Many Caribbean immigrants in particular first generation immigrants are very wary of going to see a mental health professional.  Problems are usually handled at home and many families have someone in their family who is mentally ill but has never gotten treatment and is often whispered about by others in the family and community.  Many immigrants are also very religious and feel that by going to church and praying  will make everything better.  Many Caribbean immigrants also believe that admitting to being depressed or anxious is a moral failing and won’t seek out help and will try to feel better on their own.   Many also wonder if a clinician who does not share their background will be able to understand their background and some beliefs such as “obeah” which is a form of voodoo practiced or believed in by some members of the Black Caribbean community.

Faith, Spirituality And Community

In the West Indian community, family, community and spiritual beliefs are often  great sources of strength and support.  Many West Indians  rely on faith, family and social communities for emotional support rather than turning to health care professionals.

While faith communities can be helpful at times they can be a source of distress and stigma if they are misinformed about mental health or do not know how to support families dealing with these conditions.

Reluctance And Inability To Access Mental Health Services

Less than 30% of West Indians  seek mental health care during their lives. Here are some reasons why:

• Distrust and misdiagnosis. Historically, African Americans and West Indians  have been and continue to be negatively affected by prejudice and discrimination in the health care system. Misdiagnoses, inadequate treatment and lack of cultural competence by health professionals often causes distrust and prevent many people  from seeking or staying in treatment.
• Lack of  West Indian mental health professionals.   Unfortunately there is a lack of mental health professionals who are from the West Indian or Caribbean community.  Many immigrants feel more comfortable and relate better to people who they perceive as being more familiar with their culture.

Provider Bias And Inequality Of Care

Conscious or unconscious bias from providers and lack of cultural competence result in misdiagnosis and poorer quality of care for African Americans and West Indians. .

West Indians, particularly women, are more likely to experience and mention physical symptoms related to mental health problems. For example,  describing  bodily aches and pains when talking about depression. A health care provider who is not culturally competent might not recognize these as symptoms of a mental health condition. Additionally, men are more likely to receive a misdiagnosis of schizophrenia when expressing symptoms related to mood disorders or PTSD.

Given this bias and the negative impact they have on your care, it is easy to understand why so many people  mistrust health professionals in general and avoid accessing care. While there may be reason to doubt whether professionals will mistreat you or not, don’t let this fear prevent you from seeking care..

Finding The Right Provider

For West Indian and Caribbean people it will be important to find someone whom they feel is culturally competent and understands them.  The therapist doesn’t have to be West Indian but should be someone who understands or is willing to learn the nuances of Caribbean culture.   When meeting with a  provider, ask questions to get a sense of their level of cultural sensitivity. Do not feel bad about asking questions. Providers should expect and welcome questions from their clients  since this helps them better understand you and what is important to you.  If a provider seems put off by being asked questions, they may not be the right provider.  Remember if you need help it’s ok to seek it and don’t feel ashamed about seeing a therapist.