Afro hair and mental health

A few years ago, I worked on an inpatient rehab ward where I witnessed the way afro hair was used to signal a 'decline in mental health' and placed under the category of 'self-neglect'. Phrases such as "it doesn't look brushed or washed" and "she's not taking care of herself" were quite common from a variety of professionals. However, one particular memory has stayed with me for a very long time; a picture was taken of a service user after being encouraged to chemically 'relax' her hair (a term I find problematic, because is afro hair even in a state of 'stress'?), and she was told to keep this picture as a reminder of how she "should look" and as a demonstration of her mental health recovery. It was here that I started to realise how the mental health field was underpinned by systematic racism, and just plain lack of awareness when it comes to afro hair.

As a biracial black Assistant Psychologist, I have noticed the subtle yet loud way that afro hair has symbolised deviancy and ill health, and the way that whiteness – in particular, white hair – has been used as a baseline (Johnson & Bankhead, 2014). I saw this time and time again in the everyday running of our systems. For example, on an inpatient setting, towels, shampoos, and conditioner for service users are often inappropriate and can be damaging for afro hair. Here we see how 'white' is the baseline, even though black people are five times more likely to be sectioned under the MHA and Black/Black British women experience a 'common mental disorder' at a higher rate than White British women or Other White women.

Alongside these practical issues, there are certain misconceptions around afro hair in the field of mental health. I have seen many White and Asian doctors write 'self-neglect' and 'poor hygiene' if a black service user has not washed their hair in a week, when people with afro hair do not need to wash their hair as often as others do and are not unclean for doing this.

Afro hair has been and still is correlated to 'wildness' and 'unprofessionalism' (Opie & Phillips, 2015) which can cause anxiety in those with afro hair, especially when going for job interviews or psychological assessments. In these situations, people with afro hair can often feel like they must get their hair 'done' for such occasions. Procedures that seek to 'tame' the hair, like chemical straightening/relaxers or weaves, are commonly used and can stem from the belief that this is the 'better version' of our hair and therefore ourselves. This can also bleed over into mental health management, such as managing depression. When depressed, having socially 'unacceptable' hair makes it difficult to 'upkeep': it can feel like a burden, a draining procedure that involves washing, conditioning, combing, drying, straightening, or putting into what's known as 'protective styles' such as braids or knots, which can take hours. This can be done for the health of the hair but also to avoid judgement.

It is important to highlight here that not everyone with afro hair struggles in this way, and there is nothing negative about getting weaves and doing chemical treatments if it is done safely and without shame. However, it is also important to understand the many negative thoughts and feelings that can come from doing such procedures: feelings of self-hate, fear of rejection, fear of our partner's parents not liking our hair if they're from a different race etc. We as clinicians must understand the depth, the trauma, the damage that this reception of afro hair has on people's mental health. The way we can fear 'being caught' for being black; using many hair products like edge 'control' to 'cover up' all traces of blackness. The daily stress that this can cause is often not seen by others:  being afraid to sweat too much as it will reverse the hair straightening, not washing our hair for as long as possible in order to keep the style we currently have longer, not swimming, avoiding rain, carrying hair gel and creams wherever we go. It is something we learn to do from a very young age and carry with us when attending our care reviews, psychological assessments and challenging our mental health sections – because afro hair has been, and still is, seen as a 'demonstration' of anarchism, rebellion and disorder.

We also need to be aware of the generational stigma/prejudice that involve traumatic experiences from caregivers (Mbilishaka et al., 2020). This can involve taking children to hairdressers to get their hair straightened or changed in some way, buying products to change their hair texture, or making harmful comments like "when you get older you can straighten it", "you have tough/bad hair" and "we should just shave it off". I have seen many children sat with tears streaming from their eyes as grown adults stand over them expressing their burden and frustration with their hair: eye rolling, shouting, hair pulling, yanking, cutting and even chasing. Afro hair being judged by society can lead to many harmful 'hair doing' experiences.

We judge afro hair because it does not 'behave' the way white hair does, instead of understanding and accepting that afro hair has different requirements. Is one more 'deviating' than the other for having different properties and needs? Afro hair is consistently treated as though it is a foreign body, hard to comprehend or conceptualise. It is seemingly difficult to understand that afro hair does not 'fall' nor needs to be 'straight', does not grow 'down' but up and out (Dabiri, 2019). The expectation for afro hair to be otherwise can make girls with afro hair feel unbeautiful, whereby even the games we play as kids involve some form of 'hair doing' such as wearing towels on our heads so we could 'flick' our hair like the Disney princesses.

Although beauty standards are seen as more applicable to women, judgement of afro hair can also affect men. Afro hair is sometimes strictly correlated to a lifestyle or personality which comes with common stereotypes such as "they listen to reggae", "they smoke", "they're laid back and not serious". Thanks to increasing awareness, some changes have been made, especially in the beauty industry. With what is known as the 'natural hair movement', afro hair is moving away from being seen as something 'negative' by society. So why has this wave not hit the field of mental health? Why is it that the way our hair grows from out of our head reflects our mental state, capabilities and perceived 'otherness'?

In clinical psychology we are taught to reflect and 'be critical', yet it appears that this skill is selectively used. Only when we are taught and shown said issues by black people, does a certain level of awareness and understanding come about. We need to reflect better about our perceptions and be critical, not only of research and practice, but of these systemic issues. Afro hair has an association with mental health experiences and treatment and it's time we started talking and doing something about it. Cultural awareness and competencies need to be addressed in clinical training, and thoroughly. It is so important for practitioners to be trained to spot these things for themselves and not rely on being shown or taught by others. Perhaps this resistance to challenge or change is due to the consensus that these matters are not integral to training, or the idea that it is too large a problem so "there's nothing we can do", but I have never known the field of clinical psychology to shy away from systemic issues before.

One thing I have realised whilst working in the field is that we should not put psychologists on a pedestal, nor be surprised that these issues exist. Psychologists are prone to inadequacies like any other professional, and the field of clinical psychology is underpinned by systemic racism just like any other field. However, I am hopeful for its future. I have noticed the shifts towards active social justice and change by existing and new psychologists in training. I am hopeful that this will start to include competencies on afro hair and mental health.

There are many common books that psychologists recommend to each other that are related to understanding trauma from an established clinical perspective, but I would like to recommend one from outside the field: Don't Touch my Hair by Emma Dabiri.

Heidi Pickett
Assistant Psychologist