Breaking the Code of Silence: Black Americans and Mental Health
Because of stigma, lack of access and several other factors, only one quarter of Black Americans seek mental health care. Understanding these reasons is the first step toward making a change.
Cost and Availability
People living in rural areas or underserved neighborhoods have difficulty seeking adequate providers close to them. Furthermore, accessing care can be expensive because of the price of services and travel costs. Many Black Americans lack access to quality providers due to ever-increasing costs, even with insurance coverage. According to the American Psychological Association, African Americans are more likely to use emergency medical services than their white counterparts, likely due to being underinsured.
Crippling Stigma
Given the history of African Americans in the United States in regards to slavery, collective cultural resiliency is particularly strong and in some ways a great disadvantage when it comes to accessing mental health services.Additionally, some African Americans have a hard time discussing mental health issues because their emotional conditions are often seen as “white issues.” There is still much cultural stigma around any acknowledgement of emotional conditions that are seen as a sign of weakness.
The Impact of the Tuskegee Experiment
Racism is still prevalent, making many people of color afraid of accepting mental health assistance. Experiences such as the Tuskegee Experiment mark an important cultural collective trauma that persists in African American consciousness today.
In 1932, researchers at the Tuskegee Institute — in collaboration with the Public Health Service — began a study known as the “Tuskegee Study of Untreated Syphilis in the Negro Male.” This study included 399 men who were diagnosed with syphilis and 201 men in the control group.At the time, even more African Americans lacked adequate health care. White researchers and local doctors promised the men clinic visits, treatment, and medication to manage and ultimately cure their conditions. What participants did not realize was the facilitators lied to them.The men were studied longer than they expected and many died as a result. Researchers intentionally didn’t treat them with penicillin, which emerged in 1945 as a cure for syphilis. It wasn’t until the 1960s, when black researchers began to work at the Tuskegee Institute, that the illusion of treatment crumbled and the story of maltreatment hit the Associated Press. Social worker and epidemiologist, Peter Buxton – also known as Peter Buxtun — has been credited as the whistleblower who broke the story to the press.
Alternative Sources of Support
Due to historical atrocities like slavery and the Tuskegee experiment, Black Americans have a history of accessing local spiritual and religious communities for much-needed emotional and mental support. Churches and religious fellowship have been at the heart of Black survival in the United States. Religious organizations served as organizing centers during the Civil Rights movement of the 1960s and many Black Americans continue to utilize pastoral services as a means for not only spiritual enlightenment but also for everyday guidance.
Lack of Competent Providers
Trust is critical to developing a relationship with a therapist with whom you will ultimately discuss all your hopes and fears. Many Black Americans have interacted with mental health providers and medical personnel that lack a nuanced understanding of issues faced by communities of color. This creates an environment of distrust.Fortunately, now more than ever, graduate schools and therapist training programs are helping therapists in-training gain more experience in treating diverse populations. These programs are also helping therapists uncover their hidden biases and prejudices about Black Americans and other marginalized groups. Providers are now a lot more equipped in addressing the needs of communities of color.Black Americans can be assured that therapists of all ethnicities and backgrounds are dedicating themselves to develop a deeper understanding of the needs and barriers that Black Americans face when engaging in therapy. If you are having a tough time and want support, don’t suffer in silence.If you are in NY/NYC and interested in services with me, please visit Viva to submit an inquiry.
This post was originally published at the Talkspace blog.
The Ask a Therapist Podcast! with Myleik Teele of My Taught You
I recently had the chance to speak with Myleik Teele on her popular My Taught You podcast. We talk all things therapy and answer some listener questions about setting boundaries, practicing self-care and dealing with "situationships" (and why I feel strongly about that term). Give it a listen below!
5 Self-Care Tips When You're in Recovery
Editor's note: This is a guest post from writer and pastor Steve Austin. This post discusses themes of suicide, recovery and self care.
When the police and paramedics opened the door, they pushed through the lounger, the kitchen and coffee tables, and found my body there, in the hotel room. I was lying on my back, covered in vomit. There was vomit on the bed, on the floor, and it had projected up the wall behind me and covered a massive picture that hung behind the bed. Those who found me thought it was a murder scene. Apparently the pink Benadryl pills, along with the tens of thousands of other milligrams of prescriptions and over-the-counter medications I took, made it look like blood. They thought I was dead and I should have been. I wanted to be. I had been unconscious nearly twelve hours.
The one flash I have of coming to was being transferred by the medical personnel from the gurney to the hospital bed. Everything was colored white except the navy of the nurses scrubs. I'm assuming it was in the ER. I remember them cutting my clothes off and it was all like a nightmare. I couldn't respond but I remember them counting "1...2...3..." before lifting me up and over. And what emotion do I remember from that? Shame. Ashamed of being naked. I had never been more vulnerable.
I couldn’t process all of this in that brief moment, but here I was, a failed minister, an embarrassment to anyone who ever cared about me, and I couldn’t even get a suicide right. The same thing happened when the male nurse came in the next day and I woke up in one of those momentary fogs. I wasn't worried about the pain of him ripping out the catheter. I had experienced far greater pain. It was the shame attached to being naked and having my penis touched by another man. A stranger.
After three days in ICU, the doctors decided my liver wasn’t going to fail, and I had regained feeling in my legs. I was released from ICU and immediately transferred to the psych ward. The psych ward. Me. The former worship leader. The youth pastor. The Christian radio host. The blogger. The ministry school graduate. The father. The husband. The outgoing one. The friendly one. The upbeat one. Me. I was sitting in a wheelchair, headed to the psych ward. And I stayed there for several days.
Since those darkest days, I’ve fought really hard to recover and learn to practice self-care daily. Here’s 5 ways to practice self-care during recovery:
Focus only on things that make you better
Especially in the early days of recovery, there is so much I can’t control. But I can always control how I take care of myself. I can respect my limits, fight distraction, and focus on recovery.
Remember, you are more than just a diagnosis
Labels are important, especially from a medical standpoint. They give us a plan of action. They show us a lot about our limits. They teach us which medications may help and what substances or situations to stay away from. But when we focus more on the label than the person behind it, a human being in need of love and belonging, we miss the point. And we miss an opportunity to live a full and meaningful life.
Don’t forget: hard days don’t last forever
Sometimes hard days mean I take an extra five minutes on a lunch break to hide in the server room at work and take a few deep breaths. If necessary, I am also not afraid to take medicine my doctor has prescribed specifically for those moments, or even take a “mental health day.” I’m not an advocate of hiding under the covers, but I also believe in knowing yourself well enough to acknowledge your limits.
You don’t owe anyone an apology for your story
When others don’t understand recovery from abuse, addiction, or a suicide attempt, they can make comments that seem to have a hidden meaning. Sometimes it’s intentional and sometimes it’s just plain ignorance. Either way, those jabs bring on shame. If I feel like someone thinks I should have my life more together than I actually do, I feel a need to say I’m sorry. But I don’t owe anyone an apology for my recovery. I don’t have to feel bad for having a hard day.
Boundaries, boundaries, boundaries
What do you do with the people in your life you can’t easily push away? Those who are permanent fixtures, those whom have both hurt you and been hurt by you? Maybe it’s parents or old friends. In my life, the answer to that question looks like checking in with them on my terms. I set the pace of our relationship now.If you have ever felt hopeless, if you have ever believed all the bad things in your life were beyond redemption, if you have ever felt unworthy of being loved or accepted, if you have ever feared what would happen if people found out whatever it is that haunts you — I get it. I have been there, too. Maybe you are recovering from abuse, addiction or a suicide attempt like me. Maybe you are struggling with anxiety or depression and don’t know why yet. Learning great self-care tools will help you begin to answer the question, “Now what?” Recovery isn’t easy. Self-care makes it possible.
Why I Think the University of Chicago Got it All Wrong on Trigger Warnings
Note: This post includes discussion about the topics of sexual assault and consent. There are no graphic images or descriptions of sexual violence. If you are a survivor and looking for support, please visit RAINN.
Last month, the University of Chicago sent a letter to incoming students which included discussion on the university's stance on both trigger warnings and safe spaces. In the letter, Dean of Students in The College John Jay Ellison states:
"Our commitment to academic freedom means that we do not support so called ‘trigger warnings,’ we do not cancel invited speakers because their topics might prove controversial, and we do not condone the creation of intellectual ‘safe spaces’ where individuals can retreat from ideas and perspectives at odds with their own.Fostering the free exchange of ideas reinforces a related University priority—building a campus that welcomes people of all backgrounds. Diversity of opinion and background is a fundamental strength of our community. The members of our community must have the freedom to espouse and explore a wide range of ideas."
I agree that universities and institutions of higher learning should foster a diversity of thoughts and ideas. After all, that allows for the most well-rounded kind of education. But, I think that the university’s stance on this is misguided, if not downright insensitive. We’re not talking about preserving the right to academic “discomfort” here. We’re talking about the potential benefit of limiting further psychological damage in a patriarchal, misogynist and sexist culture.The folks at the University of Chicago seemed to be conflating the ideas of free speech and reasonable access. Trigger warnings aren't about giving in to "PC culture". They're about showing compassion to another's pain and suffering.Trigger warnings aren't about limiting speech in the slightest. I see trigger warnings as being about two chief ideas:
Accessibility
Compassion
Accessibility
For those who have experienced traumatic events, such as sexual assault or abuse, the effects can be longstanding. Some go on to develop Posttraumatic Stress Disorder, though not all survivors do. Engaging in a culture which allows for trigger warnings means that before involved discussion about the ideas of consent and sexual assault, students would have the opportunity to not take part or emotionally prepare themselves for such a discussion. A notification of the impending discussion doesn’t mean that there will be no discussion, it simply gives a survivor the opportunity to exit or prepare from psychologically damaging material. For those in recovery, the power to opt out can not be overstated.
Compassion
What I find most incredulous about the whole controversy about trigger warnings is how difficult it seems to be for people to step outside of themselves and think with their hearts instead of their minds. It may take 5-10 seconds to issue a trigger warning about a certain topic, so I think that it’s fair to say that it’s a pretty minor inconvenience for most. What if that minor inconvenience for you enabled someone the ability to avoid further psychological pain? Why wouldn’t you want to help someone in that way?You may have noticed that there was a small notation at the beginning of this post. In essence it was a trigger warning about this post's content. That's really what we're talking about here.
I question any institution of higher learning that doesn’t seriously take into the account, or prioritize, the mental health of its students. And given the rate of sexual assaults on campus, particularly among first semester women, it is astounding to me that the University of Chicago would not be more compassionate about such an issue.Some may argue that participating in these discussions is somehow “good” for survivors as it desensitizes them to the language and content. In essence, some argue that this “no trigger warning, no safe space” policy enables survivors the opportunity to heal. Well, they’re wrong. Only in the context of a safe and controlled environment, such as a therapy hour, can that kind of systematic healing begin. It takes a highly experienced and trained mental health professional to foster that kind of trauma recovery experience. The classroom is no place for that.By giving trigger warnings, what do you really have to lose?
You may view a sample of the letter sent to incoming freshman of The University of Chicago at this link.
What is online counseling?
Health care has entered the age of technology. Telehealth services are on the rise and companies like Pager, Oscar and Talkspace (among many others) are disrupting the current insurance company standard and instead focusing on client (or patient) experiences. As a provider of online services, I find that there is a lot of confusion about what online counseling is and can be, so I thought I would share some thoughts with you with the hopes of clearing up any confusion.
Traditional counseling takes place in an office setting where you sit face-to-face with a therapist or counselor who talks you through your concerns and helps you explore solutions. With online counseling, you can have a very similar experience. For example, if you contact me we will start with a free consultation where we can begin to discuss what's been going on for you lately and what you may be looking for in terms of support. From there we collaborate on a plan that meets your needs and then we're off to the races!
Online counseling services can include things like text based conversations and video or audio calls. It's very flexible based on your needs, budget and lifestyle. One of the great things I love about online counseling is the flexibility for both the therapist and client. With my online practice work, we talk through your concerns openly just like you would in a face to face setting. There are some obvious limitations as it relates to crisis care, but online counseling isn't built for that, at least not just yet. Video sessions are great for those who travel often or are otherwise unable to meet with a therapist.
If you're looking to speak with a licensed therapist on a consistent basis but find traditional counseling too inaccessible or too hard to schedule then online counseling might just be a good fit for you.Whether you are trying to work through relationship concerns, work issues, depression or anxiety, or identity related (race, immigration, LGBTQ) concerns I can help. Submit an inquiry to begin your free consultation where you can learn about how online counseling could be beneficial for you.