Hip-hop is one of the world's most popular musical genres. Seven of the 10 most streamed artists in the US are rappers. With almost 50 years of history, hip-hop has evolved to give rise to many sub-genres that appeal to different people in diverse ways.
With social media being a contributing factor, more than ever before, hip-hop artists are publicly acknowledging their mental health struggles, promoting anti-stigma campaigns around mental health, and encouraging people to seek professional treatment.
The Hip Hop Psych co-founders said: "Hip-hop can be a vehicle to tackle stigma around mental health and address cultural imbalances. Hip-hop connects with hard-to-reach groups, particularly men within the Black community.
"Underrepresented communities are at a higher risk of developing mental health problems, and they are more likely to experience worsened mental health outcomes. This is in part, due to socioeconomic disparities. They are also less likely to use mental health services. Stigma around mental health issues is prevalent in underserved communities and it is a significant barrier to accessing health services.
"Discrimination, bias, and a lack of cultural competence from healthcare professionals can also lead to unmet needs, late presentation of symptoms, and poorer quality of care."
In their article, the researchers highlight various hip-hop artists and songs that have helped shape the narrative around mental health.
Hip Hop Psych added: "Since the genre's conception almost 50 years ago, hip-hop's progressive narratives have increasingly spoken up about mental health and there is no denying that it is helping to tackle stigma. Hip-hop artists are speaking candidly through their art form, and it may be helping people around the world to acknowledge their own inner struggles."
Among the artists and songs highlighted in the article are:
The Message - Grand Master Flash and the Furious Five
In the 1970s, pioneering rappers such as Grand Master Flash and the Furious Five were 'street epidemiologists' who documented the harsh living conditions and social inequalities that could be damaging to mental health. Their 1982 hit The Message describes a world of financial hardship, deprivation, and inner city violence.
Drop The World - Lil Wayne (featuring Eminem)
The relationship between mental health and masculinity is complex, as societies sometimes promote narratives like 'strong men don't cry' or 'his emotions got the best of him'. Such negative views of men expressing their emotions are seen as a 'sign of weakness'; however, men under the age of 50 are at an increased risk of taking their own lives and are less likely to seek help when experiencing a mental health crisis. A jarring inner conflict between anger and sadness is portrayed in Lil Wayne's song 'Drop The World' (featuring Eminem).
Cleaning Out My Closet - Angel Haze
In 2012, Angel Haze remixed Eminem's song Cleanin' Out My Closet, producing a song she went on to describe as "...probably the realest song I ever recorded", a candid, explicit and disturbing song about childhood sexual abuse.
1-800-273-8255 - Logic
The rapper Logic partnered with the National Suicide Prevention Lifeline, releasing a song called "1-800-273-8255" about a suicidal hotline caller getting support. When Logic performed the song at the Grammys alongside suicide survivors, calls to the National Suicide Prevention Lifeline tripled.
Sell Out - Rico Nasty
A number of female artists have also addressed mental health through hip-hop. On her most recent album Anger Management, Rico Nasty channels expressions of rage and anger into a form of empowerment. The track Sell Out describes how her "...expression of anger is a form of rejuvenation" and how she has used to her emotions to help herself and others.
Man on the Moon - Kid Cudi
In recent years, as well as opening up about their troubles, some notable rappers have helped reduce stigma by endorsing therapy. One such advocate is rapper, Kid Cudi, who posted on social media about going to an inpatient mental health treatment centre, triggering a hugely positive reaction from his fans. His songs such as Man on the Moon resonate with his fans emotionally - one comment under the YouTube video for this track reads: "If you're listening to this it's probably for a reason, keep your head up guys(: everything will be okay".
4:44 - Jay Z
Another major therapy advocate is Jay Z, who in 2018 talked to CNN's Van Jones about the "ridiculousness" of stigma surrounding mental health problems and said that he would like to see therapists in schools. His album 4:44 documents his own experiences in therapy, leading to songs such as the title track where Jay Z apologises for his behaviour, trying to make amends for what he has done.
Drs Sule and Inkster set up Hip Hop Psych as a social venture in November 2011, aiming to bridge the gap between the medical community and hip-hop culture and working directly with health professionals and the public. They analyse hip-hop lyrics for mental health themes and translate medical information in an accessible manner for the public, which generates culturally sensitive resources.
Hip Hop Psych also perform anti-stigma events in various settings including prisons, nightclubs and African and Caribbean societies. In addition, they use this same approach to educate health professionals and academics to help broaden their awareness and appreciation of some of the different ways in which people communicate and use language in their daily lives to describe their personal experiences with mental health.
Akeem Sule & Becky Inkster. Rap's battle with mental health: How hip-hop's progressive narratives are tackling stigma. BMJ Opinion; 9 Dec 2020