The Hogg Foundation for Mental Health Declaration of Racism as a Mental Health Crisis

October 2020

The COVID-19 pandemic and the economic recession have hit communities of color the hardest. The murders of George Floyd, Breonna Taylor, Ahmaud Arbery, and numerous other BIPOC (Black, indigenous and people of color) Americans in 2020 has sparked a global outcry against racism and police brutality. This long-standing history of violence against communities of color, including the high-profile murders of Black trans women, has led local and state leaders across the country to declare racism a public health crisis or emergency. Declarations like this are an important first step toward racial equity and justice. The Hogg Foundation for Mental Health declares that not only is racism a public health crisis, but it is also a mental health crisis, and it is about time we named it.

To make a declaration like this is to wield a power and a privilege that few possess. Those who are positioned to declare racism as a crisis – city councils, hospitals, school districts, medical journals, professional networks, universities  – are positioned to do so because they have been historically complicit in perpetuating the racism crisis in the first place. It is thus our responsibility to use our voices to call out these wrongs and start correcting them as institutions, communities, and individuals.

This declaration exposes nothing new or previously unknown. On the contrary, racism as a mental health issue has been well-documented, and the extent of its impact is far reaching. Racism is a mental health issue because racism causes trauma. Racial trauma accumulates throughout a person’s life, leading to activation of stress responses and hormonal adaptations, increasing the risk of non-communicable diseases and biological ageing. This trauma is also transmitted intergenerationally and affects the offspring of those initially affected through complex biopsychosocial pathways.

People of color in Texas are more likely to be uninsured than White Texans, which limits their access to mental health services. BIPOC are also less likely to seek out treatment and more likely to end treatment prematurely. This is largely a result of financial and healthcare restraints caused by systemic racial oppression, long-held stigmas against seeking help within the community, and the inability of some healthcare providers to establish themselves as credible and reliable sources of support. Current data indicates that suicide is among the leading causes of death for BIPOC youth. Additionally, given our knowledge of Adverse Childhood Experiences (ACEs), the impact of racism increases the risk of health and social problems across the lifespan. Young people of color with behavioral health issues are more readily referred to the juvenile justice system than to specialty primary care, compared with White youth. Encounters with the police for young persons of color can cause serious psychological harm, and can even have spillover effects on the mental health of people not directly involved.

With so much evidence supporting the reality of this crisis, it is incredible that it has taken all of us until now to name it. Still, the power of explicitly naming a crisis, especially in public health literature, should not be understated. It lays a foundation for future researchers studying inequities, and it validates the threat racism poses to society by equating it with other threats to public health and mental health, like the opioid crisis, foodborne outbreaks, and the COVID-19 pandemic. As a mental health community, we must do more than name these threats in silos – we must act to dismantle the systems that perpetuate these crises and rebuild our systems of care in ways that seek to undo historic injustices and inequities. Here are some key first steps:

• The establishment of an Office of Health Equity, within the Texas Health and Human Services Commission, would be an initial step towards addressing mental health and racial disparities in Texas.
• The Hogg Foundation will use this declaration of racism to guide our mental health policy priorities going forward, which will identify ways to undo the institutional racism embedded into existing policy structures. We encourage those who co-sign this letter to follow suit.
• By more effectively addressing mental health in schools, we can close off the “school-to-prison pipeline” that is a significant driver of racial disparities.
• We should be looking to incorporate mental health supports in all of the places where BIPOC live, learn, work, play and pray—these include coffee shops, barbershops, gyms, parks, schools, places of worship, and workplaces.
• Behavioral health professionals should take it upon themselves to learn about historical and cultural trauma and the impact legacies of oppression have on the present-day mental health of BIPOC.

Someday, the pandemic and the recession will be over. When will we be able to declare the same about the racism crisis, and its threat to mental health? It is our responsibility to envision this future and work towards it – a future in which all people can thrive in communities that support mental health and well-being.

Regards,

Octavio N. Martinez, Jr., M.D., M.P.H.
Executive Director, Hogg Foundation for Mental Health

To learn more about the core values of the Hogg Foundation, visit our Vision, Mission, and Values page. 

List of Co-Signing Organizations

Mia Roldan Austin Therapy PLLC
Mindful Philanthropy
MindLinx
Momentum Behavioral Health Concepts
Morris County Collaboration
Mufasa’s Pride Rites of Passage
Multicultural Recovery Center Inc
NAMI Central Texas
NAMI Greater Corpus Christi
National Alliance on Mental Illness (NAMI) Texas
National Association for Rural Mental Health
National Association of County Behavioral Health and Developmental Disability Directors
National Association of Social Workers – Texas Chapter
National Council for Behavioral Health
National Latino Behavioral Health Association
National Network of Intercessory Pray-ers
Nature and Eclectic Outdoors
New Hope Housing, Inc.
New Mount Rose Missionary Baptist Church
Nia Cultural Center
North East Regional Employment and Training Association
Nueces County Mental Health Programs
Nue Prophetz Society
Ola Wellness
Olive Branch – Muslim Family Services
OneSeventeen Media, PBC
OTA The Koomar Center
Pam C. Lyons, PLLC
People’s Community Clinic
Prelude Clubhouse
Presence Wellness
Prevention Institute
Professional Counseling Program at Texas State University
Project GRAD Houston
Project MALES/Texas Education Consortium at The University of Texas at Austin
Prosumers International
Psychiatric Advanced Practice Nurses of Austin (PAPNA)
Pyramid Consulation Services
Quality Systems Consulting
Real Urban Counselors
RecoveryPeople
Religious Sisters of Mercy
Samaritan Center for Counseling and Pastoral Care, Inc.
San Antonio Clubhouse
Sandra K Wilson ACSW, LCSW
Satcher Health Leadership Institute
Serendipity Alliance Healthcare Consultants
Serenity Solutions, LLC
Set Supper Club
Shared Vision Psychological Services, Inc.
Shurrun’s House Sober Living
SIMS Foundation
Skillful Living Center, Inc.
Social Responsibility Corporation
South Asian International Volunteer Association
Spirit Reins
STARRY
Superior Health Plan
Synergy Counseling & Coaching Center
TAN Healthcare
Teens Grounded Inc.
Texans Care for Children
Texas A&M University-Kingsville
Texas After Violence Project
Texas Appleseed
Texas Council of Community Centers
Texas Counseling Association
Texas Criminal Justice Coalition
Texas Familias Council
Texas Institute for Excellence in Mental Health
Texas Jail Project
Texas Network of Youth Services
Texas Pediatric Society, the Texas Chapter of the AAP
Texas Psychological Association
Texas Society for Clinical Social Work
The ACEs to Assets Collaborative
The Arc of Texas
The Austin Center for Grief & Loss
The Center for Relationships
The Center For True Self
The Future is US
The Head Of A Pin C.I.C
The K16 Ready Society, Inc. d.b.a. Texas Initiative Programs, Inc.
The SAFE Alliance
The Walk for Mental Health Awareness – Houston
Therapy Place Services LLC
Third Coast Research & Development, Inc
Transitions and Decisions
Travis County Child Welfare Race Equity Collaborative
Trust for America’s Health
University of Texas at Arlington School of Social Work
University of Houston Graduate College of Social Work
University of Texas Health Science Center
University of Texas Rio Grande Valley
University of Texas Social Resource Center
Unlimited Visions Behavioral Health Institute
Urban Affairs
Valeria E. Milstead-Benabdallah, LCSW, PC dba VEMB Psychotherapy Services
VASA (Voices Against Substance Abuse) Coalition a program of VOICE
Vaughngage Healthy Aging Center
Via Hope
WhatsintheMirror?
Williamson County and Cities Health District
Wisdom En Familias  LLC
WMS and Associates LLC
Workers Assistance Program, Inc.
Yashael Consulting Inc
YMCA of Metropolitan Dallas
Young Invincibles
YWCA Greater Austin