Reframing Mental Health: Resilient Social Justice Approaches to Promote Well-Being Amid the Mental Health Crisis

Aisha Badar

Mental health challenges continue to be a pervasive crisis that disproportionately impacts marginalized communities across the world, which is further exacerbated by barriers to care, like high costs of healthcare and discrimination against communities. As defined by the American Psychological Association, resilience is “the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demands”. This concept plays a significant role in addressing mental health challenges by enabling individuals and communities to overcome stigma and challenge systemic inequalities, even when barriers such as unaffordable or culturally insensitive care restrict access to mental health resources. For example, peer support groups in marginalized communities foster resilience by creating safe spaces where members can not only share experiences to reduce isolation, but also congregate to advocate for proper resources—demonstrating how resilience cultivated at the individual level can expand outward—supporting personal recovery while also strengthening collective resilience and community-wide empowerment (Uno 7). Reframing mental health support through community-based approaches focused on building resiliency—such as culturally sensitive interventions and culturally competent care—is crucial, as these strategies directly combat stigma and healthcare disparities, ultimately fostering greater access to care and improving overall well-being in marginalized populations.

As Liu et al. (527) noted, the mental health crisis disproportionately harms marginalized communities—who receive far fewer mental health resources due to systemic discrimination and lack of support—including people of color, LGBTQ+ individuals, and low-income groups. The healthcare system fails to reach these communities because of culturally stigmatized views of mental illness and a lack of culturally competent providers—professionals who understand and respect patients’ cultural backgrounds and values, allowing them to deliver care that is relevant. The Social Determinants of Health, as defined by the Office of Disease Prevention and Health Promotion, Healthy People 2030, are five domains of society that impact an individual's health, well-being, and quality of life: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context. Walker et al. investigated how these domains directly correlate to mental health through an online self-report survey measuring how global mental health symptoms of depression and anxiety correlate to social determinants and social backgrounds. The study found “higher family income is positively related to mental health, whereas more adverse events (e.g., assault, robbery, serious illness or injury), food insecurity, and commute time are negatively related to mental health” (Walker et al. 1). Higher rates of adverse events in marginalized communities—caused by systematic inequalities—result in poorer mental health outcomes than in privileged communities. Marginalized communities also face environmental barriers to receiving mental health support, making it harder for individuals in these communities to access support and thrive.

Liu et al. observed that individuals who grew up in marginalized communities–characterized by higher poverty levels, limited resources, and social exclusion, which are often shaped by systemic inequality and disinvestment—experience higher risks of poor mental health. Policies of the past continue to shape these neighborhoods, as evidenced by the continuous poverty, underfunded schools, and high rates of unemployment—conditions that are linked to poorer mental health outcomes. Structural factors like neighborhood poverty and racial discrimination significantly contribute to mental health issues, particularly among marginalized groups such as Black women and American Indian adolescents (Ravi et al., 569; Crabtree et al., 555). For example, Ravi et al. found that black women living in urban environments experience elevated PTSD symptoms due to the combined effects of racial discrimination and neighborhood poverty, highlighting how racial discrimination uniquely impacts mental health. These findings underscore how systemic inequalities continue to perpetuate cycles of poor mental health across generations.

Social stigma is another key contributing factor to the mental health crisis and prevents individuals from seeking treatment, leading to isolation and internalized shame, which exacerbate symptoms, especially for those speaking out. Garrett et al. (1) found in an analysis of 19 male Pacific Islander adolescents that “participants expressed belief that disclosing mental health challenges would ‘ruin their lives’ and held misconceptions about adults’ ability to address mental health concerns.” (Garrett et al. 1). This social stigma around mental health heightens fear and reluctance in seeking help, as individuals fear they may be seen as weak or incompetent (Huang et al. 8). Such perceptions foster emotional blunting, distrust towards therapists, and impact academic performance and social life because of untreated poor mental health. Eventually, these misconceptions can leave mental health conditions untreated, worsening the challenges faced by marginalized communities. Cultural background, specifically Pacific Islander cultural norms, plays a significant role in this study’s findings. Family and cultural beliefs, such as viewing mental health issues as shameful or private, can create additional barriers to seeking professional help. Nationwide, social stigma surrounding mental health is often rooted in cultural and family beliefs, where it is better to stay quiet, which discourages seeking professional help and promotes emotional self-reliance (Garrett et al. 25). In fact, in many communities, there is a social pressure to remain strong, which manifests itself as staying silent about personal struggles (Garrett et al. 17). The expectation to remain strong, manifested through traditional notions of masculinity and as a power strategy within marginalized communities, can discourage expression of vulnerability, fuel fear of judgment, and deepen the stigma that keeps many from seeking the mental health support they need (Garrett et al. 30).

Financial barriers and unavailability of services further limit access to care, thereby exacerbating the mental health crisis (Johnson et al. 10). These obstacles are shaped by economic stability, healthcare access, and neighborhood conditions, all factors of the Social Determinants of Health. Added to the lack of available mental health services, especially for those in rural areas, access to mental health support and care continues to be limited. Johnson et al. explained that poor public transportation, rooted in the Neighborhood and Built Environment domain of the Social Determinants of Health, is directly related to being unable to receive proper care for mental health conditions. Johnson et al. also highlighted the struggles of these communities by explaining that “in rural communities, minimal access to public transportation may make sustaining employment difficult, which can then impact health insurance” (1). Many individuals rely on employer-provided health insurance, so unstable employment can lead to loss of coverage, making mental health care less affordable and less accessible. Limited access to care not only creates physical barriers but also discourages individuals from seeking help after repeated attempts to reach these services (1), which can bring new feelings of hopelessness and strain. This cycle contributes to the stigma around mental health by highlighting the belief that support is unattainable, which can further prevent people from reaching out, only aggravating the mental health crisis.

As these financial and structural obstacles accumulate, they reflect a wider societal pattern of marginalizing communities by restricting their access to mental health care and reinforcing doubt toward the system. E.g. In addition, by limiting communities’ access to mental health care and aggravating the deepening doubt against mental health services, society creates marginalized groups and pushes from accepting resources even when offered. Cultivating culturally competent healthcare staff may address the marginalization and create a resilient community (Irfan et al. 1). Monthly seminars prepared and promoted by healthcare institutions or community organizations are a promising strategy for enhancing healthcare providers’ understanding of marginalized populations, improving cultural sensitivity, and addressing the systemic barriers these communities encounter. Crabtree et al. discovered that American Indian adolescents face heightened risk behaviors such as binge drinking, influenced by cultural identity. This finding underscores the importance of culturally competent care that acknowledges how traditions and values shape coping behaviors and mental health outcomes in diverse populations. Culturally competent healthcare professionals who are open to being educated on traditions and customs can build resilience within marginalized communities by fostering trust and creating an environment where patients feel understood and respected. When healthcare workers demonstrate awareness of cultural values, beliefs, and culturally significant history, community members can feel more secure when seeking help, adhering to treatment, and engaging in ongoing mental health care—demonstrating resilience, defined as the ability to adapt and recover from challenges, while maintaining mental, emotional, and behavioral well-being (American Psychological Association).

To combat the social stigma barrier, mental health awareness campaigns and mental health education in schools are effective first steps proven to decrease the stigma surrounding mental health. A study by De Luna et al. (1) emphasized the importance of mental health literacy on the attitudes toward seeking counseling among senior high school students and found that “the positive attitude towards seeking counseling may be attributed to increased awareness campaigns, educational programs, and societal efforts” (1). Increasing awareness and creating a comfortable environment through mental health education can help build resilient communities by empowering individuals to recognize symptoms, seek help without shame, and challenge common stigmas. This knowledge supports the communities’ fight for better resources and strengthens collective efforts to support those struggling with mental health, a connection reflected in the focus groups where participants emphasized how increased awareness encourages more openness and willingness to seek help.

Financial barriers remain an obstacle for individuals due to prohibitive treatment costs and insurance issues—usually the conflict between the insurer’s bottom line and the patient’s cost of health. One aggravating factor to this strain is the lack of employment opportunities provided to those in rural communities, a result of a lack of resources. Johnson et al. explained that “it is apparent that a lack of reliable transportation is directly tied to unemployment, especially in rural communities due to distance and limited accessibility” (3), and noted that “although they face many challenges, individuals in rural communities have been found to be resilient, especially when the proper resources are available” (4). By providing essential support, such as reliable transportation in Johnson et al.’s case, residents in rural areas are in a better position to secure employment. Career counseling can expose residents in remote/rural areas to undiscovered/inaccessible employment opportunities. However, increasing work opportunities and maintaining consistent employment rates–though requiring sustained investment and time in rural communities–is just as important in addressing financial hardships, which directly affect residents’ ability to access mental health care and maintain overall well-being.

Telehealth has become an increasingly important tool for expanding access to healthcare in underserved areas, particularly rural communities. Telehealth offers an alternative to in-person mental health services, improving access for individuals in rural and remote areas who face barriers such as distance or limited local providers. As a virtual method of delivering healthcare—often through video call or phone call—Telehealth provides endless opportunities to meet with healthcare providers when traveling isn’t feasible. E.g. Telehealth, a virtual method of delivering healthcare services, offers an alternative to in-person services by improving access for individuals in disadvantaged areas. The program is hosted through video or phone calls, providing opportunities for those facing physical barriers to meet with providers easily. Gilson et al. (2) expand, “Telehealth can increase service accessibility for specific groups such as rural and remote communities…Service users also describe having sessions within their own home via telehealth as convenient and comfortable…and it has been rated positively by young people” (Gilson et al. 2). Telehealth offers flexibility by removing the need for travel and allowing patients to access care from their homes, saving both time and transportation inconvenience. For individuals who may not be covered by health insurance, telehealth can also reduce the overall cost of treatment by eliminating extra fees that can come from commuting or childcare for parents. Snoswell et al. also found that “The marginal cost or average cost of a telehealth consultation was found to be less than an equivalent in‑person consultation in a number of studies” (16), demonstrating that the actual provision of care is often more affordable for telehealth than it is for in-person visits. This flexibility and affordability can open the doors to mental health care and treatment for those with limited access to care by addressing financial burdens.

In conclusion, addressing the mental health crisis requires a resilient approach that focuses on cultural competence, stigma reduction, and equal access to care, especially for marginalized communities. These goals can be achieved through culturally competent healthcare that acknowledges diversity, mental health education in schools and communities, equitable access initiatives such as telehealth and improved transportation in rural areas, and efforts to increase employment opportunities, which support financial stability and expand access to mental health care. By understanding the deep impact of social determinants—such as economic instability, neighborhood disadvantage, and social stigma—and bringing attention to practical solutions like telehealth, mental health education, and community-centered support, we can strengthen the current mental health system to better bridge gaps in care. Ultimately, addressing the mental health crisis requires strengthening support systems, reducing stigma, and fostering resilient communities to improve access and encourage open discussions about mental health.

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