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When Hip-hop Meets Psychiatry

What comes to your mind when you hear the word “hip-hop”?

DJ, break-dancing, rapper with gold chains and baggy pants, and graffiti writing?

Well, you grasped most of the five key elements of hip-hop, which include MC (or Emcee)/rapping, DJing/scratching with turntables, break dancing, graffiti writing, and, most importantly, knowledge.

But how does this relate to mental health?

I attended a very interesting Public Lecture at this year’s British Association for Psychopharmacology (BAP) Summer Meeting. The public lecture was presented by Dr. Akeem Sule and Dr. Becky Inkster, who are the co-founders of Hip Hop Psych. Hip Hop Psych is the interface that links hip-hop music and culture with mental health, and wants to use hip-hop culture to help raise the awareness about mental health.

During the one and a half-hour lecture, Akeem presented the history of hip-hop and its link to neuroscience and psychiatry, while Becky updated us on the new research projects they are working on linking hip-hop to neuroscience and psychiatry.

Akeem and Becky at their talk at the BAP

Hip-hop to many of us maybe just a music performance, but it is more than that, it’s a culture. Hip-hop has been used to open up conversations on many areas including politics, sociology, and also mental health.

Many may have the misconception that hip-hop originated from the Bronx in the Big Apple in the 70s, but it was actually originally from Africa, where political poets attempted to portray both facts and fiction in their work. Another part of hip-hop also comes from family tradition passed down from generation to generation thought oral stories of how one came into existence and what one’s role would be in the society. This tradition then travelled to the Caribbean and America, and is then officially coined with the name Hip-hop in 1973 when DJ Kool Herc played at his sister’s party in South Bronx.

Akeem mentioned that Hip-hop is ‘like the CNN of the neighbourhood’ - from the lyrics you would be able to know what is going on around you. For example, one of the themes commonly used in Hip-hop music is substance use in the younger generation, something that is very much happening around us.

There are many messages regarding mental health (addiction, psychosis, conduct disorder) and environmental risk factors (urbanicity, malnutrition, poor parental care) hidden in hip-hop lyrics, and part of what Hip Hop Psych do is to try to cultivate awareness, empower others and remove stigma surrounding mental health by engaging directly with youths and general public, and bring teaching innovation using a hip-hop frame work to the medical professionals and academics — indeed, such as this public lecture at BAP.

Photo by Matthew T Rader on Unsplash

For example, Hip-hop has its own slang terms when it comes to drug use: brown refers to heroin, coke is cocaine, bomb means good, indo refers to cannabis, slamming means being injected with drugs, and speed rolling refers to a special method of mixing heroin and cocaine in the crack pipe.

One of the songs Akeem picked out in his talk allows us to understand the meaning of the slang terms while also providing messages about mental health.

Listen to Lady Heroin while also reading the lyrics (and be prepared for some ‘controversial’ terms):

Now when I first met her

I was down in the dumps

’Cause my punks would funk

Some cowed on some chunk like Willy Lumb

Feelin’ sad and mad hurt

That’s when this fly honey walked up to me

In a brown leather skirt

She sat on my lap

She said “I heard that you rap”

She said “I have some prime-time skill that you need to tap”

I never met a girl

So I front with it

So I took it to crib

Sparked a blunt with it

Hit it

It was the bomb

But all of a sudden she start flippin’ and scrip talkin’

Like what have you done for me lately

Like she hate me

I wasn’t no romance without the ends

She had me drivin’ and stealin’ and illin’

Just to hit the skins

I was open

You could drive a bus up my nose

My friends tell me

I shouldn’t mess with these type of hoes….

Through the lyrics, the artist describes his encounter with heroin (the lady in the brown skirt), and how the use of heroin starts as recreational but then becomes problematic (she had me driving and stealing and illing), so much so that his friends tell him that he should stop using it (I shouldn’t mess with these type of hoes). ‘Hoe’ is a derogatory term for someone who is sexually promiscuous, and while this blog does not condone the use of such terms, it is important to highlight that in this context it is used as a critical metaphor for ‘heroin’.

Many hip-hop artists also describe their experience with cannabis in their songs, about how they smoke cannabis to fight off the withdrawal symptoms from other drugs, but then the cannabis actually exacerbates their most distressing symptoms, which can reach the intensity of psychotic experiences, like ‘hearing voices’ or feeling intensely persecuted and paranoid.

Thus, Hip-hop not only reflects the life experience of the artist, but it also provides a broader picture of the trend in cannabis use.

In fact, there are two main components of cannabis, Tetrahydrocannabinol (THC) and cannabidol (CBD): THC is more prone to cause psychotic-like symptoms, while CBD is the component that has calming and relaxing effects. As the concentration of THC in cannabis has been steadily increasing over the years, this may be reflected by the awareness within the Hip-hop culture of the increased frequency of such distressing symptoms.


Akeem also discussed how the life experiences of the artists will have an impact on their works in Hip-hop.

Akeem told the story of 2Pac or Tupac Amaru Shakur, whose mother was a black nationalist and also had problems with cocaine addiction. 2Pac’s song, Death Around The Corner, illustrated the life experiences of a young man growing up in a bad neighbourhood with environmental adversities, and wonders if he will able to survive. The song continues to give a full description of a family life where both parents have substance use problems, with his mother also using alcohol while she was pregnant with him.

Finally, Becky described several on-going research projects headed by Hip Hop Psych, some of them based on theme identified in this blog: for example, looking at the association between keywords in Hip-hop lyrics and the trends in our society, or changes in heart rate and vocal footprints in hip-hop artists.

It was a fantastic lecture that combined the knowledge of culture, hip-hop and neuroscience. Perhaps on your spare time this weekend, try to listen to a recent hip-hop song and see what’s going on in our society.


header source image Ben Wiens on Unsplash


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