Chandra White-Cummings, Managing Editor
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.