When Kanye West descended from his Wyoming mountain-top workshop to host a listening party for his eighth studio album ye, the initial reaction was understandably mixed. Hundreds of reporters, influencers, musicians, and online personalities who had been flown out for the occasion immediately flocked to the internet to share their opinions beneath the starry sky of Jackson Hole. The narrative that unfolded was centered around Kanye’s mental breakdown and hospitalization in October 2016 and his subsequent return to the limelight this past spring. With “I hate being Bi-Polar it’s awesome” plastered across the hastily put-together cover for the album, it’s no wonder that Kanye has become a recent talking point for mental health’s intersection with hip-hop.

A tumultuous past two years made for plenty of food for thought on the project, and culminated in an intimate conversation with Charlamagne Tha God that found Kanye addressing his internal struggles and the aftermath of being labeled “crazy.” In openly coming to terms with his “breakthrough” as he calls it, Kanye created a space to discuss the triggers and effects of mental illness and the difficulties faced by those who navigate it. The stigma attached to seeking treatment for anxiety and depression continues to exert a stranglehold on the black community. Of the nearly one in five U.S. adults who live with a mental illness (44.7 million in 2016), African Americans are 20% more likely to experience serious mental health problems than the general population.

Hip-hop is reflective of this cultural imbalance. It’s a genre that has long been plagued by toxic expectations that demand hyper-masculinity. Mental health is considered a taboo topic, something to be swept under the rug for fear of public backlash and ridicule. Unrealistic and downright harmful pressures to be strong and to mask emotions, paired with a resounding lack of guidance and mentorship, stifles conversations surrounding these issues. This leaves symptoms ignored and normalizes self-medication as a means of treatment. To make matters worse, African Americans aren’t prioritized by the mental health system, and are half as likely to use mental health services compared to white or Asian Americans. As a result of stigma and an inability to access mental health services, coupled with socio-economic disparities and racial realities, those who need help the most are often unable to get the treatment that they so desperately need.

“How is my favorite artist doing, mentally?” is not a question that gets asked in hip-hop. Yet at its core, the genre has always been a catalyst for awareness, and an avenue for social change that provides a voice to the voiceless. For many, it’s a healing tool, informal therapy for those grappling with physical and emotional trauma, adverse childhoods, systematic racism, or any number of stumbling blocks. There is a lengthy list of songs on which artists have expressed personal pain: The Notorious B.I.G.’s cinematic and haunting “Suicidal Thoughts”; Geto Boys’ paranoia anthem “Mind Playing Tricks On Me”; Gang Starr’s poetic “Moment of Truth”; and 2Pac’s message to his mother on “Thugz Mansion.” Eminem’s The Slim Shady LP is driven by overwhelming feelings of worthlessness, as is Earl Sweatshirt’s I Don't Like Shit, I Don't Go Outside. Kendrick Lamar’s To Pimp A Butterfly offers gut-wrenching moments of self-evaluation, most notably on “u,” where he provides insights into his depression and critiques himself with unwavering honesty. More contemporary commercial examples include Lil Uzi Vert’s “XO TOUR Llif3,” which addresses suicide, betrayal, and substance abuse, and XXXTentacion’s “Jocelyn Flores,” an ode to a friend of X who suffered from depression and ultimately committed suicide.

The discussion surrounding mental health in hip hop is not new, but it is in the midst of a watershed moment. Where hip hop once failed to provide specific details or any practical knowledge, there is a tangible evolution to a conversation that once seemed impossible. Music and business icon Jay-Z dissected therapy’s growing importance in his life on the critically acclaimed 4:44, with tracks like “Smile” standing as a testament to his defiance of the dated anti-therapy narrative. In an interview with Elliott Wilson and Brian "B.Dot" Miller on Tidal's Rap Radar podcast, Jay-Z noted that initially reluctant conversations prompted critical self-assessment and valuable realizations. "We have to watch our health—our physical health and what we're doing with our bodies," he said. "But also our mental health. A lot of people going through trauma like that, and you're too embarrassed to get help for it. Especially in these neighborhoods where we grew up.”

He also addressed how his preconceived notions of therapy were shattered: “When I first went to therapy, it was a probation thing. And I hated it… I wasn’t ready for that level of getting to know yourself. It’s easy to get to know other people. Get to know yourself and really ask yourself the question you don’t wanna hear: What role did you play in the things you’ve done?” In response to the interview, former Everyday Struggle co-host Joe Budden agreed with Jay-Z’s assessment: “I would like to see hip hop address (mental health) more. We’re so powerful as a culture. Like HOV said in that interview, ‘we move things.’ Enough of us have died from mental health issues for us to look into it.”

Kid Cudi, who delved into his problems with depression and drug addiction on tracks such as “The Prayer,” “Soundtrack 2 My Life” and “Reborn,” has been vocal about his battles to overcome personal demons. “A year ago I wouldn’t even go to a therapist or psychiatrist. But I gave it a shot,” he told Complex in 2013. “It’s working for me but it’s not for everyone. I’ve got some fucking problems. It’s good for me to talk to someone who helps me see things. I had no other choice.” After checking himself into rehab in 2016, he published an empowering Facebook post detailing his struggles and highlighting the importance of seeking help. 

Run-D.M.C.’s Darryl McDaniels published a book titled Ten Ways Not To Commit Suicide in which he advocated the benefits of therapy, and pushed for more black men to seek treatment: “When I went to therapy I realized … that therapy isn’t ‘soft,’” he said. “My saying is, ‘Therapy is gangsta.’ It actually empowered me.” Logic, whose performance of hit song “1-800-273-8255” at the 2017 VMAs resulted in a 50% increase in calls to the National Suicide Prevention Lifeline, and Chance The Rapper, who sat down with Complex in 2017 to discuss his struggles with anxiety, both remain active in their efforts to raise awareness for mental health.

Music fans connect with artists who are vulnerable and willing to share, something that is facilitated through the power of social media. Unfortunately, the advent of social media has brought destructive side effects. In a culture that consumes at an alarmingly rapid rate through a number of different outlets, image is now more important than ever. Scrutiny and sensationalism are the chief driving factors that contribute to a paralyzing cycle of denial, delusion, isolation, and unhealthy comparison. Round-the-clock social media use has been tied to increased anxiety and unhappiness in American teenagers, and a recent survey of almost 1,500 teens and young adults found that “Instagram is the worst social media network for mental health and wellbeing.”

Furthermore, the glorification of drug use as a means to cope with depression and anxiety remains a divisive and deeply problematic topic in the hip-hop community, particularly given the fact that suicide was the second leading cause of death for people ages 10-34 in the U.S. Mac Miller’s recent passing due to a suspected drug overdose is a sobering reminder of the terrible power of addiction, a problem that transcends socioeconomic and racial boundaries. With hip-hop now reaching an increasingly global audience, the calls to action from several of the genre’s most recognizable faces give hope to a young and impressionable consumer base who remain captivated by what their role models are promoting. Hip-hop has the power to de-stigmatize conversations about mental health; although I can't condone some of Kanye’s recent statements and decisions, or his blatant inability to properly articulate his thoughts, his startling transparency about his struggles is a step in the right direction. Rappers being open and upfront about their experiences with mental health, and more importantly with therapy, will hopefully encourage other members of the hip-hop community and the black community at large to acknowledge and confront issues of mental health head-on.