Time to Get (Lit)erate When it Comes to Mental Health

Adia Harris, Contributing Writer 

  

Before the age of five most children know their ABC’s, how to count, how to tie their shoes and even to stay away from strangers. Kids this age usually know how to tell their parents when they don’t physically feel well and will even point out ‘boo-boos.’ But when should we be expected to understand mental health, and what should we be expected to know?

Mental health seems to be a recent buzzword of sorts; for better and worse it’s been commonly thrust into the media spotlight. However, mainstream media often seems to assume that there is widespread understanding of mental health among the general public. Yet, research indicates many members of the public actually cannot recognize specific disorders or even different types of psychological distress—a key component of mental health literacy.

 But what is mental health literacy, when should it be taught, and what should we know?

What is Mental Health Literacy?

 The term mental health literacy (MHL) was coined in a 1997 study by Australian health psychologist Anthony F. Jorm and his research team, and is defined as having “knowledge and beliefs about mental disorders that aids in their recognition, management or prevention.”  So with a strong working definition, it should be easy to become more mentally literate, right? Unfortunately, it’s not as easy as it might seem.

Typing the phrase ‘teaching your child about…’ into Google yields diverse suggestions queued below it, ranging from God to money. But if you complete the phrase with the words ‘mental health’, very few website results come back with straightforward and comprehensive information on how to recognize, manage and prevent mental distress. This evident lack of readily available instructional information on MHL is shocking considering one in four individuals will suffer from a mental health disorder at some point in their lifetime.

When Should We Become Literate?

Less than half of Americans can recognize anxiety according to a recent national web survey conducted by Michigan State University that quizzed nearly 4,600 participants on common mental health disorders in an effort to inform policymakers about mental health education needs. This kind of research underscores a more fundamental question: When should we learn about mental health anyway?

The fact of the matter is that it’s never too early or too late to learn about mental health. Experts suggest parents should definitely be talking to their kids about mental health and illness, and the earlier they start the conversation, the better.

To facilitate learning, we also should be advocating for an increase in mental health education in our schools. A decades-long study reported on by NPR found that by age 25, young adults who participated as children in programs that emphasize social and emotional learning, are more likely to succeed academically, are less likely to be incarcerated, and have fewer mental health and substance abuse issues. Considering the woefully disproportionate rates in which African Americans are negatively impacted by socioeconomic hardships like unemployment, incarceration and mental illness, there is no reason for MHL not to be a priority within black communities.

What Should We Know?

Despite the sparse literature available on MHL, one study identified four scientifically recognized areas of understanding and knowledge that provide a good roadmap for mental health literacy.

Knowing how to develop and maintain good mental health: Just like physical hygiene (i.e. using deodorant or brushing your teeth) it’s important to cultivate healthy mental hygiene. One way to greatly improve mental hygiene is by individuals learning to understand their own emotions and developing positive strategies to deal with them.

Recognizing and understanding mental disorders and treatments: A straightforward way for folks to improve mental health literacy is to research common mental health disorders to gain a basic understanding of both symptoms and treatments.

Dispelling feelings of stigma or misconceptions about mental illness: Self-educating about mental illnesses in order to know the facts from the myths is an extremely effective way to eliminate stigmatizing beliefs. Once you know the facts, don’t be afraid to speak up to inform others about misconceptions—knowledge is always power.

Improving help-seeking efficacy: First, know that seeking help for mental health is completely acceptable. Just like knowing when to see a doctor for a high fever, learn to identify mental health symptoms that require professional attention, and research mental health resources that are accessible to you.

 Finding MHL Resources

When we have a strong understanding of mental health, we improve our own mental health outcomes in our communities. Here are a few resources to help increase your mental health literacy and help educate friends and family.

Mental Health First Aid

Every Moment Counts

Mentalhealth.gov

 

 

 

 

 

 

 


 
 
 
 
 


 

What Memorial Day can Teach Black America about Mental Health

Chandra White-Cummings, Managing Editor 

 

 

Image from History.com 

Image from History.com 

History, like suffering, can teach lessons that cannot be learned any other way. For Black America, history and suffering sometimes seem synonymous similar to how America sometimes seems synonymous with ‘white’. Memorial Day is customarily a time when observers remember both the history of Americans’ fighting in and dying during military service to this country. We are encouraged to honor the memory and lives of those who ‘made the ultimate sacrifice’ for the benefit and preservation of freedom and liberty. But do we remember sacrifices made by all Americans? Are African Americans part of the national narrative of bravery, heroism, and honor? Maybe, but much more credit and inclusion of blacks’ contributions to the victories won in the name of freedom is due. And there’s no better way to do that than by consulting history about the origins of Memorial Day and the legacy of the first black soldiers who served both in service to, and resistance against, this country.

Historians credit General John A. Logan, a commander during the Civil War and founder of the Grand Army of the Republic, with being the creator of Memorial Day. On May 5, 1868, he issued a document titled, General Orders No. 11, designating May 30, 1868 as a day “…for the purpose of…decorating the graves of comrades who died in defense of their country during the late rebellion.” The document goes on to herald the memory of civil war (particularly Union) soldiers: “Their soldier lives were the reveille of freedom to a race in chains, and their deaths the tattoo of rebellious tyranny in arms.” General Logan was a secessionist, not an abolitionist, whose interest was in preserving the union of the states, not the freedom of black Americans, and even this attempt to unify white soldiers as the war wound down was met with the characteristic recalcitrant contrariness of the Confederacy; they refused to join the commemoration until after World War I when the nation began a uniform observance. Eight states still maintain separate days to honor those who died fighting to preserve the confederacy: Alabama, Florida, Georgia, Louisiana, Mississippi, South Carolina, Tennessee, and Texas.

The reference to those soldiers whose actions benefitted the ‘race in chains’ makes the case that the black fighters who fought for their freedom and the freedom of their families and neighbors are not included in the poetic and touching call to remembrance and honor. Absent seems to be any acknowledgment of the first black Union soldiers organized to fight in March of 1862, formerly and very recently enslaved men recruited from tenement communes referred to as ‘refugee camps’ in South Carolina. These are the same soldiers who later became Company A, First South Carolina Volunteer Infantry, the longest-serving African-American military unit in the Civil War. 

Even during the harrowing times of that war, when they could have easily been shot down by their fellow white Union soldiers in not-so-friendly fire, these men fought with a courage and determination that inspired their commander Colonel Thomas Wentworth Higginson to write of their legacy in his memoir, Army Life in a Black Regiment, “Till the blacks were armed, there was no guarantee of their freedom. It was their demeanor under arms that shamed the nation into recognizing them as men.” Their persistence during an intense campaign in Jacksonville in which they held off Confederate troops for three weeks spurred Abraham Lincoln to lift his previous sanction against allowing black soldiers in combat and is described by historians and biographers as a tide -turning event of the entire Civil War.

What about that history lesson? Every good lesson begins with a provocative question, so we ask ourselves, What kind of people can join a war that is at best intended to benefit them only collaterally by those who wage it on both sides of the issues? What frees the minds of men and enables them to volunteer for a cause when just a few weeks before signing up for battle they were laboring under the tyranny of a society in scandalous rebellion against the God who created them all? How do oppressed people become champions and heroes of their own deliverance?
This type of legacy can only be forged by people who can strike the delicate mental balance of remembering and forgetting.

It is the most beautiful of minds that can remember the struggle but forget the pain and limitations of that struggle. People who have the mental and emotional skill and fortitude to distinguish between circumstances and themselves are the ones who will be prepared to fight for missing black children, win policy changes that put less of our people in prison, and plug up that school-to-prison pipeline. The collective mental health of black America depends in large part on developing a mindset that allows construction of a wall high and broad between the situations that challenge and the systems designed to subjugate, and the inner essence of who we are. Mass incarceration is happening to us and coming against us; but it is not who we are. The attack on voting rights and the people orchestrating those attacks, are situations but they do not define who black America is. 

Black America also does well to understand that resistance is sometimes its own victory. The men of those Jacksonville regiments did not prevail against Confederate troops by storming their camps and exerting superior force. They held their position and resisted the advance of the opposition. And they sustained that resistance for three weeks. Sustained resistance requires a mental commitment to persevere at all costs and accepting that injuries and casualties will happen during the course of that resistance. Resistance also requires mental and emotional regulation.

Considering the lives and deaths of soldiers like those of Company A challenges us to now be bold in our rejection of stigma and pursuit of mental health. Embracing the humility necessary to seek help from friends, family, and professionals takes on new meaning when viewed in the context of individual health for collective strength. Anyone who asks for help should receive it. Those who can help should provide it. Solutions-oriented conversations about challenges and illness should be encouraged and applauded. Resources should be identified and shared.

This Memorial Day remember men and women like those Civil War heroes and commit to protecting and strengthening mental health.
 

What Black Millenials Need to Know Now About Mental Health

Chandra White-Cummings, Managing Editor 

 


 Citing U.S. Census data, the 2016 Nielsen report, Young, Connected, and Black, says there are 11.6 million black Millenials—young people between the ages of 18 and 34. That’s a whole lot of turning up and many gallons of tea being sipped. By all appearances, they seem to have it going on. They are reported to be more optimistic than their non-Black counterparts and convinced of their ability to be change agents for a better society. The report also highlights their educational gains, with 70.9% of black high school graduates having enrolled in college in 2014 outpacing the white enrollment rate by five percent. Incidentally, black women led educational gains: in the 2012-2013 academic year, they earned 65% of bachelor’s, 70% of master’s, and 64% of doctorate degrees among black college graduates. And perhaps most notably, they ignited a movement of social justice and civil rights provoked by killings of unarmed young black men beginning with Trayvon Martin. But with so many positive realities shaping their existence, is everything truly well with black Millenials? Maybe not. 


As they set the world on fire, today’s largest generation needs to be sure to tend to the inner life as well as outward appearances. There are disappointments, fears, and troubling circumstances  with which to contend. The 2015 Black Youth Project (BYP) compilation of surveys and third party data highlights some of the challenges they face. BYP reports that over half of respondents said they or someone they know had been harassed by, or experienced violence at the hands of, police. A third of the black millennial woman told of discrimination at work, and 20% of men and women admitted to experiencing discrimination during their job search.

The BYP data also indicated that in 2013, the percentage of black 18-24 year olds living below the poverty line was almost double the percentage of white millennials in the same predicament. True to their optimistic outlook, many seem to recognize the need for building and maintaining strong inner reserves to confront obstacles and be the change catalysts they envision themselves to be. Black Millennial women are spearheading mental health outreaches like Healing Melanin, Melanin Mental Health, Redefine Enough, and others, demonstrating the kind of awareness required to hang tough for the long haul. Everyone, even this technologically savvy group, can learn more about mental health and wellness. Here are a few pieces of wisdom for their journey.

Mental and emotional wellness involves not only self-care and self-love but also care and treatment of others. An emphasis on loving oneself is perceived by many millennials to be the foundation of good mental health. Accepting one’s own flaws, vulnerabilities, and hangups is a necessary steps but it is not the only step. Extending the same tolerance and patience to others deepens wellness by redirecting thoughts about other people in a positive rather than negative direction. Science is revealing that chronic negative thoughts can produce toxic stress which ages and weakens the immune system, making the whole bodily system more susceptible to disease.

Remember that inner mental disturbance and imbalance will show itself in other areas of life, so learn to connect issues that might surface in relationships, at work, or in education settings to problems with mental or emotional health. Dr. Carleah East, LMHC, Psychotherapist, and owner of S.M.I.L.E. Counseling Services, explains:


Black Millennials need to recognize that mental health not only has internal impacts but also external effects. For instance, Blacks diagnosed with depression not only have an emotional struggle to face, but this struggle manifests itself in their work and home environment, resulting in absenteeism, poor concentration, and interrupted ability to formulate new ideas and share in open communication. …


The bumper crop of Millennials who identify as creatives should pay special attention in this regard because staying mentally healthy and emotionally sound is directly connected to keeping the creative juices flowing.

Educate yourself on your own experience and gain understanding of how it has affected your current situation. Many black Millennials had childhoods and adolescent periods characterized by intimate and community violence, food and housing insecurity, an incarcerated parent or significant other, and social isolation and loneliness. These are traumatic experiences. Don’t excuse or normalize them. Because something is common doesn’t make it acceptable or ‘normal’. Cousin Larry pressing a girl against a wall and groping her is not okay, even if all the girl cousins in the family received the same treatment. Study trauma and adverse childhood experiences (ACES) and their impact on developing brains and emotions. Dr. Nadine Burke Harris, Founder and Chief Executive Officer of the Center for Youth Wellness, is a leading expert on childhood trauma and ACES, and has delivered a TEDMED talk discussing the effects of trauma over a person’s lifetime. Use the vast and viral reach of social media to pass on resources like these to contacts and networks. Educate and re-educate one another on stress, trauma, anxiety, and depression.

Fiercely, courageously, and aggressively guard your mental health and emotional stability. This includes shedding the stigma against professional help to get or stay mentally healthy. The Boomer and Generation Xers have perpetuated the cultural bias against medical and healthcare professionals too long. Original intentions were good. Atrocities did happen. But now, a new day is dawning, and there is much more awareness of the need for cultural competence and for black and other minority mental health professionals to provide treatment in ways that will speak to Millennials. Psychiatrists are on YouTube. Psychologists are highly visible on social media. Black social workers and advocates are leading peer support groups and healing circles.

Family members and even friends might still not understand going to therapy. That’s alright. Throw on your red-bottom shoes, fluff up your fro and go anyway. Take a friend with you if it will help ease your transition. Ourselves Black has resources on this site that give information from professionals on how to know if it’s time to seek a therapist’s help, and what kinds of treatment they provide. Use resources as preparation on responding to and interacting with different medical establishments and providers. Share on social media about your experiences according to your comfort level. And once some traction has been gained in your quest for mental wellness, reach out and help someone else fight for theirs.

Music on the Mind: Can Music Improve Mental Health?

Adia Harris, Contributing Writer 

The key to longevity is to learn every aspect of music that you can.
— Prince
Free source Internet Image 

Free source Internet Image 

 

Music Universal Effects
Despite our human differences, music is a uniquely unifying phenomenon to which we all respond. Since the evolution of man, we have created and listened to music to enrich our lives through rhythm and melody. 

Both science and the media actively examine the functional and cognitive roles of music. But, at least from a cultural standpoint, music has always been a therapeutic and expressive medium. Consider African American experience. From the Negro spirituals steeped with the harsh realities of slave life, to the billowy tunes of jazz and blues lamenting social injustice, to even the complex, yet immensely popular multi-billion dollar industry that is hip-hop—music continues to change and develop as we do. 

Music on the Brain
It has been scientifically proven that listening to music elicits a strong reaction in our brains. According to Ellen Mannes, author of The Power of Music, scientists have learned music stimulates the brain more than any other human function. 

In fact, psychiatric studies have found music is even processed in different ways by our nervous system. Some examples include: 
•    Perceptually: how we physically feel and hear music
•    Emotionally: how different aspects of music (intensity, harmony, loudness) affect our neural           responses
•    Autonomically: how our autonomic bodily functions (i.e. blood pressure, heart rate, and                   respiratory rates) are affected.

Utilizing technology such as functional magnetic resonance imaging (fMRI) scans researchers continue to investigate the interaction between music and the mind. One study, conducted by neuroradiologist Dr. Jonathan Burdette at Wake Forest Baptist Medical Center, researched levels of brain connectivity based on self-identified music preferences in 21 subjects. The results of the study showed listeners’ preferences, and not the genre of music they listen to, has the greatest impact on brain activity.

"These findings may explain why comparable emotional and mental states can be experienced by people listening to music that differs as widely as Beethoven and Eminem." Burdette stated about the study.

This arguably suggests music plays an impactful role in how we develop our sense of self and the world around us.

Positive effects of music on mental health
Research on the connection between music and health outcomes, including treatment of mental health disorders is still in a relatively infant stage. Yet scientists are convinced, there is just ‘something’ about music.

A meta-analysis study conducted by David Levitin, psychologist and author of This is Your Brain on Music, found one study providing solid evidence that music can lower anxiety and cortisol levels in patients pre-surgery at a more effective rate than medication.

Although more research is still needed, Levitin finds the medical certainty of music as a form of therapy to be more than promising. “We've found compelling evidence that musical interventions can play a health-care role in settings ranging from operating rooms to family clinics.” 

Music therapy as a clinical course of study has been around since the 1940s, predominantly borne from the need to rehabilitate war-beleaguered veterans of WWII with physical and psychological issues. Today, music therapy is used in clinical settings to address a diversity of physical, emotional, cognitive, and social problems.

Some types of music therapy include:
The Bonny Method of Guided Imagery and Music (GIM) -- a common music-assisted therapy, GIM facilitates mental exploration of significant life issues, memories, traumas, and health conditions


Neurologic Music Therapy (NMT) -- often used in the treatment of neurologically debilitating disorders such as Parkinson’s, NMT facilitates the rehabilitation of biological movement. 


Drum Therapy -- a holistic therapy, mindful drumming has been found in some instances to increase production of cancer fighting cells and even change the genomic marker for stress.

Utilize music for your Well-being 

We can’t know for sure what our primal utility for music is. But, we’ve all used music to elevate our moods, for social interaction, and even to remember times past.

Sometimes, music can be the best medicine.

Here are a couple of easy ways to use music to improve well-being right now:

Create a playlist: Creating collections of music that generate positive feelings is a good way to regulate emotions.

Share music: Music is a great way to bolster social interactions and feel more deeply connected to individuals in your life.

Make it: No matter how you feel, music is a great way to vent and express your emotions without words.

Lesser Known Self-Stigma Just as Dangerous to Black Mental Health

Adia Harris, Contributing Writer 

 

You’re walking down the street and a man on the corner you are approaching is acting strangely. Maybe he’s oddly dressed, appears disheveled or perhaps homeless. He is muttering to himself, looking up at the sky as if waiting for answers. 

What do you do?

Possibly, you avert your gaze to avoid eye contact and mistakenly engage this individual. You might instinctively surmise this person is mentally ill, and could potentially be problematic when engaged.

And perhaps, on a surface level, this is true. NAMI statistics show over a quarter of both the prison and homeless populations in the U.S. are comprised of individuals with a recent history of mental illness.  However, any apparent connection between me,ntal dysfunction and socioeconomic hardship should be investigated further. Research contrastingly shows that many common misconceptions borne of negative stereotypes about mental illness, including lack of cognitive capacity and assumptions about people with mental illness being violent, are not as true to reality as the public often thinks. 

So how do our socially accepted views affect individuals suffering from mental health conditions, and why does it matter?

 

Pinterest Image

Pinterest Image

Most of us are familiar with the term stigma, or as defined by a quick Google search, “a mark of disgrace associated with a particular circumstance, quality, or person.”  Significant amounts of mental health research are dedicated to how public stigma operates, however most of us are not familiar with its potential effects on individuals who are actually struggling with mental illness, particularly as a main contributing factor to a symptom known as self- stigma.

Self-stigma is a form of stigma that occurs when an individual with a certain trait/behavior (i.e. bipolar disorder or schizophrenia) believes and internalizes negative public attitudes (i.e. individuals with depression are emotionally weak, therefore I must be emotionally weak.) This internalization is often detrimental to an individual’s self-efficacy and can impede recovery during episodes of illness.

Erica James, an Atlanta-based marriage and family therapist, who also works with children and adolescents in foster care, has found internalized stigma can surface as significantly low self-esteem. 

“A lot of work I have to do in addition to helping work through issues is empowering my clients to learn and uncover traits about themselves they already possess that are positive, so if they are suffering from disorders like depression or anxiety, it’s not the only trait that they have and it is something they can work through.”

Unlike with physical conditions such as diabetes or cancer, individuals with mental illness may view their disorders as a character flaw rather than a common treatable condition. Instead of compartmentalizing their illness as one aspect of themselves, they may believe it to be their complete identity. This can lead to what is academically considered the why try effect, when individuals behave in ways that devalue their sense of worth and abilities, disrupting recovery, and even hindering the long-term pursuit of personal goals.

From a racial standpoint, research indicates African Americans are more prone to experience higher levels of both public and internal stigma than their white counterparts, and can even face what is known as double stigma. Double stigma occurs when someone feels doubly discriminated against because of their membership in two separately stigmatized groups, possibly leading to treatment-resisting behavior for fear of negative identification in more than one social circle.

“I think [prevalent mental health misconceptions in the black community] are shifting a little bit, but it really comes from us depending on our communities and families for help of any kind, [but] sometimes they are just not equipped or knowledgeable enough to help us though certain challenges,” James stated.

It may not be possible to completely eradicate symptoms of internalized stigma, however there are positive resources available to individuals, including peer support groups with others dealing with similar mental health concerns. 

There is a clear need for increased public awareness about mental health on a societal level.  Because public stigma can be a powerful inciting cause behind the internalizing of negative attitudes, we must collectively aim to delegitimize misconceptions through education to improve mental health outcomes.

As a therapist, James agrees that education is key. “A lot of people kind of fear the phrase mental health…they have an idea of what it is and may think of it in just one way. But mental health is an umbrella term and a lot of things go underneath it.”


Combating Stigma Resources & Initiatives: 
NAMI - Stigma Free
Mental Health America - African American Mental Health
Project 375
 

Ourselves Black Professional Spotlight and Dialogue: Dr. Kimya Dennis

Chandra White-Cummings, Managing Editor 

 

Dr. Kimya Dennis 

Dr. Kimya Dennis 

Periodically Ourselves Black will converse with and highlight the work of African American professionals working in diverse areas of mental health. One way to lessen stigma around mental health is to build and enhance the exposure to black psychologists, therapists, counselors, psychiatrists, sociologists and others who have education, experience, and training to be reliable sources of information, support, and treatment for the Black community. 


Our first dialogue is with Dr. Kimya Dennis. She has a PhD in sociology from North Carolina State University and combined with a masters degree in criminal justice, she is well prepared and qualified for her interdisciplinary work in suicide, self harm and mental health. We recently had an enlightening conversation with Dr. Dennis about suicide, mental health stigma and cultural dynamics in the black community. The discussion has been edited for length and clarity.

OB: Would you say that [the mindset of ignoring and dismissing mental health issues] becomes counterproductive in the area of suicide? Often these [issues are complex; and there are underlying reasons why people are making the decisions they make]. If you are in a community in which people are suppressing things, you may have people who are struggling and who need to interact about [their issues]. [Talking] could be a turning point for someone. How do we get people to understand that?


DD: That can be extremely difficult because one thing we know is that people know how to act. They know how to save face. But what they do when they get back in their own space is different from what they say [in public]. One thing I tell people is ‘I know I can’t change your mind, and you’re welcome to think whatever you want to think but now let's challenge what you’re doing’. Let’s say a family member seems to be having mental or emotional struggles, might have some suicidal ideation…let’s just say the person is acting different [sic] than they tend to act. Instead of people feeling the need to dissect everything, and agree with everything, I say please take that person to the doctor. That’s a first step. Call a suicide hotline. Usually when I say that people will grunt and say “Girl I don’t have time for that” or “Pray about it.” That’s when I say ‘Well I’m not going to try to change your mind about prayer but I know people who are praying for health insurance. And if they’re praying for health insurance, they’re praying for medical help. Just look out for the other person and try to help them because it doesn’t have to make sense to you in order for it to be a reality for someone else. We can apply that to mental health , suicide, drug abuse, alcoholism, over eating, type 2 diabetes, high blood pressure, fibroid tumors. We have so many things that people consider culturally normal. There are so many families where everybody has type 2 diabetes or all the women have fibroids, and if they find out you’re going to a gynecologist, they’ll say, “Girl don’t forget where you come from.”

Dr. Dennis’ comment about circumstances that people consider culturally normal led to a provocative segment discussing the normalization of pathology and illness in the black community. She feels strongly that African Americans and those of African diaspora must begin to redefine ‘normal’ as it relates to health and wellness. During  past presentations she has challenged her audiences to describe black culture without mentioning Dr. King, Rosa Parks or slavery, and she invariably gets a response of silence. Her point is that if blacks can only identify culture with anger, sadness, unhappiness and other vestiges of oppression, and consider that normal, how can illness ever be recognized and effectively addressed?


OB: Are there cultural adaptations that should be made to the suicide prevention model that’s being used right now? Particularly the warning signs, risks, and suggested actions? Two aspects of the model stand out specifically: 1) the instruction to go to a doctor or mental health professional, and 2)the suggestion to call a suicide hotline. Most would say those are things black folks are not going to do. We hear the narrative around distrust of the medical establishment, around how you don’t go sit and talk to other people about your stuff but at what point do we culturally adapt this to say if people insist on holding on to these attitudes, what else can be done to bring treatment and mental wellness to culture?


DD: That’s a question that so many of us have been asking for years. We have people who are working on that. Like the pastor in Baltimore who is doing work on trauma and violence in the black community. We have people who are trying to redesign these trainings to make them more culturally conscious. The difficulty in adjusting trainings to account for cultural variants is that most of the people who created these trainings tend to think that mental health and suicide are neutral and objective topics that do not vary. This is similar to how it took doctors so long to recognize the social components of health. In some of my community work with the American Foundation for Suicide Prevention , we’re all very eager to do community programs and to address how to reach different populations and how the training should be adjusted. An example is how the Mental health Association  [in my area] has the equivalent of church fans with mental health information on them. Churches, mosques, and synagogues are trying to get more mental health services. So there are people who have tried to reshape the training.


OB: I wonder if it wouldn’t be equally as effective to try to start at social ground zero, which is families. I think about my own family and it seems to me when you set a certain culture in your own family…for example with my sons I’ve worked hard to say [our place] is a safe zone so please talk, express yourself. I want there to be openness, communication, and non-judgmental understanding. So maybe families could designate Aunt so-and-so as the safe place and person so that if someone’s struggling they can call, text, or visit with her. This way it’s built in [to the fabric of a family] that you do not have to sit in a crisis with nothing and no one to help you. Sometimes we expect a bigger leap than people are ready for. We’re trying to get people to go see a therapist but they haven’t even been to a regular doctor in 20 years. Rather than trying to push people across that chasm initially, maybe we should teach ourselves to seek help within our own circles first. Learn how to do that and go from there. 


DD: There are trainings that are for people that are family, friends, or colleagues of people that might have health conditions. For example, people can get mental health certification. We know that one of the central issues is that people don’t want to tell other people their thoughts, feelings, actions or business because usually if you express suicidal ideation or other mental health issues, you can never really live that down. People will not leave you alone about that. If you go to someone and say “I’ve been thinking about killing myself”, the other person might refer you to a mental health professional but [there’s a good chance that] at the next cookout they’re going to look at you and wonder [what’s going on]. So a lot of people don’t want to be put in that category because they figure life is hard enough for them internally; they don’t want it to be hard for them externally, too. This especially happens in families where unfortunately many people are taught to keep their business to themselves because if you tell your business to someone else, you’re going to hear a long sermon. Your mama, grandmother, everybody will start preaching to you. They consider it a form of deterrent, kind of like “we're going to scare you out of it.” When you shame people like that, it’s not really going to make them stop doing anything. A lot of people will just get more crafty. They will learn how to hide it better. That’s where self-harm behavior comes in. [Many] people who use substances are self-healing; they’re hiding from feelings by getting high or drunk.


OB: You’re right, there are many intracultural issues we need to overcome.

To learn more about Dr. Dennis and her work on suicide, stigma, and other mental health topics, visit her website.
 

Yes, Black Teens and Young Adults Die by Suicide, Too

Chandra White-Cummings, Managing Editor 

 

 

On March 31, Netflix released its series adaptation of Jay Asher’s young adult novel, 13 Reasons Why. Like it or not, the topic of suicide is moving into the mainstream. And it’s about time.
The much-talked about show tells the story of high school student Hannah who dies by suicide and answers the question that haunts almost every family member, friend or coworker in the aftermath of real-life suicides: why? Viewers learn as the narrative unfolds that there are 13 people whom Hannah considers in some way responsible or contributing to her decision. One reason relates to rumors started about her—bolstered by misleading photos—by a classmate with whom Hannah has a brief physical encounter. She is humiliated by the damage to her reputation and the guy’s abandonment of her. That explanation seems straightforward but as research demonstrates, very little is that simple when it comes to suicide. It is precipitated by complex and interrelated circumstances in a person’s life. For Black youth and young adults that complexity is shaped by powerful societal realities that traumatize still-developing psyches and bring hopelessness and despair. Hannah is white, and her circle only included two African American teens, but the reality is that black adolescents and young adults die by suicide also, more than is commonly believed.

In the audio segment below, listen to a brief discussion of recent data on suicide among black youth 10-24 years old, as well as thoughts to put the data into perspective.
 

Clearly, suicide is a problem among black youth, too. Individuals, families, communities, and organizations need accessible, culturally competent and often confidential resources to help people at risk for suicide, and those recovering from an attempt. Often family and friends feel powerless because they don’t know what signs to look for or how to assess what they do observe. The American Foundation for Suicide Prevention identifies these warning signs that someone you know might be at risk for suicide:


What They Might Talk About                            How They Might Feel
Having no reason to live                                         Depressed
Being a burden to those around them                     Anxious
Feeling trapped                                                       Humiliated/Shamed
Ending their life                                                      Irritable/Enraged

What They Might Do

Excessive drinking/drugs                        Contacting people to say goodbye
Reckless conduct                                     Behaving aggressively
Isolate themselves/withdraw

Another way in which people feel at a loss when it comes to suicide is not knowing who in their life and social circles might be at risk. No one wants to constantly scrutinize their friends and family members, and teenagers and young adults can be especially challenging to read sometimes. Knowing proven risk factors combined with understanding your sons and daughters baseline personalities can save lives. The American Foundation for Suicide Prevention and other organizations say to be on the lookout for these evidence-based risk factors:

Risk Factors Related to Health


Having a mental health condition like depression, anxiety disorders, borderline personality disorder
Alcohol or drug addiction
Having a chronic health condition like HIV, cancer, diabetes, sickle cell anemia

Risk Factors Related to External Circumstances in Life

Death of a close friend or family
Prolonged stress from things like harassment, bullying, relationship problems, unemployment
Exposure to another person’s suicide

There are many organizational and educational resources for support. 


American Foundation for Suicide Prevention

Comprehensive resources for those who have lost someone to suicide, suicide attempt survivors, these who are concerned for someone they know, and advocates. AFSP brings awareness training to communities through programs like Talk Saves Lives ™ and suicide bereavement support group facilitator training. The site also has general statistics about suicide rates.

Suicide Prevention Resource Center

Provides training and materials support for professionals and practitioners who serve populations at-risk for suicide. 

Suicide Prevention Lifeline—1-800-273-TALK (8255)

A national network of local crisis centers and a 24/7 phone and online chat service to assist people trying to help a friend through a crisis or is facing a crisis themselves. 


ReachOut USA

The USA-based counterpart to Inspire Foundation/ReachOut Australia. Operates an online prevention and intervention resource for teens and young adults. Includes support forums and a crisis text line and loads of information, including a section on racism and mental health.

The Trevor Project

A crisis intervention and suicide Prevention Resource for LGBTQ youth and young adults, including The Trevor Lifeline 1-866-488-7386. 

If you or someone you know needs information or someone to talk to, please go to these websites, call the crisis help lines, or chat online with someone trained to help. Live life. Save life.
 

Tech Offers Promising Way to Narrow Black Mental Health Treatment Gap

Adia Harris, Contributing Writer

With nearly 90 percent of Americans owning mobile phones the ‘tech age’ is not just upon us, it's all around us. We use our mobile devices to solve problems, broker social interactions and even as pillow companions before falling asleep.

And that’s powerful stuff. Somewhere in the ‘app for that’ magic, mental health care is finding a new home in tech. The question is: Can it provide effective solutions?

The answer is not crystal clear. What is clear is that adequate help for mental health conditions is lacking. The National Institute of Mental Health reports that 50 percent of U.S. counties have no mental health providers, and research reveals disparities in treatment access are severely impacting minorities, leading to higher rates of misdiagnosis and more costly treatment.

Increasing access to timely and cost-effective treatment is vital to narrowing the mental health treatment gap. Here are some tech resources currently available:

Online support groups: The need for support is universal, and online forums created a new cyberspace for connections. Today, people continue to connect via support websites from everywhere imaginable.

The Pros: 
•    Transcend geographic barriers: Connecting online can break isolation barriers felt by sufferers of mental illness by providing a space to share stories, express intense emotions, and garner support when direct interactions are difficult.

•    Accessibility: Online support groups are usually free to join and are accessible at any time, day or night.

•    Community environment: Virtual communities help lessen negative feelings brought on by stigma, and are a great forum to share information about health resources.

The Cons:
•    No physical interaction: Anonymity helps facilitate open interactions, but be mindful of information you share online. Individuals you interact with can provide support only, not a plan of treatment. 

•    Not clinical therapy: Support groups are not legally liable to provide accurate medical advice. Seek professional help during periods of severe crisis.

Notable websites: Project Hope & Beyond   The Mighty   Psych Central (group listings)

Remote and Online Counseling: Talk therapy is a clinically proven method of treatment for mental disorders and Computers and mobile phones continue to expand access to this of treatment.

The Pros:
•    Transcends geographic barriers: Like online forums, patients and therapists can connect regardless of their physical locations.

•    Effective instructional therapy: Therapist Gillian Isaacs Russell states, “Therapies such as cognitive behavioral therapy (CBT) and positive psychology can be very appropriate for online use because they are didactic and not relationship based.”

The Cons:
•    Limits nonverbal communication: Research indicates at least 60 percent of communication is nonverbal. Consider the nature of your mental health concerns to determine whether in person therapy would be more effective.

•    Ineffective for crisis situations: Time and distance constraints can make remote therapists unreachable during emergencies. Always have contacts readily available when in immediate crisis. 
National Suicide Prevention Lifeline: 1 800 273 TALK (8255) 
Crisis Text Line: Text HOME to 741741

Notable services: Better Help   Talkspace   Breakthrough

Mental Health Applications: Mobile apps are making impactful waves in healthcare. We use these devices for a number of daily activities to make our lives easier and more productive, why not use them for mental wellness?

The Pros:
•    Affordability: You can search for free mental health apps in your smartphone’s app store; apps that do cost are usually between $1-$6.

•    Brain Training: Many mental health apps are geared toward skill assessment and development, regularly exposing users to a broader range of thinking and coping methods.

The Cons:
•    No evaluation standards: There is no clinical criterion for rating mental health websites or apps. You may want to consult with a healthcare provider for suggestions, and or develop your own rating criteria.

•    Choosing Wisely: Be careful not to inundate yourself with too many applications. Start with one or two apps to find what works best with your treatment plan.

Notable apps: Headspace   Lantern   Pacifica

Wearable Tech: Wearable tech is the most passive form of mental health tech. It can help with early diagnosis and in determining effective treatment methods.

The Pros:
•    Allows for self-management: Wearable tech can facilitate a personal understanding of mental health conditions and patterns of behavior.

•    Data Collection: Wearable tech gathers data without user assistance. Clinicians and therapists can use this data to track potential relapses and determine long-term treatments.

The Cons:
•    Privacy: When dealing with personal health data, vigilance is key. Mental health tech is relatively new and systems of governance are still developing.

•     Medical vs. consumer devices: Not all wearable tech is created equal. Clinically tested tech is likely to provide the best results, but consumer devices can be just as costly. Do your research.

Notable tech: Fitbits   Spire   

Although mental health technology is relatively new territory, with legitimate concerns to be addressed, it undoubtedly empowers both patients and mental health providers. Digital mediations cannot replace the necessity of physical interaction, but they are promising resources for bridging the treatment gap.

Black and Missing: Resources, Support, and Finally Girls

Chandra White-Cummings, Managing Editor 

 

If you’re Black and on social media, you have no doubt seen the tweets sounding the alarm about a recent cluster of black girls who have been reported missing from the D.C. area. Except for one of the missing girls—who we now know was located at an unnamed adults’ residence—not much background has been disclosed about the girls’ disappearances: possible reasons why, locations last seen. When we hear of black women missing, the instinctive thought is that trafficking, kidnapping, and/or gang activity is involved, and maybe that’s true. But is it possible that some of these girls really have left voluntarily, without forcible taking being involved? Is it possible that they left because of the lure of a potential romantic relationship which very likely could ultimately result in trafficking? Or could any of them have needed to escape the traumatic stress and pressure of their environments, even if just for a little while? If either of these reasons is true, does it make their disappearance any less urgent and their recovery any less vital? No, just the opposite.


D.C. mayor Muriel Bowser has announced the creation of a task force to address missing children. Her approach thus far seems to emphasize children who would be classified as runaways. Named initiatives include: identifying advocacy and community-based organizations that work with runaways and provide them with greater support; creating and promoting the 800-RUNAWAY hotline  and website for youth and their parents/guardians; and increasing the number of police officers assigned to the children and family services division. Her approach reflects recognition of a complex set of factors that are very likely involved when young black girls disappear. 


D.C. can be a tough place for anyone not connected to the bright lights and privileged existence of its elites, especially African American girls trying to navigate school where they might be invisible when it comes to support and guidance but overly scrutinized when it comes to discipline and punishment. Disappearances often occur when or close in time after school is in session. What kind of education environment are they facing? The D.C. Public Schools (DCPS) Equity Report for the 2015-2016 school year reports that black students had the second lowest in-seat attendance rate of all demographic groups (89.3%), but the second highest rate of suspension, at 11%. Females represented 6.5% of total suspensions. The report doesn’t measure sub-sub groups like black females but national reports like African American Policy Forum’s Black Girls Matter: Pushed Out, Overpoliced and Underprotected have highlighted the plight of black girls in the educational and juvenile justice systems. And there is an effort underway to change how data is reported so that needed attention can be focused on the educational needs of black girls.


In December 2015 the White House Initiative on Education Excellence for African Americans held the African American Women Civic Leaders Educational Policy Briefing. The agenda was the creation, collaboration, and coordination of a national blueprint to focus on black girls in education. Monique Morris states in her Ebony.com article covering the briefing:

From interrupting school to confinement pathways…to preventing campus-based sexual assault, African American female students are in need of a remedy to the negative effects of society’s mischaracterizations of Black femininity, particularly in schools.


Mirroring the focus on black men and boys of former President Obama’s My Brother’s Keeper program, DCPS in 2015 launched its Empowering Males of Color Initiative with a commitment of $20 million over three years to improve educational outcomes for its black male students. To date, no such program has been created for black female students.


Another key to the wellbeing of D.C.’s black women and girls is housing security and availability. Relisha Rudd, who disappeared at eight tender years of age, was living with her mother at a homeless shelter at the time she was reported missing. The 2016 Metropolitan Washington Council of Governments annual survey found that homelessness increased 20% that year and that 68% of the metropolitan areas homeless population is in D.C. A 2016 Washington Post story reported that for the first time ever, the number of homeless kids and parents outnumbered the number of homeless single adults. Housing support is as complex as maintaining housing, but any efforts aimed at addressing missing girls must also address their vulnerable families.


Now that the light has been shined more brightly on the issue of missing black women and children, it’s time for measured decisive, and thoughtful action. In the meantime, for those families caught in the nightmare experience of a loved one disappearing, there are effective resources available to work through the search and recovery process. Two national organizations, recognizing the media coverage and law enforcement investigation disparities for missing persons cases involving people of color, offer guidance and information. Black and Missing But Not Forgotten (BMBNF) offers a tips heat, What to Do if Someone Goes Missing, which includes advice on where to look for the person, what description of the person you should be prepared to give the police, and who besides police can be asked to help find the loved one. Similarly, the Black and Missing Foundation, Inc. provides a Missing Persons Checklist and a link to the Department of Justice publication, A Family Survival Guide.


Absent from these resources, though, and absent too from initiatives to address the problem of missing people of color, is identification and inclusion of mental health supports and resources. 
Every child who disappears should automatically receive the benefit of a mental/emotional heath screening with interpretation of results by a licensed mental health practitioner. Family therapy and counseling should also be offered to the family. An aftercare program similar to what’s provided to sexual trafficking victims is needed, with a care-centered, not perpetrator- minded focus. 


Ourselves Black will follow this story and provide updates on issues involved.
 

Black Stress Needs Black Action

Chandra White-Cummings, Managing Editor

Every year the American Psychological Association (APA) releases its Stress in America™ report with results from an annual survey on how Americans experience and react to stress, including what participants identify as their most significant sources of stress. The results of the August 2016 survey showed the lowest levels of overall stress in the 10 years the APA has conducted the survey. Questions dealing with the upcoming election were added, and results showed that 52% of participants were experiencing very or somewhat significant levels of stress related to the outcome of the election. In January 2017, it followed up with what it calls a snapshot, a much shorter, highly-focused set of questions designed to measure Americans’ stress levels regarding the political climate, the nation’s future, and the election. Not surprisingly, African Americans reported the highest levels of stress among all demographic groups surveyed.

Specifically, 69% of Blacks are stressed out about Trump being the leader of the free world; 71% are worried about police violence targeted toward minorities; and 70% are concerned about their finances. Fully a third of all Americans surveyed are experiencing symptoms commonly associated with mental health issues: feeling overwhelmed, feeling nervous or anxious, or feeling depressed or sad. (It’s interesting to note that even with the information now known about the differences in how minorities, particularly African Americans, manifest stress and onset of mental and emotional disturbance, the descriptions of emotional states still doesn’t include markers like anger, frustration, or irritation.)

Faced with stress levels like those reported in the survey and stressors more likely to get worse before they get better, strategic, intentional action is the cure for lessening the well-documented negative health effects of chronic, toxic stress. Exercise, meditation, reading, and the like can alleviate the damage done by cortisol build-up and its cell-aging action. But working to reduce and eliminate the sources of the stress gives more bang for the buck every time. 

The problems ‘out there’ must have solutions identified and developed ‘in here’. The average African American did not personally know Michael Brown, Trayvon Martin, Philando Castille, Oscar Grant, Rekia Boyd, Sandra Bland, Jordan Davis, Oscar Ramirez, Tamir Rice, or any of the other men, women, or children gunned down by cops. But police and community relations might still be a concern in your city or neighborhood. Maybe you did not lose your home in the big foreclosure blowout in 2008 or you are not unemployed. But perhaps money is still tight, and every month finds you struggling to put food on the table. Whatever your sources of stress are, consider doing the following to impact the roots of these problems and finally make some headway in relieving your stress.

Do the work to understand the issue(s).

With the vast amount of information on the Internet, via libraries, bookstores, and other information sources, it’s easier than ever to get at least a basic understanding of the pivotal issues affecting your community. If your child’s education keeps you up at night, go to the central administration office of your school district and grab copies of the quarterly newsletters. These publications are chock full of information on the strategic priorities of the district, data on teacher qualifications and performance, and student performance by school within the district. They also usually provide website addresses for the state Department of Education, and contact information for executive leadership and policy makers. Refuse to be deterred by barriers like not being able to attend PTO/PTA meetings during the day. Connect with other parents and caregivers with similar schedules, arrange your own meetings, and select a representative to collect the group’s concerns and availability to help with the problems, and email them to school and/or district leadership. 

Learn how to be an effective advocate.

The Texas Rangers organization has a saying: One Riot, One Ranger, meant to convey that any Ranger is sufficiently trained, experienced, and knowledgeable to handle situations so that each problem can be solved by just one of them. Aim to be the kind of person who is a skilled problem solver. The key to effective advocacy is to understand that every issue is at its core a person or group of people who need help. It’s also important to understand the effective use of emotions, influence, and negotiation. A protest, march, or rally—even good ones—won’t solve issues at the grassroots level. A skilled advocate knows the proper role of various change tactics and when to use each one. Find a workshop or class, or if money is tight, borrow a book from the library; invest in training to become a good champion for your children, neighborhood, and community.


Shift from a passive consumer mindset to an engaged actor.

As you consider ways you can work to eliminate the sources of stress, ask and honestly answer these questions:

How long has it been/Have I ever done a concrete action that addresses an issue that causes me chronic stress?

Do I know the leaders and policy makers who govern in my city/community/state? Have I ever contacted any of these people to express my views and/or offer my time to work on an issue?

Do I contribute money to any groups or organizations with practical expertise in my stressor issued? Can I name at least three such groups or organizations?

Have I taken any positive, concrete action based on something I’ve read, seen, or participated in the last six months?

DO. SOMETHING.
 

New Media to Help You Stay Woke to Black Mental Health

Chandra White-Cummings, Managing Editor 

Media focused on black mental health is exploding. Whether it’s social media, visual media, or the written word, discussions about and portrayals of  what it looks like to be black and experience anxiety, depressed mood or depression, fear, or Bipolar disorder have been on the rise since late 2016. People are rejecting the shame and stigma typically attached to mental disorders and illness and are openly admitting to struggles. And it’s about time and right on time. 


It’s no secret that media of all types is a powerful vehicle for exposing issues, provoking dialogue, and even suggesting solutions and productive strategies. In 1977 Roots, The Miniseries hit the airwaves and became a media and social juggernaut, with estimates that it racked up an audience of 80-100 million viewers for its last episode, and plenty of anecdotal evidence that it sparked much-needed and overdue dialogue. “Roots provided one of those rare sit-up-and-wake-up moments in American culture. After the show, hundreds of schools used the series as a history lesson. Whites…used it as an eye-opening exercise”, reported Teresa Willtz in a 2012 article on the show's 35th anniversary.

The weekly television dramedy, A Different World, which aired from 1987 to 1993, had a distinct and measurable impact on enrollment in historically black colleges and universities  (HBCUs). Dr. Walter Kimbrough, a former president of Philander-Smith College, describes this impact in a 2010 Q & A session on the New York Times blog, The Choice:


From the debut of “The Cosby Show” in 1984 until the end of “A Different World” in 1993, American higher education grew by 16.8 percent. During the same time period, historically black colleges and universities grew by 24.3 percent—44 percent better than higher education. But in the 11 years after “ A Different World” ended, while all of higher education grew at a robust 20.7 percent, historically black colleges and universities reward only 9.2 percent.

Racism and black higher education are two seminal issues of our time. The results of the 2016 presidential election, escalating and more visible episodes of police brutality against black citizens, threatened rollbacks of hard-won civil rights gains in voting and health care create a perfect storm to precipitate chronic challenges against the mental and emotional wellbeing of African-American and other-origin black people. Increasing numbers in the black community view protection of minds and hearts as the vital acts of resistance required now. Open discussion of pressures being faced is arguably the most important first step in making this a reality. Young filmmakers, writers, bloggers and artists are leading the way in producing media that has the potential to affect change similar to what happened with shows like Roots and A Different World. These are just a few.

SHRINK Web Series, Created and Written by Katrina Smith Jackson (British) 

The social media profile describes SHRINK as a “new digital drama series created by Katrina_SJ about a troubled therapist battling with her own mental ill-health and the intertwining lives of her clients.” The first season’s six episodes tackled a what’s-what of top issues blacks have faced for decades. Episode five, ‘Pretty for a Dark Skin Girl’ deals with colorism and its often devastating effects. Natasha, the lead character therapist has a client whose face gets disfigured from skin bleaching chemicals and has trouble coping with the embarrassment of the injury.

Episode two, ‘Some Sort of Arrangement’ shows a real-life application of the problems with deep-rooted stigma and shame among blacks about having mental health challenges. Natasha’s client is visibly disturbed by being at the therapy appointment, barely looking up at all during the explanation of the mood self-assessment she is given to complete. Complicating matters, Natasha’s coworker blackmails her bY forcing a sexual relationship to keep her own secret of mental illness hidden. The show has both anthological and episodic elements, drama and humor.

Each episode on average runs between 15 and 20 minutes but is packed with relevant issues and suggestions that can be used both for introspection and for public discussions.

Giants Web Series, Created and Written by James Bland
(Episodes release on Wednesdays)

Giants is a weekly web show that follows a group of black millenials as they navigate young adulthood facing very adult issues like hiding from who they think is the landlord because they are late paying rent, encountering the truth about themselves in ways and from sources they’d rather not deal with, trying to find the right path to the dreams they have for their lives, and yes, doing life with a diagnosed mental illness.

The most appealing aspect to this show is its unapologetic authenticity. There’s lots of profanity (which is how millennials talk), the situations are sometimes bracing but still not unrealistic (Malachi, one of the main characters, feels compelled to take a job as a sexual surrogate for a middle-aged white couple), and they don’t hide the physical and emotional manifestations of mental illness (Journey, the female lead, can’t get out of bed and cries and throws up when she’s having a particularly rough depressive bout).

Mental health and illness is definitely front and center in this series and that fact is bound to get people talking and hopefully acting on behalf of themselves and others who face these challenges every day.
 

AFFIRM Podcast, Created and Hosted by licensed therapist Davia Roberts
Biweekly episodes on SoundClou

This is a brand new media offering—2 episodes in—that was developed to provide safe-space conversations on topics for women of color who value and pursue wholistic wellness, and who want resources and content to support them. Ms. Roberts recognizes the need to have information and resources available especially to women who might be unable to pay for mental health services. 

Her last episode covered self-care, and there is also a self-care webinar scheduled for Thursday, March 2: “Self Care for Surviving 45-A 60 minute we binary for the woke, broke, and folks just trying to stay afloat.”


Check out and refer others to these media. Participate in your own mental health and help others participate in theirs.

Black Access to Mental Health Care Not as Simple as It Seems

Chandra White-Cummings, Managing Editor 

 

Kennesaw State University online image

Kennesaw State University online image

 During the years that Barack Obama was President, the statistics regarding numbers of African Americans experiencing mental/emotional and/or psychological distress did not change much. Blacks still report being in serious psychological distress at a rate about 10% greater than non-Hispanic whites. Serious psychological distress is a measurement of likelihood of having a “diagnosable mental illness  and associated functional limitations”. The assessment most widely used for this measurement is the Kessler “nonspecific distress scale” and uses six (K6) to ten (K10) questions, each with five possible responses. The K6 has become the preferred version because although it has fewer questions it has proven to be just as reliable as the 10-question version. A score greater than 12 on the K6 scale indicates emotional or mental disturbance that probably warrants attention and treatment. Now that Donald Trump has become President, indications are that those numbers might only increase. 


Odds are good that the average African American has never been evaluated with the K6 or K10, or any other official mental health assessment for that matter. But self-disclosures on social media, conversations where black folk have always had them—churches, salons and barbershops, informal get-togethers—and now even books like Benilde Little’s memoir Welcome to my Breakdown reveal that anxiety, depression, Bipolar disorder, and other mental illnesses are things that yes, even Blacks are dealing with. It’s therefore a welcome sign that self-care has exploded as a meaningful and viable form of help for those experiencing challenges to their mental and emotional health. Some types of self-care are mostly feel-good remedies, things like window-shopping, binge-watching a favorite show, or redecorating a room that could use a seasonal refresh. Other types of self-care offer a little more substance and are evidence-based behaviors proven to have longer, more sustained demonstrable effect on brain function and mood. Sleep, exercise, meditation, prayer, and even reading fit this category. Besides being a solid cultural expression of Kujicichagulia, the self-determination principle of Kwanzaa, intentionally practicing self-care is also a self-preserving response to a mental health care system too slow to change, too expensive for many, and too inhospitable to black and brown faces.


 The popular narrative has been that African Americans don’t see psychiatrists or other therapists and counselors mainly because they don’t trust the medical profession, stigma shames people into isolation, and treatment is financially out of reach often even for the insured. Not to say that any of those statements is untrue; they just don’t tell the whole story. The distrust of medical practitioners is due in part to a dangerous and deadly history of experimentation and hyper-scrutiny on one hand and outright neglect on the other. Blacks definitely are reticent to admit or discuss mental and emotional problems and still have an irrational fear of being labeled ‘crazy’. And  insurance coverage can still leave an insurmountable payment gap for people to close. But a more fundamental problem underlying these issues is access—there aren’t nearly enough black mental healthcare providers to meet the need. 


The Bureau of Labor via its Occupational Information Network (O*NET ONLine) service reports the following 2014 employment data for mental health related professions:


Therapists – Marriage & Family   34,000
Counselors – Mental Health (excluding social workers, psychologists, and psychiatrists) 128,200-135,000
Psychiatrists- 28,000
Psychologists – Clinical, Counseling, and School  155,000
Mental Health & Substance Abuse Social Workers (Clinical)  118,000


These numbers are not race or gender-specific so then the question becomes how many black mental health practitioners are potentially available to treat African Americans with mental health illness. Not as easy to determine as you might think.


State licensing boards are not permitted and do not collect race information on mental health professionals. Membership in professional groups and associations is better than nothing but even many of the websites for black professionals don’t provide information about how much of the profession is represented by their members, and often not even how many members they have. The National Association for Mental Illness (NAMI) in a fact sheet created as part of its partnership with Alpha Kappa Alpha sorority, indicates that 3.7% of American Psychiatric Association members and 1.5% of American Psychological Association members are African American. Nonetheless, membership in a professional group is a subset of a subset because not all licensed professionals are also members in associations.


There are alternative ways to receive treatment for mental disorders including peer support and other types of support groups, but for those persons who truly require the knowledge and training that is only provided by a licensed mental health professional, where do Blacks go and what is the answer for them? Governmental agencies and policy groups push cultural competence as a solution to close the access gap for blacks seeking treatment. The idea is that while a psychologist may not be black, she can be taught cultural understanding and empathy through specialized education. The Office of Minority Health defines cultural competence as being able to function effectively in a cross-cultural setting taking into account a patient’s language, customs, beliefs, values, and institutions. Part of the established standards of culturally-competent care is that the care be “respectful of and responsive to” those beliefs, practices, and needs. Cultural competence has gained traction in important policy and public health discussions, but enforcement of national standards is challenging. Moreover, the addition of linguistic considerations to the cultural competence model has diverted some of the earlier focus from blacks to language-diverse communities like Hispanics, Filipinos, and other ethnic groups.  


The provider shortage and increasing demand might cause more people to reconsider their insistence on ‘buying black’ when it comes to mental health treatment, but it can still be a hard sell to convince African Americans to put their mental health in the hands of someone who doesn’t look like them. Dr. Nekeshia Hammond, principal of Hammond Psychology & Associates, 2017 President of the Florida Psychological Association, and author of The Practical Guide to Raising Emotionally Healthy Children says that cultural competence and same-ethnicity providers are important but “it is not recommended that someone not receive the care they need because there are not enough African-American mental health professionals in your area."

Perhaps arguments similar to those made to Blacks who are hesitant to date or marry non-Blacks; there is something to be said for simply connecting with someone despite differing race or gender. In that regard Dr. Hammond believes, “The reality is that one of the most important factors in a therapist-client relationship is a positive connection”, and she suggests people “look for a therapist who is culturally competent, but also place emphasis on someone you can trust and [with whom you can] feel comfortable discussing your concerns.”


Before access becomes the issue, it’s necessary to understand if professional care is warranted, what type of mental health professional will best meet the individual need and how to find one.

Part two of this series will discuss those issues.

 

Trafficking is a Problem for Black Girls, Too

Chandra White-Cummings, Managing Editor 

A teenage girl bounds down the steps to her kitchen, assures her mom that she has no time for breakfast but will grab something at school, says she is walking to school with her best friend, heads out the door happy, and vanishes. The police and even school personnel try to characterize her as just a rebellious or flighty runaway. She was actually snatched a block from her home by a sexual trafficker.


This particular scenario is the beginning of a novel by Pamela Samuels Young, Anybody’s Daughter, but similar situations happen daily in real life. Data on child sexual trafficking is complex, not integrated across related issues, and underreported but the following statistics shed light on the problem:


The 2012 United Nations Office on Drugs and Crimes’ Global Report on Trafficking in Persons reported that 6 in 10 survivors had been victims of sexual trafficking.


Girls Educational & Mentoring Services (GEMS), a nonprofit that provides services to teen survivors of  commercial sexual exploitation and domestic trafficking, reports that 85% of victims are female, 75% were involved with child welfare services and/or foster care, 70%-90% have a history of sexual abuse, and that in 2015 94% of its clients were girls of color.


Data from the 2015 annual report of The National Human Trafficking Resource Center show that 85% of its calls/contacts related to trafficking of minors involved in sexual exploitation.


As is the case with other issues like missing persons, juvenile justice and reform, and education, sexual exploitation and trafficking of black women and girls is overshadowed by media attention on whites because of racial and gender bias and stereotypes. And as it is with those issues, the black community can’t be content to sit in the shadows while more lives are impacted.

 
Atlanta attorney Sherri Jefferson is committed to educating the public and raising awareness of the phenomenon she has labeled “urban sex trafficking”, which she defines as “a concept of approaching the experiences of victims of sex trafficking within urban, suburban and rural corridors whose pimps, purchasers and profiteers rely upon and take advantage of metropolitan areas (epicenters or urban centers) to traffic women and children.” Highlighting the plight of African-American and other minority girls and women allows the inclusion of cultural and environmental factors that help people recognize trafficking in inner cities and differentiate it from racially-motivated characterizations that portray sexual exploitation as lifestyle choices and moral deviancy. Gang-affiliated home-based sex parties, exotic dancing and stripping, and music video production are all contexts Jefferson identifies as situations that hide sexual trafficking and exploitation of black females in urban areas. Another entrée into child trafficking is featured in Young’s novel: contact with young girls through ‘relationships’ with fictional people on social media. Vulnerable girls are targeted and approached by men posing as a guy in the target’s age group, sometimes older. The female is groomed by creating emotional attachment and then persuaded to meet the new ‘boyfriend’ away from family and friends. Black and brown girls are especially vulnerable because traffickers pick targets who don’t have a male presence in the home, have been abused/neglected, or are poor and potentially responsive to economic incentives and gifts. 


Girls and women subjected to trafficking and exploitation suffer unimaginable physical, mental, and emotional trauma. Being emotionally manipulated then trapped in degradation and made to believe there’s no escape and no one who cares about what’s happening to them, trafficked and exploited women and children who survive and do get out describe the serial rape they endured in shocking yet plain terms. Some describe having to service up to 50 men a day with little rest or food, others report being savagely beaten by especially depraved and violent perpetrators or by pimps and ‘managers’. And for a majority of these girls, their trafficking experiences are simply the latest phase in an ongoing cycle of abuse. Survivors need specialized mental health and social services to heal deep wounds and prepare them for successful living in their communities. There is tremendous need for support, and more organizations are providing resources. 


To get involved, get educated. These books and organizations can help.


Books
Girls Like Us: Fighting for a World Where Girls are not for Sale, Rachel Lloyd (Nonfiction)
Anybody’s Daughter, Pamela Samuels Young (Fiction)


Organizations
GEMS, Girls Educational and Mentoring Services  www.gems-girls.org
Sherri Jefferson/ African American Juvenile Justice Project www.sherrijefferson.com
Urban Institute, Justice Policy Center  www.urban.org/policy-centers/justice-policy-center
FAIR Girls www.fairgirls.org