For the longest time, white women were the face of mental health struggles even though they're the demographic most likely to talk about their feelings and seek help. But compared with the general population, black men and women in the US are 20 percent more likely to suffer from mental health issues at some point in their lives. Elsewhere, around 15 percent of the Latino and Hispanic population and 13 percent of Asian Americans and Pacific Islanders had diagnosable mental health problems in the previous year, according to 2016 data from the US Department of Health and Human Services' Office of Minority Health.

Cultural barriers and poor socioeconomic status make it harder for people from communities of color to seek help. Mental health issues come with a stigma and are often seen as weakness or simply “white people problems.” To make matters worse, there’s also a general shortage of mental health providers and even fewer therapists from minority backgrounds. This creates another barrier for people of color who might prefer to talk to a therapist they can identify with.

And while white men enjoy privileges relating to race and gender, middle-aged white men are the demographic with the highest suicide rate in the US, with white males accounting for nearly 70 percent of all US suicides in 2017, proving that mental illness does not discriminate.

Eben Louw is a Berlin-based therapist who works with black and ethnic minority clients and specializes in the detrimental effects that racism and other forms of discrimination have on mental health.

“Both men and women from racial minority groups feel the pressure of having to outperform their white counterparts,” Louw says. “However, the tendency to hide weaknesses is higher among men of color than it is among women of color. Black men and men of color have issues with shame when it comes to describing feelings, emotions, or even adversities they have encountered.”

In recent years, however, there has been a noticeable shift toward more open discussion about mental health issues. That shift has had a ripple effect across all demographics and given more people the confidence to open up about their own mental health problems.

This is true in all areas of pop culture, including hip-hop. The genre has arguably been detrimental at times to African American mental health due to its focus on so-called “champagne therapy.” The sex, drugs, alcohol, and material consumption in hip-hop glamorize unhealthy coping mechanisms for coping with traumatic experiences rather than actually dealing with them.

That said, for many rappers and fans, the music itself is therapeutic. Putting trauma into rhymes is a way for black people to deal with pain, fear, and anger. Rap lyrics also shed light on the harsh living conditions many communities of color still face today.

When Grandmaster Flash and the Furious Five released “The Message” in 1982, the words described social inequality, injustice, and a sense of frustration still prevalent in communities the rest of US society seems willing to forget. In “Mind Playing Tricks on Me” in 1991, Geto Boys rapped about how street life and drug use can lead to paranoia, depression, and suicide. And “Suicidal Thoughts” from Notorious B.I.G.'s 1994 debut album Ready to Die ended with him taking his own life.

These lyrics were full of hints, but it took rappers a while to really open up about mental health issues. Years before Kanye West put the words “I hate being bipolar, it’s awesome” on the ye album artwork, he admitted to having dealt with depression and suicidal thoughts. Many applauded West for going public about his mental health, but others argued that calling his bipolar disorder a “superpower” on “Yikes” would discourage people with the condition from seeking the help they needed.

In a 2013 interview, Kid Cudi spoke about his antidepressant medication, emotional breakdown, and seeking therapy. Back then, this was seen as revolutionary, but it wasn’t long until other rappers followed suit.

In 2015, Tyler, the Creator discussed having had a mental breakdown, while Stormzy opened up about his battle with depression in a television interview in 2017. In 2018, in a CNN interview with Van Jones, JAY-Z talked about the stigma attached to mental health among African Americans. The candid way he talked about dealing with trauma and PTSD by seeking therapy had a huge impact. On The Breakfast Club a few months later, Meek Mill compared the trauma from his time on the streets to a soldier experiencing PTSD, something he referenced in the track "Trauma."

And rappers are opening up in other ways. Kid Cudi and Kanye West’s self-titled Kids See Ghosts album reflected on mental illness, introspection, and moving past one’s demons. Big Sean talked about his battle with anxiety and depression in a series of Instagram posts shared on his 30th birthday. Likewise, Diddy grieved over the loss of Kim Porter, the mother of his children, on Instagram and in the media.

Diddy has become an advocate for addressing depression and other mental health issues. He is a great example of dealing with problems in a healthy way, even if that means being vulnerable and talking about having a three-hour-long cry. His self-care moments are priceless and spread the message that bottling up emotions doesn't help anyone.

After Logic performed “1-800-273-8255,” a track whose title is the number of the National Suicide Prevention Lifeline, at the 2017 MTV VMAs, calls to the organization went up by 50 percent. They tripled after he performed the song at the 2018 Grammys. The song's video, which stars Don Cheadle and Luiz Guzmán, among others, is reminiscent of Moonlight, the Oscar-winning coming-of-age drama in which a young black man suppresses his sexual identity and deals with the damaging consequences of toxic masculinity.

“I have noticed a shift, in that a lot more people of color seek psychotherapy than in the past and their decisions are far less motivated by a current crisis,” says Louw. “A great number of the cases I received were from people who became aware of the role of their own mental health in the struggle for racial equality. Empowerment programs and anti-discrimination awareness events have also sensitized people of color to their basic human rights, which includes the right to health. This made some of my clients more aware that they are entitled to mental health and a better quality of life.”

All of this shows how rap has made a difference, not just among black people, but across society. “It makes it easier for all kinds of other people to see themselves in that situation, rather than do what those artists have talked about on records previously, when seeking out help was perceived to be sort of the ‘weaker’ route,” says A.D. Carson, professor of hip-hop and the global south at the University of Virginia. “To hear your favorite rapper talking about getting treatment, I think it definitely does change how you have that conversation.”

If you or someone you know is having suicidal thoughts, there are resources to help you. The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones. You can call directly at 1-800-273-8255. In the UK, you can contact Samaritans on 116-123.

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