TL;DR:
BIPOC mental health patients are impacted by race-based trauma, systemic disparities, and chronic stress that can affect both emotional well-being and brain function.
This blog explores barriers to care, including stigma and misdiagnosis, and explains how trauma impacts the brain. It also highlights how a brain-based, culturally informed approach can lead to more accurate diagnosis and better outcomes.
Medically reviewed by Larry Momaya, MD, Amen Clinics
When Black, Indigenous, and people of color (BIPOC) individuals seek mental health support, an often-overlooked factor can add complexity to their condition.
They frequently experience racial trauma or race-based traumatic stress (RBTS). Indeed, at least 63 percent of Black Americans and 47 percent of Latino individuals have reported experiencing race-based traumatic events. In other studies, 58 percent of Asian adults report that they’ve ever undergone unfair treatment based on their race or ethnicity.
According to research from the American Psychological Association, unlike post-traumatic stress disorder (PTSD), RBTS is not a mental health disorder but rather a mental and emotional injury that can occur as a result of living within a racist system or experiencing events of racism.
This distinction reflects what BIPOC Mental Health Awareness Month aims to highlight: how systemic experiences can affect mental health, as well as brain health, without defining or labeling identity as illness.
When it comes to treatment, it’s important that members of the BIPOC community seek help from mental health providers who are sensitive to the effects of this type of trauma.
RBTS symptoms can look very similar to PTSD and can include depressed mood, hypervigilance, low self-esteem, and/or somatic symptoms such as headaches, GI distress, and insomnia, to name a few.
In this blog, we’ll examine BIPOC mental health disparities, key stressors, and brain-based approaches to care.
BIPOC mental health care can be more effective if it is culturally informed, comprehensive, and tailored to an individual’s brain health.
BIPOC stands for Black, Indigenous, and people of color. It refers to the communities that have historically experienced racial and ethnic marginalization.
BIPOC Mental Health Awareness Month was established in 2008 to raise awareness of the unique mental health challenges faced by these communities and also to improve access to culturally responsive mental health care. It is observed every July.
The aim of this initiative has been to underscore challenges faced by BIPOC patients, such as delayed diagnosis, limited access to care, and poorer treatment outcomes. Such disparities are showcased in the prevalence of mental health conditions across various BIPOC populations.
According to research by the National Alliance on Mental Illness, approximately 20.9 percent of Black adults in the U.S. reported to have had a mental health condition in 2023. Additionally, research from the National Survey on Drug Use and Health shows that approximately 21.4 percent of Hispanic/Latino adults reported undergoing any mental health illness in the past year.
This highlights the need for awareness and culturally responsive care.
Among the BIPOC communities, mental health disparities are driven by different evidence-based factors that affect access to timely care, the recognition of symptoms, and treatment outcomes.
Hinderances to access, like provider shortages, insurance issues, and geographical limitations, can significantly lower the likelihood that these individuals receive mental health care when it is needed.
For instance, studies have shown that white adults who report fair or poor mental health have a higher likelihood of receiving mental health services compared to Black or Hispanic adults who have the same needs, showcasing inequalities in care utilization.
Research conducted by the National Institute of Mental Health in 2022 found that approximately 56.1 percent of white adults received mental health treatment in the previous year, compared to about 37.9 percent of Black adults, 39.6 percent Hispanic adults, and 36.1 percent of Asian adults.
Cultural stigma has been a persistent barrier over the years, as a sense of shame is attached to mental health issues in BIPOC communities. This leads to individuals shying away from seeking help as they fear being judged or embarrassed. Such stigma has contributed to lower rates of treatment initiation and sustained engagement with care.
There have been experiences of inequitable treatment in healthcare systems that have caused mistrust, discouraging the use of mental health services. Implicit bias and past mistreatment in clinical settings can contribute to individuals being reluctant to seek or continue with treatment.
Language barriers are a hindrance to effective communication between providers and patients, limiting accurate diagnosis and also culturally responsive treatment planning. In some cases, clinicians lack cultural competence, which compounds the barriers. This reduces the likelihood that they’ve fully understood symptoms or that they’ll properly address them.
Underdiagnosis and misdiagnosis can occur if culturally diverse expressions of symptoms are not fully recognized or are interpreted through bias, contributing to challenges in diagnosis and treatment planning.
Social health determinants like housing instability, socioeconomic status, education, and employment influence the risk of mental health problems and access to services. Systemic inequalities in those determinants can create systemic stress, elevating vulnerability to psychological distress among BIPOC communities.
Additionally, exposure to trauma, including experiences of systemic racism and discrimination, exacerbates challenges in mental health and contributes to disparities in both incidence and outcomes. Stress and trauma impact brain function and are often associated with a number of mental health symptoms. With such exposures, there is an increased risk of conditions such as depression, PTSD, anxiety, and other mental health disorders. It highlights the need for trauma-informed, culturally sensitive care.
Traditional mental health models have been playing an important role in the process of identifying and treating mental health concerns. That said, they have been facing limitations when trying to address the full complexity of mental health challenges across diverse populations.
Many approaches primarily depend on symptom-based diagnosis, usually without incorporating neurological or biological assessments that can help clarify the underlying contributors to mental health issues.
In some instances, healthcare providers put more emphasis on medication-first approaches. While medication can be of benefit, it may not fully account for differences in how an individual patient’s brain functions, their medical history, and their environmental stressors. Not having this kind of specific data can limit personalization of treatment.
Assessment tools that are commonly used can have limited cultural nuance, which may influence the identification and interpretation of symptoms across populations. Such issues reflect how complex BIPOC mental health care can be. They highlight the need for approaches that are more comprehensive and culturally informed.
A brain-based approach views mental health symptoms through the lens of brain function. It recognizes that symptoms are often influenced by the dysfunction of certain brain regions. Thus, mental health conditions are brain-based. They are not reflective of a flaw in the individual. When this is understood by the patient, stigma and shame are reduced.
A brain-based perspective recognizes that symptoms (like depression or anxiety, for example) can arise from different underlying brain blood flow and activity patterns. That means that two people with depression symptoms can actually have different underlying brain activity patterns, which explains why people may respond in different ways to the same treatment.
Additionally, the brain-based approach highlights the importance of identifying potential medical factors that can contribute to mental health symptoms like sleep apnea, thyroid imbalances, nutritional deficiencies, and prior brain injury. Such factors can complicate diagnosis and consequently affect treatment outcomes if left unaddressed.
Brain SPECT imaging at Amen Clinics helps to evaluate the patterns of blood flow and activity in a patient’s brain. Instead of replacing clinical assessment, SPECT imaging provides additional biological context to support more individualized treatment planning.
Clinicians examine how symptom clusters correspond with different patterns of the brain to understand why conditions like depression or anxiety can present in varied ways. The framework supports the belief that brain function can be targeted and improved, and personalized interventions can help improve outcomes with time.
For BIPOC individuals who have experienced some of these unique stressors, including generational trauma, a brain-based approach is even more critical. There’s evidence that suggests trauma may impact brain function with a distinct pattern.
Amen Clinics has conducted multiple brain SPECT imaging studies on individuals with a history of trauma, including a study published in PLOS One. SPECT scans consistently reveal heightened activity in the brain’s emotional centers, forming a distinctive “diamond” pattern.
The brain regions most commonly affected include:
Anterior cingulate gyrus: This is known as the brain’s “gear shifter.” It helps you transition from one thought to another. Overactivity in this area is associated with getting stuck on negative thoughts or behaviors.
Basal ganglia and amygdala: These areas play a central role in anxiety and fear. Overactivity here is associated with heightened tension, worry, and fearing the worst.
Thalamus: This area acts as a relay center, processing incoming sensory information. Overactivity can lead to increased sensitivity to your surroundings.
In some cases, the right lateral temporal lobe may also be overactive. This area of the brain helps interpret social cues and understand others’ intentions. When it is overactive, it can lead to misreading situations or assuming others have negative intent toward you.
When you are repeatedly exposed to race-related trauma and stress, it can impact your brain and drive mental health symptoms. Treatment methods focused on addressing trauma-related brain dysfunction can get to the heart of the problem and lead to better outcomes.
Related: How Can Stress Affect Your Mental Health: 9 Key Signs You Shouldn’t Ignore
Some of the mental health patients in the BIPOC communities experience ongoing stressors that may influence their brain function and emotional health over time. These types of experiences may vary from one individual to another.
This includes prolonged vigilance or economic strain. This kind of stress can keep your nervous system in a heightened state, contributing to mood symptoms, anxiety, and sleep disruptions.
If an individual’s stress response stays activated for a long time, it can affect the brain regions responsible for attention, emotional regulation, and impulse control. Sustained activation of the stress response can also disrupt the autonomic nervous system and cortisol balance.
RBTS or discrimination-related stress results from repeated instances of bias or exclusion. Even though race-based traumatic stress may not be classified as a mental illness, it is usually associated with trauma-like symptoms that can influence mental well-being.
Such experiences can contribute to emotional exhaustion, changes in stress reactivity, hypervigilance, and difficulty feeling safe in everyday environments.
Trauma is connected to historical inequities that may impact stress responses and coping patterns across generations. According to research, being exposed to prolonged or collective adversity could influence biological stress responses and learned coping behaviors in families. It has the potential to affect mental health vulnerability over time.
This can occur as individuals try to navigate pressures so that they can adapt to a dominant culture while they maintain their cultural identity.
In the long run, that ongoing balancing act can contribute to identity conflict, emotional strain, and heightened stress responses, especially when individuals feel like they are compelled to suppress various aspects of their cultural experiences or values to feel understood or accepted.
Although they may be subtle, microaggressions can accumulate with time and increase psychological strain. Repeated exposure to microaggressions can contribute to emotional fatigue, heightened stress reactivity, and persistent vigilance, which can eventually affect self-esteem, mood regulation, and overall mental well-being.
Exposure to community violence may be direct or indirect and can affect an individual’s perceived safety and ability to regulate stress in the long term. Continuous exposure, whether through community awareness or media, can reinforce heightened threat perception, strain the emotional regulation systems and disrupt sleep, especially if safe and consistent recovery environments are limited.
It’s important to note that while chronic stress can alter an individual’s nervous system functioning and brain health in measurable ways, the changes are treatable.
Accurate diagnosis plays a crucial role in facilitating appropriate mental health care for patients in the BIPOC communities. This is essential, especially in patients with complex symptoms that overlap across conditions.
Studies suggest that delayed diagnosis or misdiagnosis can contribute to treatment gaps even among individuals who are going through significant psychological distress.
The same research has additionally shown that misdiagnosis and underdiagnosis can affect BIPOC individuals who are struggling with mental health challenges by contributing to delays in providing the right kind of care and effective treatment planning.
Sometimes conditions like behavioral and psychotic disorders are overdiagnosed, while anxiety and mood disorders can be underrecognized, even if the symptoms are present.
Different cultures express distress differently. That includes the ways stress, emotional pain, and trauma are communicated. This can influence how clinicians in standard clinical settings interpret symptoms. The accuracy of diagnosis may be reduced if these differences are not fully considered.
To ensure accurate diagnosis and effective care, it is important for BIPOC patients to undergo more comprehensive evaluations that include more than recording symptomology.
At Amen Clinics, our comprehensive evaluation takes a whole-body approach. As described earlier, it includes a detailed medical history and consideration of biological contributors and lifestyle factors, plus clinical assessments, and diagnostics, if necessary. Additionally, Brain SPECT imaging at Amen Clinics adds objective data concerning how the brain functions.
SPECT measures blood flow and activity in the brain, Specifically, it reveals problematic areas of overactivity and underactivity, as well as areas of healthy function. For example, the trauma-associated “diamond brain” mentioned earlier shows a pattern of areas with overactivity. SPECT helps our clinicians practice precision medicine as they use the information it provides, plus other collected data, to carefully consider what is happening inside your brain.
The insights provide important clues, especially with complex cases and co-occurring mental health conditions with overlapping symptoms, to help determine the most accurate diagnoses and effective treatments. Our thorough approach can help reduce diagnostic uncertainty and support more precise care.
Our clinicians practice holistic psychiatry, crafting individualized treatment plans that use primarily natural ways to treat mental health conditions, plus lifestyle recommendations, different types of therapy (including somatic therapy and EMDR, which effectively treat trauma), and medication only when necessary.
BIPOC Mental Health Awareness Month creates an opportunity to bring needed attention to the persistent disparities in mental health care. It also emphasizes the importance of recognizing how cultural, biological, and social factors intersect when it comes to care.
Keeping the focus on brain health helps to reduce the mental health stigma that is so present among BIPOC communities.
Mental health care can be more effective if it is culturally informed, comprehensive, and tailored to an individual’s brain health. With personalized treatment and the right kind of support, it is possible to improve brain function and also witness meaningful progress in patients from BIPOC communities.
If you or your loved one is experiencing mental health struggles possibly linked to race-related stressors, it’s important to seek a thorough evaluation from a qualified mental health professional who is also skilled at diagnosing and treating the complex presentations common in BIPOC individuals.
BIPOC stands for Black, Indigenous, and people of color. In mental health contexts, the term is used to highlight communities that have historically experienced disparities in access to care, diagnosis, and culturally responsive treatment.
Observed every July, BIPOC Mental Health Awareness Month raises awareness about mental health challenges and care barriers affecting diverse communities. It also encourages conversations about access, stigma, culturally responsive care, and early evaluation.
Cultural background can shape how symptoms are expressed, how help is sought, and how treatment is received. Understanding cultural context can improve communication, trust, and treatment alignment.
Yes. Without culturally informed assessments, symptoms may be misunderstood or misinterpreted. Comprehensive evaluations that consider medical, psychological, and neurological factors may help reduce diagnostic errors.
Brain imaging, such as SPECT scans, evaluates patterns of blood flow and activity. While not used as a standalone diagnostic tool, it can provide additional information for more accurate diagnosis and personalized, brain-based treatment.
Stress, trauma, anxiety, and other mental health conditions can’t wait. At Amen Clinics, we practice precision medicine—using brain SPECT imaging and comprehensive evaluations to understand what’s really happening in your brain, not just your symptoms.
Our whole-body approach to holistic psychiatry combines cutting-edge neuroscience with natural ways to treat mental health conditions, including targeted nutrition, supplements, lifestyle strategies, therapy, and medications (when necessary). Every treatment plan is personalized to address the root causes of your struggles and support the health of your brain, body, and mind.
Don’t settle for guesswork. You deserve answers—and a plan built specifically for you. Speak with a Brain Health Advisor today at 888-288-9834 or visit our contact page to get started.
About the Reviewer
Dr. Larry Momaya is a board-certified adult psychiatrist and Fellow of the American Psychiatric Association. A UC Irvine College of Medicine graduate, he completed his psychiatry residency at UC Irvine in 2004 and has helped thousands of patients at Amen Clinics Orange Country Metro Area since then. He works with mood and anxiety disorders, ADHD, emotional overeating, addictions, relationship issues, and self-esteem concerns. Dr. Momaya uses an integrative approach that may include psychotherapy, hypnosis, visualization, spirituality, meditation, breathing techniques, and thought investigation to support mental wellness and personal empowerment.
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