Minority Mental Health Month. A necessary component of this is recognizing the greater stress that is placed on minorities across all domains: race, religion, sexual orientation, gender identity, sex, disability, and more. In psychology we talk about something called the minority stress theory. The minority stress theory states that people from marginalized communities experience excess stress unique to their identity, often a minority, and its accompanying model is derived from sociological and social psychological theories¹. The model is comprised of nine parts: circumstances in the environment, minority status, general stressors, distal and proximal minority stress processes, minority identity, characteristics of minority identity, coping and social support, and mental health outcomes. Circumstances in the environment lead to general stressors, which everyone experiences. Minority status is sexual orientation, race/ethnicity, and gender. Distal minority stress processes are external, objective prejudice events such as discrimination and violence. There are three proximal minority stress processes: rejection sensitivity: the tendency to anxiously expect, readily predict, and overreact to social rejection and having a heightened sensitivity to rejection based on identity; identity concealment: the concealment of a concealable identity for the purpose of safety or security; and internalized homophobia: incorporating negative societal views about one’s sexual orientation into their own self schema. Characteristics of minority identity are prominence, valence, and integration. Whereas minority status contributes to distal minority stress processes, minority identity contributes to proximal minority stress processes. In light of all previous components, there is coping and social support. They are commonly found as: situation selection: approaching or avoiding situations on the basis of their anticipated emotional impact; situation modification: individuals’ attempts to actively alter a situation; attentional deployment: shifting one’s focus from non-emotional aspects of a situation or moving attention away from the immediate situation altogether; cognitive change: reframing and deconstructing heterosexist attitudes and using the media to support this; and response modulation: venting feelings, substance abuse, and suppression. Finally, general stressors, both proximal and distal minority stress processes, characteristics of minority identity, and coping and social support all culminate in either positive or negative mental health outcomes. Research has found that proximal minority stress processes are linked with higher rates of depression, substance use, and worse physical health outcomes. For instance, among HIV patients, identity concealment was linked to lower CD4 count and higher viral load.

Violence and hate crimes are also a pervasive issue. Concerning rates of violence against LGBT people, overall violence has actually decreased by 32% but homicides increased by 11%. More recent research has found that in 2017, there was a 29% increase in LGBT homicides. Of of all LGBT homicides, 80% were people of color and >50% were trans, and from all homicides the attacker knew the victim such as a neighbor, employer, or family member. As of August 23, 2017, The National Coalition of Anti-Violence Programs (NCAVP) has found that there is a steadily increasing rate of trans homicides over the past five years. In 2017, of the 36 hate-violence related homicides that have been reported, 19 of them were towards transgender people, and 16 of those 19 were transgender women of color (Waters and Yacka-Bible). These statistics come out to be just over 50%. It was also found that the people attacked knew their attacker (Kearney).

Sexual orientation and gender identity are not the only minority aspects linked to hate crimes. In 2017, 2,040 agencies of the 16,149 that reported to the FBI, there were 7,175 hate crime incidents involving 8,437 offenses. According to the FBI’s UCR data, race was the most contributing factor, accounting for 58% of all single bias incidents. Second to race was religion at 22%. Violence against people of color has been a long unsolved issue in the United States.

Along with discrimination, these problems lead to a shortened lifespan for people of color. As mentioned earlier, social situations such as identity concealment among HIV positive patients was linked with a lower CD4 count and a higher viral load. Among adolescents, black boys were more likely to commit suicide. In the following graphic, there seems to be a sharp increase in the suicide rate for black boys between 1998-2002 and 2003-2007. It’s not quite clear as to why, but this could be summed up to something as simple as more reliable reporting or related to the well-known issue of underreporting of physical and mental health problems among minorities.

One of the more obvious reasons for the rise in LGBT homicides is the Pulse nightclub shooting in June 2016. However, the 17% rise in LGBT homicides excluded Pulse because it is an outlier. When Pulse was included, the number jumped to a whopping 217%.

Minority mental health is an incredibly important topic that is deserving of special attention due to both stigmas and discrimination. Although there are plenty of problems related to this, there are things that make the lives of minorities better. Community connectedness has been shown to act as a coping mechanism for minorities and can moderate the strength of all the stressors that have so far been mentioned. Supporting and promoting these communities would serve beneficial, but society needs to change, too. Laws should be enacted that promote and protect minority mental health.  

References

1. Meyer, I. (2003) Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychology Bulletin, 129(5), 674-697.
2. Kearney, L. (2017, June 12). LGBT Murders Rose in 2016. Retrieved from usnews.com
3. Waters, E., Yacka-Bible, S. (2017) A Crisis of Hate A Mid Year Report on Lesbian, Gay, Bisexual, Transgender, and Queer Hate Violence Homicides. National Coalition of Anti-Violence Programs.
4. UCR 2017 Data