The Emotional Toll of Racism

Colbie Lofton’s first week of classes at Appalachian State University is sealed in her mind.

Lofton, who is Black, asked her macroeconomics professor a question during class and heard someone sitting behind her say, "I guess n****rs don’t understand."

Lofton, "completely shocked" to hear a racial slur used so casually, said nothing, and neither did her professor, who Lofton said paused and appeared to have heard the comment. When the class ended, Lofton left, reeling from hurt, and went to a nearby bathroom to cry. She then returned to her dorm and confided in her roommate, but she said she didn’t report the comment to the university because she was not aware of the process to do so.

That 2018 incident was a marker for other racial incidents that would follow at the predominantly white campus in North Carolina and leave Lofton without any illusions about the deep prejudices that some students on campus have against Black people. She has felt “out of place” ever since and hyperaware of her surroundings, which has taken a toll on her mental health.

"That is a story that continues to sit with me," said Lofton, who is now a junior.

She is not alone. Black students at many predominantly white colleges have long complained of the racial hostility, subtle and blatant, that they regularly encounter on their campuses. Whether victims of constant microaggressions or outright verbal or physical assaults, many have stories of being called a racial slur directly or seeing it scrawled on a campus wall, viewing racist posts by classmates on social media, or sitting through a presentation by a classmate professing a white supremacist conspiracy. The incidents were the focal points of protest movements and demands for change for several years, but the calls for action seemed to reach a crescendo this year as Black students at colleges across the country repeatedly called for college administrators to condemn and address racism on their campuses.

The national racial justice movement fueled by outrage over the police killings of George Floyd and other unarmed Black people has given the students’ cause momentum and forced college administrators to act more forcefully and urgently to speak out against racism and implement diversity, equity and inclusion initiatives. But even as the students welcome that they are finally being heard, their efforts have come with a heavy price.

Students of color who engage in activism and leadership frequently sideline their own mental health needs to focus on the fight for racial justice on their campuses. They have less time and emotional bandwidth to dedicate to typical student experiences, such as creating and maintaining personal relationships and a social life, performing academically and navigating what is likely their first time living away from home. Black student leaders noted that the amount of stress they endure and the time-consuming nature of activist work -- plus the racist incidents that inspire this work -- can cause students to fall behind in their studies or can become so emotionally burdensome that they drop out.

"Right now, everybody is very tuned into changes that they would like to see in our world and our country," said Sharon Mitchell, president of the Association of University and College Counseling Center Directors, or AUCCCD. "It’s great that students are engaged, but there’s always been that struggle … you overcommit to things where you’re putting your academics or health in jeopardy."

College administrators, in surveys, repeatedly list student mental health as one of their top concerns and improving it as one of their top priorities. They have focused more attention on setting and meeting diversity and inclusion goals to hire and promote more Black faculty members, administrators and professional staff and pursued new ways to improve the lives of students of color on campus, as conversations about racial injustice in American institutions continue.

But mental health experts, particularly Black psychologists and students themselves, say not enough is being done to address a lack of diversity in college counseling and the stigma associated with seeking help, and students are suffering as a result. Annelle Primm, a nationally recognized cultural psychiatry expert and senior medical director of the Steve Fund, a youth mental health advocacy organization that focuses on equity and young people of color, said the consequences of individual acts of racism and a campus climate that is hostile to Black students can be detrimental to their education.

"There’s a high level of students of color suffering in silence," Primm said. "That’s unfortunate, because the mental health needs can have an impact on academic performance and whether they stay in school. If they’re a student with financial challenges, they may make the decision to leave school altogether if all these challenges mount on them."

An Urgent Wake-Up Call

Higher ed leaders across the country rushed to publicly declare their commitment to inclusion and racial justice in May in the days after Floyd’s death, as American streets filled with young people of all races demanding change. Presidents of predominantly white colleges joined the public discourse about racial injustice and systemic racism in all aspects of American life, including at the institutions the presidents -- the large majority of them white -- run.

While many presidents acknowledged the hurt and pain that Black students were understandably feeling and expressed their shared sadness and grief, for some students the statements were not nearly enough.

More often than not, students who experience racism on campus are left feeling invalidated, ignored and undervalued by administrators who consistently maintain that hateful speech is protected under the First Amendment or require students injured and offended by such speech to seek redress through bureaucratic and time-consuming processes that significantly slow the policy changes they want and need to feel comfortable being Black on campus.

Psychologists and other experts say that addressing racism in a meaningful way on campus can improve these students’ mental health.

"There could also be some harm done if it’s not successfully resolved, or if they’re put in a situation where they feel voiceless," Ivory Toldson, a professor of counseling psychology at Howard University, said.

Students can be "psychologically scarred" if they experience neglect from institutional leaders and when a college does not directly approach issues of racism and inclusivity, he said.

Several racist and anti-Semitic incidents propelled a days-long sit-in at Syracuse University in 2019 and another monthlong occupation earlier this year, when students slept on the floor of a campus building and risked suspension to have their concerns about campus safety taken seriously and to push for policy changes. While the demonstrations led Syracuse president Kent Syverud to agree to multiple policy initiatives demanded by the students, including a more diverse base of university counselors, students also emerged with a deep mistrust of administrators and the Syracuse Department of Public Safety, due to initial disciplinary action taken against them for staging the sit-in.

Racially insensitive comments by Salisbury University students after Floyd’s death left Black student leaders there hoping for a strong condemnation by the university president and other administrators, which the students felt never came.

The leaders were disappointed that in a video posted to social media shortly after the students’ comments, President Charles Wight noted that the offensive language was protected under the First Amendment, "no matter how much we abhor what is said or what is written." A statement from the university at the time also said it "condemns and repudiates racism in all its forms" and that the incidents would be investigated.

Savannah Johnson, a junior and public relations officer for the Salisbury student chapter of the NAACP, was not surprised by Wight’s response. She said issues that deeply affect Black students frequently "fall to the bottom" of administrators’ priorities, despite the emotional toll they take on the students.

She said in the weeks that followed Floyd’s death, she struggled to get out of bed because she was so overwhelmed by the incident and the public reaction nationwide.

"I had multiple breakdowns," Johnson said. "It seems like people are just starting to wake up to things we’ve been trying to say for years, decades, centuries."​

Dealing with regular microaggressions and overt acts of racism on an individual level, while also living through the constant debates and discussions of systemic and institutional racism, can be sources of pain, trauma and stress. For some students, it can also lead to more serious conditions such as anxiety and depression and leave them feeling hopeless that things will improve.

Additionally, the coronavirus pandemic has had a disproportionate impact on Black and brown people who have died from COVID-19 and suffered financially at much higher rates than white people.

A recent survey report by the United Negro College Fund highlighted the emotional turmoil that students who attend historically Black colleges and universities are experiencing due to the coronavirus pandemic and economic recession. One student who responded to the survey wrote that it has been hard to "cope with the constant death and sickness around me."

"Dealing with COVID-19, the police brutality, and trying to come up with money to pay for fall semester is [causing] me a lot of stress and anxiety because either way it’s the stress of trying not to get sick, not getting killed by police or finding a way to pay for school that has me on edge." --Student response to UNCF survey

Primm, of the Steve Fund, said it’s not surprising that a deadly public health crisis and an epidemic of deadly police shootings of Black people could lead to poor mental health outcomes among Black students.

As racial incidents are more widely covered by national news outlets and shared on social media, the subject of systemic racism is being more openly discussed, debated and analyzed. This new spotlight on specific and particularly traumatic examples of racism can be “emotionally burdensome” for all Black people, but especially youth, said Primm, former deputy medical director of the American Psychiatric Association and former director of the association’s division of diversity and health equity. Students already coping with the impact of the pandemic on their education and social life may struggle to simply focus on being students and “trying to find their way in the world,” she said.

“They have experienced a mixture of emotions: anger, sadness, fear for their own safety, anxiety, being easily distracted and [having] difficulty concentrating,” Primm said. This wide range of emotional responses is “not a recipe for academic success or balance,” she said.

The Steve Fund recently formed a coronavirus crisis-focused task force, which issued recommendations for how educational institutions should respond to the increased mental health needs of students of color during this time. The task force, which includes students, mental health experts, corporate and nonprofit executives, and college representatives, is the “first time leaders from across sectors have come together to consider the mental health status and needs of young Americans of color,” a report about the task force recommendations said.

The report recommended that college administrators take a “trauma-informed” approach to their leadership and communications strategies, which includes more listening and demonstrating empathy toward students of color for the injustices they may have experienced, the report said. The group also encouraged more collaborative partnerships between college counseling centers and staff members from the diversity, equity and inclusion and student affairs offices, as well as student organizations that advocate for and support students of color.

“Counseling centers alone do not have the capacity to provide customized outreach for students of color and handle elevated demand,” the report said. “Offices such as Diversity, Equity and Inclusion (DEI) and Student Affairs are natural partners. Working collaboratively, they have the potential to promote mental health among students of color, while bolstering equity, inclusion and belonging.”

The report also recommended colleges invest in teletherapy resources that may better meet the needs of students of color. Some telehealth applications and web platforms, for example, advertise a diverse base of mental health professionals from outside the college or university and could provide students of color with a counselor of their same ethnic or racial background, who tend to have a better understanding of the racial experiences of students of color, or share their perspectives about those incidents. Many colleges struggle to employ enough therapists to meet student demand in general, much less staff their health centers with therapists of color, which the counseling profession itself lacks.

"I’m tired, frustrated, and upset. COVID-19 [is] out here killing us and so is the police and I’m tired. I never felt like I needed more therapy in my life." --Student response to UNCF survey

Of course many Black students have long been aware of systemic racism and have experienced examples of it firsthand prior to this year, Primm said. Common incidents such as being racially profiled by campus police, receiving disparate treatment by staff members, witnessing a white professor using the N-word or being stereotyped by peers all contribute to heightened mental health concerns, she said. Even if they attend colleges with large numbers of students of color and where they are less likely to have racial problems and tensions on campus, students of color are still in greater need of mental health support for racism that occurs off campus, Primm said.

“While those students might experience some kind of an oasis in terms of cultural similarity and have a greater sense of belonging in those settings, their experiences in the larger society are consistent with those of students of color who attend a predominantly white institution,” she said. “There’s really no escaping these negative, racially charged forces in our society, especially at this point.”

The result is a generation of Black students more likely to be suffering from anxiety or depression than their white peers and in need of culturally competent mental health support from colleges.

Most of all, Black students dedicating their time and energy to calling out or preventing racist incidents continue to hurt their mental health in myriad ways.

Fighting Campus Racism Is ‘a Whole Other Job’

Kyndavee Bichara, a junior at Appalachian State, said she frequently feels burned out because of the antiracism work she does on campus.

Bichara is a varsity track and field athlete, president and co-founder of the Black Student Athlete Association, and president of the Black Student Association. She’s also part of a collective of Black student leaders, called BlackAtAppState, which is an ongoing campaign to improve Black students’ experiences at the university through policy changes and administrative action. In late May, Bichara and Lofton, who is a student leader for Appalachian Social Justice Educators, helped organize a Black Lives Matter march in Boone, N.C., where the university is located.

Lofton said she received messages on social media from residents who identified her as one of the organizers of the protest and said that the movement doesn’t align with the values and beliefs of the Boone community. One commenter posted directly on BlackAtAppState’s Instagram account, calling the student movement "terrorism."

Just 4 percent of the 17,518 undergraduate students enrolled at the university were Black in fall 2019, according to the most recent data from the National Center for Education Statistics. White students made up 82 percent of the undergraduate population. Boone is a town of about 20,000 and is 93.5 percent white and 2.7 percent Black, according to a U.S. Census Bureau population estimate from 2019.

Bichara said Black students do not necessarily always “want” to constantly call out racism and advocate for the Black community on campus. But they often feel responsible for speaking up on racial issues that are important to Black students, play a role in their academic outcomes and affect their overall college experience on campus and off, she said. Being a Black leader on a predominantly white campus requires the frequent retelling of experiences of racism, leading discussions and presentations about racism, and putting aside personal mental health needs to address the needs of the community, she said.

“Students who aren’t fighting these fights have the luxury to be college students,” Bichara said. “It’s almost like a whole other job added on to just trying to be a student. A lot of times, student leaders who are from marginalized groups, we exhaust ourselves … our grades drop, our mental health is at stake and a lot of people have even gone as far as dropping out because of the mental burden that being a marginalized student leader comes with.”

Mitchell, of the college counseling directors association, said these "extra" burdens frequently come with being Black on a college campus. Black student activists in particular expend a lot of mental energy trying to initiate change, which is sometimes a slow and “disheartening” process, said Mitchell, who is also the senior director of student wellness and director of counseling services at the University at Buffalo.

“There’s the racial battle fatigue of constantly having to explain why you’re upset and why it’s problematic,” Mitchell said. “It’s something that makes being a student and being a human being difficult.”

Lofton, the Appalachian State student who overheard students using a racial slur about her in class in 2018, said the experience has shaped her perspective of the university in the years since. She wouldn’t be surprised if other Black students felt the same way. She noted that the town of Boone has a smaller Black population than the university and that students are also sometimes verbally victimized off campus. White residents make racist comments directed at Black students while they shop at the local Walmart or walk down the town’s main streets, she said.

Lofton said she often feels unwelcome in town and on campus, but she’s driven to keep pushing for change so that Black students in future classes will not experience the same racial hostility as she and her classmates.

“It takes a large toll on my mental health,” she said. “I know that students have been facing this for multiple years. I think about, why is this still happening today? But that drives me to work harder. It drives me to make sure the generations after me have it better.”

Activism as an Outlet

Mitchell said being part of a community of campus activists with shared experiences, beliefs and goals can be a helpful way to cope with the additional stressors of discrimination. It’s also a way for students of color to understand that racism against them isn’t unique to them as individuals and is a larger societal problem, she said.

“If nothing else, they have found a sense of community,” she said. “They have found like-minded individuals that are identifying some of the same issues or problems … A lot of time I think people can feel that, ‘I’m the only one who feels this way or has had this experience.’”

Toldson, from Howard University, said student activists who feel they are not being heard tend to suffer emotionally. They could experience increased feelings of “voicelessness” and impostor syndrome, a persistent feeling of inadequacy and self-doubt, he said. But when student activists and college administrators work together to improve the racial climate on their campuses, it can be very positive for the psychological health of the students, he said. This is especially true if the students and administrators come to a “successful and healthy” resolution about controversial incidents on campus and the college provides additional resources or make administrative changes demanded by the students.

Toldson is co-editor of a book about campus racial unrest, Campus Uprisings: How Student Activists and Collegiate Leaders Resist Racism and Create Hope (Teachers College Press), which is a collection of essays written by students, faculty members and campus leaders about the nonviolent protest movement for racial justice on college campuses over the last decade.

Primm, of the Steve Fund, said she also views student activism as a way of “counterbalancing” the negative mental health impact of the racism and discrimination that students of color face.

“It can give students and young people a sense of agency and self and collective efficacy,” she said. “That kind of activity engenders hope, that things can get better. That’s good for mental health. To not be isolated and alone, but feel like you’re part of a whole, with other people that are of like mind and good conscience.”

Bichara said as an active student leader at Appalachian State and member of multiple organizations, she has learned to develop self-care habits such as disconnecting from social media and email messages for a few days when feeling overwhelmed. She took note of the positive feedback and support BlackAtAppState has received for giving voice to Black students and outreach from fellow student activists who checked in on her well-being.

Mitchell said the University at Buffalo’s counseling center has been developing “self-care for activists” workshops this fall for students who are doing advocacy work or attending protests, largely in response to the social unrest and large demonstrations against racial injustice across the country this summer. The workshop will discuss topics such as, “How do you be socially aware and socially involved, but also find a way to recuperate, rejuvenate, have downtime before you go back out there? How do you stay safe,” she said.

When it comes to mental health support for students of color, it can be difficult for campus counseling centers to deliver what a student might be looking for, such as a person who shares their cultural background or life experiences, Mitchell said. Traditionally, the role of a campus therapist is to remain officially neutral about social or political issues and not share their personal beliefs with students in order to be seen as unbiased and welcoming to all students, especially those who might not share those same beliefs, she said.

Primm said there is a “dearth of medical health professionals and counselors of color” over all. Lack of diversity in counseling centers can discourage Black students from seeking or continuing care, even though white professionals are supposed to be trained to work with students of different cultural backgrounds, she said.

Shortage of Counselors of Color

Racial and ethnic representation in college counseling centers that is on par with the racial and ethnic makeup of the institutions’ student body is ideal and “something to strive for,” Mitchell said. But that is largely not the case at most colleges that are not historically Black institutions or don’t serve mostly students of color. Among the BlackAtAppState students’ demands is that the university hire a Black mental health counselor and increase student access to Black medical professionals through telehealth services.

In 2019, 11.7 percent of staff members working at college counseling centers were Black or African American, and 6.6 percent were Hispanic or Latino, according to the AUCCCD’s most recent survey of center directors. The U.S. Census Bureau reported in 2018 that 15.1 percent of all undergraduate college students were Black and 20.9 percent were Hispanic, according to a press release.

Lofton and Bichara at Appalachian State have both sought counseling from the university’s on-campus providers, but they were discouraged by the lack of diversity among therapists at the center. They both gave up on counseling after their first therapy sessions because they felt the white counselors could not relate to the experiences that were driving them to seek help in the first place. Bichara noted that the counselor she met with was a nice person but unable to connect with her because of a lack of shared perspective.

"Being a Black woman and specifically going to counseling to talk about how taxing being a Black woman is, it’s hard to talk to someone who isn’t a Black woman about that issue," Bichara said. "I looked very hard for a Black therapist and couldn’t find one, even in the surrounding Boone area."

Social justice issues have been increasingly incorporated into master’s degree curricula for therapists over the last decade, Mitchell said, and this shift is helping therapists understand how discrimination or a poor racial climate on campus can affect the mental health of black students.

"If social injustice contributes to poor mental health outcomes for people, even as professionals we have to figure out how we speak to that and really validate that," Mitchell said. "Those are things that go into being proponents of mental health on a campus -- not just dealing with the individual."

Mitchell said she looks for this type of cultural competency and understanding in everyone she considers hiring to work in counseling services at the University of Buffalo. She has called on white mental health professionals to participate in antiracism work and be allies to their colleagues and student patients of color.

Primm said therapist and patient relationships between people of different backgrounds are successful with the right training on systemic racism and “cultural humility” rather than a therapist imposing their own cultural viewpoint on a patient.

Negative experiences can discourage students of color from seeking therapy, Primm said. Black students and other students of color also run the risk of being labeled a “person of concern” or a threat on campus simply for seeking mental health support, which fits into stereotypes about Black people being dangerous or unstable.

“There’s also the issue of cultural mistrust, given the fact that most therapists and counselors are not from diverse cultural backgrounds,” Primm said. “There’s concern about sharing one’s most personal experiences with someone considered an outsider … Some students, if they’re going to see any provider of mental health services at all, prefer it to be someone of their background.”