Living Many Lives: Representing the Experiences of Black Women Living with Severe and Persistent Mental Illness

Rates of mental illness for African-American women in the U.S. are higher than average due to myriad environmental and psychological factors that are a direct result of being a black American. The U.S. Census Bureau (2007) reports the poverty rate at 26.3% for black women—more than twice that of white women. Prior research purports that black women do not receive adequate mental health care because they tend to minimize their illness (Walker, 2010). Few studies focus on the voice of the black woman living with a mental illness; literature suggests that, instead, professionals may assume they know the best interests of the black woman as patient-client (California Black Women's Health Project, 2002). This study uncovers answers to the questions: How do Black women with diagnoses of severe, chronic mental illness describe their experiences and mental health challenges? How do the women account for their life histories and mental health needs, and how do their interpretations compare to current research about others' experiences of mental illness as they vary with respect to race, class, and gender?

This phenomenological study includes 9 case studies; most averaged three hours. Participants were recruited through agency referral, flyers, and snowball sampling. Confidential individual interviews took place at settings of the women's choice (home or agency), with a semi-structured protocol based on life story interview techniques covering memories of all lived experiences from earliest to present. Interviews were taped and transcribed. The theoretical framework includes “representing the women as people, rather than as problems to be solved” and identifying illnesses as part of their stories, rather than barriers to “normality.” Feminist narrative analysis techniques promote holistic representation of participants' lives from their own standpoints (Smith, 1999). Combining life history techniques with feminist narrative analysis reflects the women's standpoints, and does not lead to particular findings or predetermined outcomes based on the researchers' frames of reference.

The interviews revealed that the women contextualize their illness as an important part of life shaping their activities, beliefs, and how others see them. Moreover, themes arose around the problems that others have with the women. These include discrimination and abuse from family members, acquaintances, employers, and strangers. Other major themes that emerged through the women's voices include desire for work, pursuit of education, religion and spirituality, desire for community, and the fundamental impact of race on their role in their own mental health treatment and their subjectivity as actors throughout their lived experiences.

Findings support the importance of black women as primary presenters and interpreters of representations of their life stories, accounting for their whole lives and everyday experiences. The study supports the notion that black women have different realities and needs than white women. The women challenge the idea that mental illness for black women is their “lot in life” or “cross to bear.” Practitioners can support efforts to alleviate damaging symptoms and work toward social change. The results can influence policy and practice, focusing on discrimination faced by black women with mental illness and promoting social inclusion.