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A Call to Action: Higher Education Must Implement Culturally Responsive Mental Health Practices

By Tanya J. Middleton, Donna Y. Ford & Emeka Obinnakwelu Jr. 


As Black educators, we are constantly mindful of the quality of lived experiences in the academy, mainly predominantly white Institutions (PWIs) for minoritized students. A working paper recently published by the National Bureau of Economic Research reported that PWIs can learn how to better support Black students by implementing best practices from historically Black colleges and universities (HBCUs). The paper cites a 2021 study that found that graduation rates for Black students at HBCUs are 32% compared to 44% for Black students at other institutions. Context is important - when HBCUs are compared to similar institutions—taking into account factors like size, selectivity, finances and the socioeconomic demographics of students—Black students at HBCUs were 33% more likely to graduate than Black students at similar non-HBCUs. Students attending HBCUs are noted for having better academic performance, greater social involvement, and higher levels of thriving and being prepared for life after college.

There are unprecedented rates of anxiety and depression for college students. A recent U.S. News survey revealed that 70% of 3,649 students struggled with mental health since starting college. Mental health is synonymous with psychological wellness, a multidimensional construct involving satisfaction and balance among mind, body, and spirit (Myers & Sweeney, 2005). Achieving and maintaining a healthy balance between physical, emotional, and social functioning is critical for psychological wellness and optimal academic performance in higher education. This is particularly true for racially minoritized students, who, unlike their white racial counterparts, must deal with academic pressures while navigating through systems (e.g., predominately white institutions) known to facilitate discrimination, isolation, and marginalization.

For racially minoritized students, race and cultural values are known predictors of psychological wellness (Uchida et al., 2014). Those with high racial pride, values, and esteem are more likely to overcome associated stressors and lean into their racial identity as a tool to overcome negative encounters. However, frequent exposure to discrimination and racism littered through PWIs can profoundly hinder well-being over time. Such inhospitable conditions also increase physiological symptoms (i.e., high blood pressure, fatigue, and headaches), subsequently, impacting educational success and positive health outcomes for racially minoritized students (Smith et al., 2020). Given the circumstances, it is not surprising that racially minoritized students experience mental health symptoms at higher rates than white students (Lipson, 2022). Unwelcoming and non-supportive environments exacerbate symptoms and lead to underachievement, low self-esteem, and a sense of worth (Ford & Moore, 2004). The unfortunate reality is that, despite the need, racially minoritized students are less likely to seek mental health treatment or support, thus leading to maladaptive coping patterns.

We maintain that culturally responsive protective factors and interventions are necessary to support the academic achievement and psychological wellness of racially minoritized students in higher education. Below, we review stressors faced by this population while offering strategies and protective factors to enhance their academic development and personal wellness.

Sense of Belonging/Acceptance

Racially minoritized students who attend PWIs often report feelings of isolation, marginalization, lack of support, and exclusion from faculty and peers. Additionally, those who perform well and are associated with white peers may experience criticism from same race/ethnic peers who accuse them of “acting white” – a notion that we understand but completely reject.

These students benefit from intentional practices to develop a community on campus and improve their sense of belonging. One example is consistent support groups (weekly) for minority students led by student leaders identifying as racial/ethnic minorities. Sessions can focus on racial/ethnic minority development and cultural pride activities (e.g., Kwanza celebrations, minority health month, healing circles). Additional mentorship efforts can include pairing students with mentors of the same sex, race, or ethnicity who regularly meet with to provide support/guidance and modeling.

Religion has also been identified as providing encouragement, enhancing faith, and guidance from a collectivistic approach. For example, as a staple in the community, the Black church can collaborate with college campuses or minority student organizations to implement spiritual wellness, a component of psychological health for racially minoritized populations, cited as being helpful. On-campus worship, outreach efforts, and networking to improve the accessibility of services for those lacking transportation or carpools to assist with attending in-person services can be helpful.

Mental Health Issues

As stated, racially minoritized students may suffer from mental health concerns due to various issues but fail to seek treatment. While there have been improvements in on-campus counseling services, many lack the resources to meet the growing demand (Watkins et al., 2011).  College counseling centers are typically staffed by counselors not representative of the minority student’s racial/ethnic makeup and interns who lack the experience to apply culturally relevant interventions.

Strategies for improving engagement may include hiring more counselors of color to strengthen rapport and trust. Also necessary is training white providers to be culturally responsive and avoid both minimizing culture and engaging in implicit bias. Counseling centers should also consider creative and culturally responsive methods rather than traditional treatment and theoretical orientations grounded in white hegemonic principles. This may include implementing culturally appropriate modalities, such as Afrocentric or Narrative Therapy. Holistic perspectives integrating mind, body, and spirit, such as medication, yoga, or exercise, can also engage more students of color as this nontraditional approach can incorporate creativity. Dance (e.g., Korean pop, salsa, Western African tradition) and rhythmic exercises have also successfully limited mental health symptoms (Conner et al., 2021). Healing circles to aid in dealing with racism and discrimination may also provide an opportunity for collective engagement.

Mental Health Stigma

Racially minoritized students who already face discrimination and isolation on campus may not feel safe and want to attend mental health counseling from professionals who more than likely represent racially based agents that have impeded success. Many are likely to believe that mental health is a sign of personal weakness, and to experience shame when they suffer from mental concerns. Black women, for example, may ascribe to the “Superwoman Schema” and prioritize caregiving and being supportive toward others while suppressing their own needs (Woods-Giscombe et al., 2020). Black men may accept toxic masculinity connotations and feel that disclosing their emotions and admitting a need for help is viewed as diminishing their manhood and sense of pride.

Strategies for overcoming stigma can include intentional efforts to dispel mental health myths, for example, Black people not going to therapy due to being weak or having to be strong and resilient. Other efforts include counselors of color in conversations on campus about mental health, such as the Hutchinson Center for African & American Research, to provide clarity and examine potential solutions to improve engagement.

Social Determinants of Health

The World Health Organization (WHO) defines social determinants of health (SDOH) as conditions in the places where people live, learn, work, and play that impact positive health outcomes (WHO, 2008). Studies have recognized how these conditions lead to racial/ethnic health disparities, higher rates of obesity and behavior concerns, poor cardiovascular health, and lower rates of quality of life (Monroe et al., 2023). For college students, the most likely SDOH were food insecurity, transportation, safety, social support, and housing (Nazmi et al., 2018). Studies have linked SDOH to poor mental health and academic outcomes (Johnson, 2021).

For racially minoritized students, these factors must also be considered, given the likelihood that they may struggle with financial concerns and associated risks. Food insecurities impact mental health and psychological wellness; therefore, it is essential to ensure that racially minoritized students have an adequate food supply and education about healthy options. For example, collaboration with social service agencies can assist with enrolling in federal food assistance programs and offering free nutritional classes that guide budgeting and meal preparation for those residing on and off campus (Becerra & Becerra, 2020). Other ideas can include teaming with local food banks or churches to donate care packages to support students. There is room for collective work and mutual relationships if campuses have agriculture and food departments.           

Due to social inequities, racially minoritized students are at higher risks for social determinants of health and financial constraints faced at home. Therefore, it is likely that many students arrive on campus without transportation, such as a car. This may make accessing support like food banks or religious services difficult. Arrangements can be made within the community or minority student organizations to create communication channels for carpools or shared rides.

Additionally, methods for improving safety may include official or unofficial support systems for walking to and from classes and events in the greater community where they are likely to be in the minority. Advocacy groups that are active and concentrated on minority rights may also improve safety and security in environments with systemic barriers and biased policies.

Academic Pressure           

Racially minoritized students may need help with the academic demands of attending PWIs. Past studies have reviewed the lack of college preparation and readiness encountered in high school, which can impede academic success. Attempts to fit in and succeed in white spaces while also facing denigration from same-race peers can be taxing on self-esteem and scholarly identity.           

Positive associations with fraternities or sororities, racially minoritized alumni, fellow students, and faculty of color who can continue to instill racial pride can support racially minoritized student development. Having mentors in the same or varying fields of study can demonstrate the benefits of academic success while mitigating the negative messages from external factors that may be internalized, contributing to dissonance. Support networks and guidance may also decrease isolation while providing information about resources, such as financial scholarships and internship or employment opportunities, often kept from students of color. Such groups can also offer tutoring and study sessions for finals or exam preparation. Additional efforts may include first-year experience programming that can develop pathways toward success.

A Final Word           

To support the academic success and psychological wellness of racially minoritized students, culturally responsive interventions are necessary.  We urge higher education institutions to prioritize culture when implementing mental health programs and strategies. In conclusion: The “secret sauce” of HBCUs’ success in supporting Black students comes from their emphasis on “Black identity formation” and levels of support and inclusion, which can boost self-confidence and academic performance. By design, this includes active and proactive support for students from professors and alumni, programming, and supportive measures to enhance strong pathways to career and educational aspirations to improve psychological wellness.


Dr. Tanya J. Middleton is an assistant professor of counselor education at The Ohio State University

Dr. Donna Y. Ford is Distinguished Professor of Education and Human Ecology at The Ohio State University

Emeka Obinnakwelu Jr., is a doctoral student in Counselor Education at The Ohio State University


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