Healing from Generational Mistrust in the Medical System

For many BIPOC individuals and people who have been incarcerated, the decision to seek mental health support is not simply about finding a therapist or scheduling an appointment. It is about confronting a long and painful history of harm, neglect, and exploitation at the hands of medical systems in the United States. This legacy doesn’t just live in the past, it shows up today in the quiet hesitations, the guarded conversations, and the deep mistrust that keeps many from reaching out for help.

Medical harm against people of color is not theoretical- It is historical fact. From forced sterilizations and racist diagnostic practices to unethical experimentation and systemic denial of care, communities of color have endured generations of disrespect and dehumanization. Black people, in particular, have been subject to medical abuse that has shaped how families talk about doctors, hospitals, and mental health care. These stories are passed down like warnings, reminding each generation to be cautious, to protect themselves, to never let their guard down.

People impacted by incarceration carry another layer of trauma. Inside jails and prisons, medical neglect is common. People are denied needed medications, misdiagnosed, or given minimal treatment. Mental health support, when it is offered, is often tied to punishment, control, or surveillance. Instead of healing, the experience reinforces a belief that medical systems are unsafe or untrustworthy. When someone returns home, they may have little reason to believe the community health system will be any different.

This mistrust isn’t irrational. It is a survival response to real, lived experiences. But it also creates a profound barrier to healing. When someone has learned to expect harm- or at least indifference- from medical professionals, they are less likely to share openly, ask for help, or return to care after a negative experience. They may fear being dismissed, judged, or labeled. For some, the idea of telling a stranger about their trauma feels like opening a door that could lead to more harm.

The impact is far-reaching. People delay reaching out until they are in crisis. They try to handle everything alone. They minimize their pain because being vulnerable in a system that has hurt them feels too risky. And when they do engage in care, many feel they must brace themselves, editing what they say, hiding parts of their story, or staying alert for signs of disrespect.

Healing requires trust. Trust requires safety. And safety comes from systems and providers who acknowledge this history, honor people’s lived experiences, and create culturally grounded spaces where clients feel seen and respected.

Rebuilding trust is possible, but it begins with recognizing the harm and giving communities control over their healing journey.