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Black Mental Health Matters

Unbeknownst to me as I wrote last week’s post about #BlackLivesMatter, it turns out that July is Minority Mental Health Month.

In school, I was fortunate to take a course entitled Race, Gender and Public Policy. I actually had little interest in race at the time, but was a budding queer feminist and so was interested in taking any courses that discussed gender. Our professor, Dr. Julia Jordan-Zachery (a Black feminist scholar) taught us about intersectionality – the ways in which people hold multiple identities which often overlap and “intersect” (thus the term). In the course we learned about how various factors such as race and gender impact people, specifically with reference to people who were HIV+ or living with AIDS. But how do these factors relate to people living with mental health?

While our discussion in the class focused primarily on HIV/AIDS, we did still touch on mental health as it related to addiction, given that IV drug users are particularly at risk for contracting the virus. As a learning experience, Dr. J-Z had us choose something we loved, that brought us great joy – and asked us to go without it for one week. As a Catholic, this didn’t seem that daunting to me given the fact that I’d grown up “giving up” something each year for Lent. But still, I was intrigued.

At the time I wasn’t sure what to give up. I was pretty vain at the time – could I give up looking in mirrors? I came up with the excuse that others would have to suffer as a result so I shouldn’t do that. My cell phone? I wasn’t that strong. I ended up choosing iced coffee – which for Bostonians raised on Dunkin’ Donuts the way I was – is Our Daily Bread. And despite my Lenten training, it was still a challenge! I actually found myself more obsessed with iced coffee while I was trying to give it up, then I was when I was just partaking of it as part of my usual daily routine.

The moral of the story? If I was that “strung out” by not being able to have my daily iced coffee, with the cravings and obsession (I believe I substituted tea for coffee and so didn’t get the caffeine withdrawal headaches which would’ve made it only that much harder), how would I react if I had to give up something which was that much more central to my life the way a drug of choice is for the addict (and often with much more excruciating withdrawal symptoms)? It was eyeopening. We had done the activity to a get a glimpse of what it’s like for an addict, and what they go through when they try to get sober and give up their drug of choice. I actually had forgotten this insight until just now in writing this story (and I work in the field of addiction recovery, so it’s important that I remember this empathic knowledge).

When someone has a mental illness like addiction (and I’d imagine the same goes for severe obsessions and delusions as well) to give up your drug of choice/obsession/delusion is to lose a part of yourself. And if it’s anything like that iced coffee was for me, it’s losing a part of yourself that helps to make you feel more alive and whole, albeit only temporarily and/or with negative consequences.

So how does this relate to Minority Mental Health and the issue of race? It’s interesting because I was at a meeting the other day and the facilitator raised an interesting question. He was referencing the state budget crisis (he is a clinician and due to cuts will no longer be facilitating the meeting I was at) and was talking about what he foresees his role being in the mental health/addiction community going forward. He said how when services get cut the way the are, unfortunately it doesn’t make those who are ill go away, but rather it just redistributes them so that certain providers will end up getting gluts of services. Specifically he mentioned how those who are mentally ill end up getting diverted to places such as Emergency Rooms and prison.

Black Americans make up approximately 13.3% of the population, but more than a third of the prison population. Similarly, while they are a small fraction of the population, Black children are three times as likely to grow up in poverty compared with their white counterparts. One study showed that people of African descent “are at a higher risk for involuntary psychiatric commitment than any other racial group” and that people of color “in low-poverty areas were more likely to be referred for commitment by a law enforcement official” than whites.

Even when people of color have the resources and choose to seek treatment, it’s unlikely they will see a mental health professional who looks like them. According to the National Alliance on Mental Illness (NAMI) “only 3.7% of members in the American Psychiatric Association and 1.5% of members in the American Psychological Association are African American”. Speaking for myself, I would not feel comfortable being vulnerable with someone who I felt didn’t understand me, especially if I felt (whether justifiably or not) that person represented the source of some of my malaise.

We know that poverty (a lack of access to resources) has implications for an individual’s health. We also know that in this nation, where institutional racism has been the law of the land (from slavery, to Jim Crow, to the War on Drugs and beyond) since its inception, that Black folk have been systematically excluded from our economic system. So it’s not hard to see how disparities in mental health between blacks and whites could be explained by these political issues.

And this isn’t history – it’s reality! I am a white millennial and my parents grew up (white) during Jim Crow, which means Black millennials are the children of parents who grew up Black during Jim Crow. We’re only one generation removed from segregation.

As mental health advocates, I believe it is essential that we do everything in our power to eliminate the socio-economic disparities which inhibit people inhibit people from enjoying good mental health. And here in the United States, that also means eliminating racism and other forms of prejudice, which have historically been determinants of one’s socio-economic status which has historically been a determinant of health outcomes. Black Mental Health Matters – let’s make it actually seem that way.