Background: In the context of a cohort study that has been examining the impact of social determinants, including racial/ethnic discrimination, on physical and mental health for three decades, we collected brief write-ups on experiences of racial discrimination from 160 Black and Latinx adult study participants. These write-ups were intended to elicit a stress response to be measured through self report and biological indicators. However, a content analysis of the write-ups revealed critical insights about the chronic and pernicious mental health effects of exposure to racism. This analysis can contribute to the debate about the reliability of existing tools to assess the health effects of racism, a highly critical issue given the current sociopolitical climate in the US.

Methods: The write-ups were collected between 08/2018 and 3/2020. Participants were asked to write about a personal experience of racial discrimination or one they had witnessed, and rate how stressful this experience was when it occurred and after writing about it using a 1-10 scale. The analysis was conducted by a multiracial and multidisciplinary team of eight coders. Following an iterative coding process, the team developed a coding scheme that pertained to the following domains: (1) context where the racist event took place; (2) time when the event occurred (childhood or adulthood); (3) personal experience vs. witnessing: who was exposed to racism; (4) response: how did the writer respond to the event; and (5) description of race/ethnicity: ways of referring to race/ethnicity.

Results: The emerging analytic themes are the following: (1) racism’s ubiquity, from the public to the private spheres, (2) racism’s protracted adverse effect on mental well-being, (3) vicarious racism’s adverse impact, (4) range of coping strategies, from cognitive (e.g., discrediting the perpetrators) to behavioral (e.g., seeking justice through legal venues), (5) resilience’s protective effect, and (5) explicit and implicit discussions of racism, impact on mental wellbeing.

Conclusions: This study’s brief write ups generated a plethora of insights that can inform survey design and scale development to assess the effects of racism on mental wellbeing.