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What Do the American Psychological Association’s New Guidelines Mean for Black Men and Boys?

Text: Lisa D. DeNeal and Stanley B. Chambers Jr.

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Nelson McCoy was 10 years old when he heard the words that would forever define how he views racial strife, particularly against black people: “Son, there are some people that value the life of a dog over yours.”

His father first spoke those words after footage of Rodney King’s beating by four Los Angeles Police Department officers was released in August 1992. Years later, McCoy, now 38, spoke those same words to his then 12-year-old son in 2013 after George Zimmerman was acquitted of murdering Trayvon Martin.

McCoy, who has received counseling since his youth, said psychologists should highlight and address the pressure black men face in dealing with racism, but without impacting their treatment.

"Psychologists should look at black men in all of our different arenas to fully understand the impact of institutional discrimination, negative media references and the legacy of false perceptions that were passed down,” said McCoy, a full-time doctoral student in Jacksonville, Fla. "They should treat us like people who have been through different levels of trauma. Because not all of us have experienced the same things in the same way.”

The American Psychological Association released “Guidelines for the Psychological Practice with Boys and Men” to help psychologists better address their male patients who are either victims or accused of bullying, physical or sexual harassment, depression, and/or anxiety. While the guidelines serve to address boys and men regardless of their backgrounds, the APA acknowledged that specific identities--including race—play a role in how masculinity is experienced and performed. The guidelines come as the organization aims to help psychologists address high violence rates among men while admitting its decades-long concentration on white men for male-focused psychology.

Racism and inequality can lead some to "avoid identifying with their cultural heritages" and have been associated with poor psychological and physical health outcomes, including high blood pressure, prostate cancer, cardiovascular disease and stroke.  The U.S. Department of Health and Human Services’ Office of Minority Health reports that black Americans are 20 percent more likely to experience serious mental health problems than the general population. According to the APA, black men are more likely to absorb their strife instead of seeking external help, according to the APA.

That’s a statement Dr. LeRoy Reese, director of behavioral health at Akoma Counseling and Consulting in Decatur, Ga., said he found problematic.

“In truth, part of the reason they don’t seek help, is because they don’t realize that they need help. The health of men subverts when they are tied to the traditional norms of masculinity, but there is no ongoing feedback system to boys and men about opportunities for growth. So in order for me to get help, I have to know I need help. And it has to be the norm, that it’s okay for me to go for help.”

Reese said that while he applauds the efforts of the APA, he also questions the principles of the updated guidelines.

“Some of the principles are really on one level, aspirational. But the problem with that is they can also sometimes be discouraging, as in an ideal world versus the world that we currently have,” said Reese, who is also an associate professor of community health and preventive medicine at Morehouse School of Medicine in Atlanta. “I applaud the big picture, but I am concerned about some of what is missing. They have a couple of opinions that I think can become actionable. I think the APA has an opportunity to show that they are serious about this by thinking about how they require the training of applied psychologists to consider the inclusion of these principles and guidelines. Because otherwise it becomes academic paper that sits on somebody’s shelf, and, at that point it is of no use to anybody. So there are limitations and problems with the document but I think we have to be careful to not minimize the good in search of the perfect.”

While parts of the report could’ve been better said, such as not using the outdated term “cool pose,” Dr. Phillip Murray sees the recommendations as a “good stab at a pretty ambitious goal” and a step in the right direction that won’t trigger mental health professionals to double down on any negative perceptions of minorities.

“I think they’re trying to highlight these things as factors so psychologists can be aware they exist as opposed to not treating these people in certain ways,” said Murray, an emergency psychiatry physician at the Carolinas HealthCare System in Charlotte, N.C. “The whole thing is more about how masculinity influences boys and men’s mental health.”

Murray sees the guidelines as a way for psychologists to help reduce the stigma around masculinity for black men and boys.

“I think the goal of deconstructing traditional masculinity is good, it’s helpful, it’s healthy,” he said. “It gives boys and men a wider range to communicate about emotional topics when a lot of times, the larger culture says that’s not what boys or men do. And I think that will trickle down to African-American culture as well, but it’s something that can’t come from a traditional organization. It has to be attacked from multiple angles.”

One of those angles, Murray pointed out, is personalities and hip-hop artists like Charlamagne Tha God, YG, and A$AP Ferg openly discussing their mental health, an effort Andre McDowell views as a good way to help remove the mental health stigma within minority communities.

“I don’t see any shame in mental health treatment and I wish more of use felt comfortable enough to do it,” said McDowell, 41, a restaurant manager in Richmond, Va. “I don’t put the onus squarely on psychologists or the psychology field. I think that it would be helpful if they did something more to help in a particular race’s…if they help with the comfort. I wish there was more to help with the comfort.”

Psychologists, psychiatrists and therapists may sometimes have to visit a patient’s home or a community center to make male patients comfortable, Reese said. Reese said he almost exclusively sees black men and boys in his office, and has a three-month waiting list for new patients.

“My office represented a foundation or his being pathologized and by me going to the patient’s home, or community center, the person then says, ‘this is where I can meet Dr. Reese.’ The more places where young men and boys of color go to get help, the less likely that they’ll have to come to the therapist’s office. So, it’s not about them seeking help where they provide help, but providing help where they are.”