When Asking for Help Becomes Dangerous: Mental Health Disparities in Black, Brown, and Indigenous Communities
May is Mental Health Awareness Month, and this year, we want to shine a light on a crisis hiding in plain sight. Even here in Colorado.
We talk a lot about "getting help" when it comes to mental health. But for millions of Black, Brown, and Indigenous people in America (including right here in Boulder County), getting help isn't always simple. And in some cases, it can be life-threatening.
The gap is real, and it isn’t an accident.
Mental health disparities in Black, Indigenous, and People of Color (BIPOC) communities don't happen by chance. They are the predictable result of centuries of systemic racism: policies, institutions, and structures that have deliberately limited access to wealth, housing, education, and healthcare for non-white communities. Both the National Alliance on Mental Illness (NAMI) and the CDC have formally declared racism a public health crisis.1
The numbers reflect this. Research shows that 24% of people who regularly experience discrimination show significantly higher levels of depression, anxiety, and perceived stress.2 Black youth and adults face a scientifically established link between racism exposure and increased rates of depression, anxiety, substance use, and suicide, not by coincidence, but as direct cause and effect.3
For Indigenous people, the burden is especially severe. The Indian Health Service reports that American Indian and Alaska Native people experience serious psychological distress at 2.5 times the rate of the general population and have the highest suicide rate of any minority group in the U.S.4 These are not cultural failings, they are the documented consequences of genocide, forced displacement, land theft, the destruction of language and culture, and intergenerational trauma that was, by design, never allowed to heal. Indigenous women experience postpartum depression at 87% higher rates than white women.5 This is what structural racism does to communities across generations.
Women of Color Carry a Double Burden, and Remain Understudied
Women of color face mental health challenges at the intersection of racism and sexism (what researchers call gendered racism), yet remain critically underrepresented in clinical research. A rigorous review in Fertility and Sterility found almost no systematic data on how anxiety or premenstrual disorders affect women of color differently.6 We don't know what we don't measure, and for decades, women of color haven't been measured.
What we do know is alarming. Despite being at elevated risk, women of color seek mental health care at less than half the rate of white women (5–10% compared to 21.5%).7 Black women are specifically less likely to seek care for postpartum depression, out of a well-founded fear that showing vulnerability could result in their children being taken by the state.8 That isn't paranoia, it is a rational response to a system with a long history of surveilling and punishing Black motherhood.
There is also the weight of the "Strong Black Woman" stereotype, a cultural narrative demanding Black women suppress emotions and project strength at all costs. Research confirms this schema is not empowerment but a documented barrier to care, directly linked to higher depressive symptoms and reluctance to seek help.9 Being called "strong" while suffering is not a compliment. It is a form of erasure rooted in individual and systemic racism.
Latina women face their own compounding barriers: language access, immigration-related fear, lack of culturally competent providers, and uninsurance rates nearly three times those of white women. Hispanic women who are uninsured access mental health care at 70% lower rates than uninsured white women.10
Queer Women of Color: Invisibility Within Invisibility
The data gap deepens for queer and transgender women of color. Research shows that queer people of color (QTBIPOC) face worse mental health outcomes than both white queer people and heterosexual people of color (the most underserved intersection of multiple systems of oppression), and yet they are the least likely to be studied or diagnosed.11
More than one in four LGBTQ+ adults of color have no health insurance, compared to 8% of the general adult population. Only 29% report being diagnosed with a depressive disorder, compared to 39% of LGBTQ+ adults broadly.12 A 2024 survey found LGBTQ+ women experience depression and anxiety at two to three times the rate of the general population, and that LGBTQ+ women of color were twice as likely to report lacking access to quality health care compared to white LGBTQ+ women.13 Transgender women of color face compounding violence: they make up the majority of transgender murder victims in the United States.14 These realities are not random, they are the product of a healthcare system built around white, cisgender, heterosexual bodies.
Colorado Is Not Exempt
A Colorado Health Foundation report found that fewer Black and Hispanic Coloradans receive behavioral health support compared to white Coloradans, even when controlling for need.15 Nationally, 80.9% of mental health professionals identify as white, making
culturally competent care hard to find for BIPOC Coloradans who already navigate deep, justified distrust of systems that have historically harmed them.16
Right here in Boulder, stops by police result in arrest twice as often for Black residents as for non-Hispanic white residents.17 Boulder Police Chief Steve Redfearn has publicly acknowledged that the city's lack of mental health and addiction treatment is directly fueling police use-of-force incidents, meaning the system fails people before they encounter law enforcement, then sends officers to handle crises they were never trained to resolve.18
When a Mental Health Crisis Meets a Police Response
For many BIPOC individuals in mental health crisis, a 911 call can escalate into violence or death. People with serious mental illness are more than 11 times more likely to experience police use of force.19 With an untreated mental illness, you are 16 times more likely to be killed by police.20 When individual racism (an officer's bias) combines with systemic racism (defunded mental health infrastructure and no alternative crisis response), the results are fatal.
Monte Cullors, the brother of BLM co-founder Patrisse Cullors, has lived with schizoaffective disorder since his teens. First beaten by LA Sheriff's deputies at a detention center before receiving any mental health care, he spent decades cycling through incarceration and inadequate treatment. Patrisse spent over 20 years publicly demanding her brother be treated rather than caged, writing that police contact "only exacerbates his state of crisis, further triggering his post-traumatic stress."21 His story reflects a brutal truth: for Black men with mental illness, jail cells are far more accessible than hospital beds. Some 350,000 adults with serious mental illness sit in U.S. jails and prisons on any given day instead of receiving treatment.20
Ezell Ford, a 25-year-old Black man with schizophrenia in Los Angeles, was shot in the back by LAPD in 2014. His community knew him. The police knew his diagnosis. None of it mattered.20
Paul Glass, a man in mental health crisis in Clear Creek County, Colorado, called 911 for help in 2022 and was shot by a deputy. A grand jury found officers needlessly escalated the standoff. His family received a $19 million settlement (the largest for a police killing in Colorado).22 It happened right here, and it is a reminder that the failures of our mental health and policing systems harm people across racial lines, but land hardest on those where racial bias compounds every other risk.
Naming What This Is, and What We Can Do
Systemic racism is why mental health services are underfunded in communities of color, why Indigenous communities lack culturally grounded care, why BIPOC neighborhoods are over-policed and under-resourced. Individual racism is why a neighbor calls 911 on a Black man walking home. Both forces compound daily for BIPOC communities, especially women, queer people, and those holding multiple marginalized identities.
Here in Boulder County, we can push back:
· Know the alternatives. Support expansion of Boulder's CIRT co-responder program and advocate for fully unarmed community crisis teams.
· Seek and fund culturally responsive care. The Loveland Foundation offers subsidized therapy for Black women and girls. The National Queer and Trans Therapists of Color Network (NQTTCN) serves queer and trans BIPOC people. The Inclusive Therapists directory includes Colorado providers.
· Support Indigenous-led healing. Organizations like the Native American Rights Fund and IllumiNative address root causes. Amplify Indigenous voices.
· Advocate for data. Push local officials to collect disaggregated race and gender data in all health and policing systems, because we cannot fix what we refuse to measure.
· Show up for each other. Community care is mental healthcare. It always has been.
This Mental Health Month, let's be honest about who gets to safely ask for help, and let's fight, together, for a world where the answer is everyone.
By Mylène Vialard
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In crisis? Call or text 988 (available in Spanish). BIPOC crisis support: BlackLine 1-800-604-5841. LGBTQ+ support: Trans Lifeline 877-565-8860. Boulder County resources: boco.org/mentalhealth.
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References
1. National Alliance on Mental Illness (NAMI) & CDC declaration on racism as a public health crisis. pathlightbh.com/resources/bipoc-mental-health-facts-statistics
2. Tava Health — Mental Health in Black, Indigenous, and People of Color (BIPOC) Communities (July 2024). tavahealth.com/resources/mental-health-bipoc-communities
3. Howard University / Thurgood Marshall Center — Police Violence, Mental Health, and Black Communities. thurgoodmarshallcenter.howard.edu
4. Indian Health Service — Behavioral Health Fact Sheet. ihs.gov/newsroom/factsheets/behavioralhealth/
5. PMC (2024) — Indigenous women's mental health across the life course: a global policy brief for rights-based, culturally safe care. pmc.ncbi.nlm.nih.gov/articles/PMC12847398/
6. Phimphasone-Brady et al. (2023) — Racial and ethnic disparities in women's mental health: a narrative synthesis of systematic reviews and meta-analyses of US-based samples. Fertility and Sterility, 119:364–74. pmc.ncbi.nlm.nih.gov/articles/PMC10754063/
7. Psychiatric Times — Mental Health Care for Women of Color: Risk Factors, Barriers, and Clinical Recommendations. psychiatrictimes.com/view/mental-health-care-for-women-of-color-risk-factors-barriers-and-clinical-recommendations
8. Journalist's Resource — Racial disparities in mental health care: An explainer and research roundup (September 2024). journalistsresource.org/home/racial-disparities-mental-health/
9. Springer Nature / Sex Roles (2026) — Gendered Racism and Mental Health: A Test of the Mediating and Moderating Role of the Superwoman/Strong Black Woman Schema and John Henryism. link.springer.com/article/10.1007/s11199-026-01640-7
10. PMC — Intersectional disparities in mental healthcare utilization by sex and race/ethnicity among US adults: An NHANES study. pmc.ncbi.nlm.nih.gov/articles/PMC12517490/
11. Journal of the Society for Social Work and Research (2022) — Experiences of Queer People of Color in Mental Health Care and Substance Use Treatment: A Systematic Review. journals.uchicago.edu/doi/10.1086/721454
12. Human Rights Campaign — QTBIPOC Mental Health and Well-Being. hrc.org/resources/qtbipoc-mental-health-and-well-being
13. NPR / Shots Health News — LGBTQ+ women face high rates of trauma, other mental health issues, report finds (October 2024). npr.org/sections/shots-health-news/2024/10/08/nx-s1-5131619/lgbtq-women-mental-health-care
14. Pathlight Mood & Anxiety Center — BIPOC Mental Health Facts & Statistics. pathlightbh.com/resources/bipoc-mental-health-facts-statistics
15. Colorado Health Foundation — New Report Reveals Stark Disparities in Mental Health. coloradohealth.org/articles/news-release/new-report-reveals-stark-disparities-mental-health
16. Colorado Access (January 2025) — In an Effort to Reduce Stigma, Community Groups Partner with Colorado Access to Improve BIPOC Mental Health Access. coaccess.com/news/bipocmentalhealth/
17. YWCA Boulder County — Racial Justice Resources (citing KUNC, May 2019). ywcaboulder.org/what-were-doing/racial-justice-resources/
18. Boulder Reporting Lab (March 2025) — Boulder police chief links use-of-force incidents to untreated mental illness, addiction. boulderreportinglab.org/2025/03/18/boulder-police-chief-links-use-of-force-incidents-to-untreated-mental-illness-addiction/
19. NIH / BMC Psychiatry (2021) — Measuring disparities in police use of force and injury among persons with serious mental illness. ncbi.nlm.nih.gov/pmc/articles/PMC8513301/
20. Mic / Patrisse Cullors (October 2019) — Black Lives Matter's Patrisse Cullors on the criminalization of mental illness. mic.com/life/black-lives-matters-patrisse-cullors-on-the-criminalization-of-mental-illness-19209822
21. BET (November 2019) — Patrisse Cullors: An Open Letter to LA County Officials on Behalf of My Missing Brother. bet.com/article/malmkc/patrisse-cullors-an-open-letter-on-behalf-of-my-brother
22. PBS NewsHour (May 2023) — Family of Colorado man killed by police during mental health crisis gets $19 million settlement. pbs.org/newshour/nation/family-of-colorado-man-killed-by-police-during-mental-health-crisis-gets-19-million-settlement