The Impact of Systemic Oppression on Mental Health
Katherine [Katu] Medina-Pineda, MHC-LP
Systemic oppression is not only a sociopolitical issue—it is a significant determinant of mental health. From discriminatory policies to chronic marginalization, individuals whose identities have been historically oppressed are left to contend with disproportionate emotional and psychological labor that has a lasting impact across one’s lifetime and generations to come. This becomes even more nuanced as one considers how multiple minoritized and oppressed identities compound with folks at the intersections of multiple identities to have uniquely challenging experiences that only become less and less comprehensible to the mainstream the more oppressed identities a person embodies. Mounting evidence reveals that systemic and structural racism, along with other forms of oppression, directly contributes to widespread mental health disparities across racial, ethnic, gender, and socio-economic lines. For instance, the systematic hunt of Black and Brown people by ICE is not only about immigration, it is also about reproductive rights, gender-affirming care, marriage equality, and economic justice– we cannot consider only one identity when we discuss oppression.
What Is Systemic Oppression?
Systemic oppression refers to the deeply embedded and enduring patterns of inequality that are reinforced by institutions, laws, policies, and social norms. According to Braveman et al. (2022), systemic and structural racism are not merely individual acts of prejudice, but pervasive conditions that restrict opportunities, perpetuate inequity, and harm health through long-standing institutional practices such as residential segregation, unequal education funding, environmental injustice, and biased policing. These structural disadvantages often go unnoticed by those not affected, yet they set the stage for profound psychological consequences for marginalized communities.
Chronic Oppression as Psychological Trauma
The psychological impact of oppression goes beyond stress—it can be traumatic. Research using the Trauma Symptoms of Discrimination Scale (TSDS) demonstrates that discrimination can elicit symptoms akin to post-traumatic stress disorder (PTSD), including anxiety, hypervigilance, and intrusive thoughts. Williams et al. (2023) found that individuals who experienced racial trauma scored significantly higher on TSDS measures, with symptoms strongly correlated with depression, anxiety, and PTSD.
Unlike traditional conceptions of trauma as single, discrete events, the trauma induced by systemic oppression is chronic and cumulative. This is particularly harmful for individuals with multiple marginalized identities. Intersectionality—being both a racial minority and LGBTQ+, for example—can compound psychological distress. The accumulation of discriminatory experiences from various sources creates an ongoing state of emotional vigilance and erosion of self-worth.
Additionally, part of the systems working exactly as they were intended to, capitalism and white supremacy co-create a sense of urgency; meshing self-worth and identity with employment. Poverty is perceived as a moral failure instead of a deliberate structural outcome, leaving people to experience cycles of shame, overwork, and burnout for the promise of social mobility and financial security.
Mental Health and Structural Racism
As noted by Shim (2021), the social determinants of mental health—conditions like housing, education, employment, and exposure to violence—are largely shaped by structural racism and social injustice. These determinants influence both the prevalence and severity of mental illness across racial and ethnic lines. For example, Black and Latinx communities have significantly lower access to mental health services, with nearly 70% of Black adults and 67% of Latinx adults reporting no treatment for mental health issues.
The mental health field itself has a history of structural racism. Shim (2021) outlines how psychiatry once pathologized normal responses to oppression. Diagnoses like “drapetomania,” invented in the 19th century to describe enslaved people’s desire to escape captivity, are clear examples of how the profession was used to rationalize racial subjugation. Today, although the language has changed, structural inequities persist in mental health research, education, and clinical care. Certain psychiatric diagnoses are more frequently applied to BIPOC- often inaccurately- due to racial bias in the diagnostic process. The tendency to misattribute symptoms as inherent cultural or biological differences (essentially leaning into the invention of race and eugenics), rather than acknowledging systemic stressors, leads to misdiagnosis, overdiagnosis, and poor treatment outcomes.
For example, Cameron (2007) conducted a study with 117 participants that showed white non-hispanic individuals made up 24.4% of the participant pool diagnosed with conduct disorder (CD), whereas 43.3% of hispanic boys and 34.4% of Black boys made up the rest of the participant pool. Grimmett, et al. (2016) notes that a major factor for the overrepresentation of Black american boys in the oppositional defiant disorder (ODD) diagnostic category is the direct result of diagnosing white children presenting the same symptomatology with a lesser, less stigmatizing and temporary diagnosis of adjustment disorder which requires to be reviewed and changed after six months of treatment. This is but one example of how the Mental Health Industrial Complex is structurally designed to stigmatize and pathologize behaviors, which can have a lasting impact on the individual’s sense of self and how they are perceived by their environment- whether it be navigating the school system or searching for employment.
Addressing the Harm: Toward Mental Health Equity
To effectively combat the mental health effects of systemic oppression, it is crucial to move beyond individual-level interventions. Mental health equity requires dismantling the root structures that uphold injustice. This includes:
Expanding Definitions of Trauma: Incorporating chronic oppression into diagnostic frameworks is essential to ensure marginalized populations receive appropriate care and recognition of their experiences.
Cultural Humility and Structural Competence: Mental health professionals must commit to ongoing education about the systems that shape clients' lives. Recognizing how structural forces influence individual symptoms is a foundational step toward equity in care.
Policy Advocacy: Real change must be supported by systemic reforms—such as equitable access to housing, education, and healthcare—that address the social determinants of mental health.
Community Healing Initiatives: Culturally grounded and community-based healing models that acknowledge the collective trauma of oppression can offer more effective support than Western, individual-focused approaches.
Conclusion
Mental health does not exist in a vacuum, in fact, it directly correlates to how we relate to the world as much as how the world relates to us. Our current environments have been shaped by decades of systemic oppression. Recognizing the trauma embedded in social injustice is not only a clinical imperative but a moral one. As Shim (2021) aptly states, achieving mental health equity is inseparable from the pursuit of social justice.
References
Braveman, P., Arkin, E., Proctor, D., Kauh, T., & Holm, N. (2022). Systemic and Structural Racism: Definitions, Examples, Health Damages, and Approaches to Dismantling. Health Affairs.
Grimmett, M. A., Dunbar, A. S., Williams, T., Clark, C., Prioleau, B., & Miller, J. S. (2016). The process and implications of diagnosing oppositional defiant disorder in African American males.
The Professional Counselor, 6(2), 147–160. https://doi.org/10.15241/mg.6.2.147
Shim, R. S. (2021). Dismantling Structural Racism in Psychiatry: A Path to Mental Health Equity. American Journal of Psychiatry.
Williams, M. T., Osman, M., & Hyon, C. (2023). Understanding the Psychological Impact of Oppression Using the Trauma Symptoms of Discrimination Scale. Chronic Stress.