Suffering In Silence: Mental Health Conversations in Communities of Color

As a person of color, the topic of mental health is avoided like the plague in our community. We all have that family member or friend who, at the mere mention of going to counseling, shouts back “I’m not crazy”; “You should pray about it”; “Tough it out”; “Therapy’s for White people”. These answers are further distractions from the real problem. I’m not saying there’s anything wrong with seeking counseling services from your religious leaders, of which is a great support system for those who believe. However, there are some things that require a different outlook. There’s just something about a fresh perspective that can bring about change. I’ll admit to being a novice in the field, but I can say that I do have some African American clients. However, amid the few, a substantial portion fails to receive continuous care (Snowden & Yamada, 2005). High levels of untrustworthiness and the stigma drenched with the word therapy/counseling may influence this lack of commitment. A part of the problem lies in the lack of public discussion and recognition of these disparities in our community and what can be done about them. Something needs to change ASAP because I, for one, am tired of hearing about the behavior of members of another race being dismissed as a result of mental health difficulties, but my own people who are struggling mentally, just as much in some areas and more in others, being publicly ridiculed, never even given the chance to defend themselves, while struggling to stay afloat in a society that was built on our backs and which is working hard to keep us that way.

The key word here is suffering because that’s exactly what we’re doing. While many people from all different backgrounds find the topic of mental health a difficult one to discuss, African Americans especially have created such a negative association with the term that discussion is actively avoided. According to the U.S. Department of Health and Human Services Office of Minority Services, African Americans are 20% more likely to report having serious psychological distress than non-Hispanic Whites. Unfortunately for us, this stress is often coupled with higher levels of poverty, with those living below the poverty line being 3 times more likely to report psychological distress, when compared to those living twice the poverty level. Yet and still, White people are receiving nearly double the amount of mental health services than African Americans. A more common practice in the African American culture is to seek help from family and friends, not from “out-group members” as therapists may be viewed (Vogul et al., 2007).

To go back to the earlier misconception of being “crazy” as a reason to seek counseling, I for one do not like to use the “c” word with anyone. EVERYBODY has struggles at one point or another in their life. Therapy helps you work through them and helps you find the most effective and productive resolution. Everyone in therapy doesn’t have a diagnosis of Bipolar or Schizophrenia. Therapy can also help you work through grief, trauma due to things such as natural disasters, relationship stress, among countless other things. Yes, you can lean on friends and family for support during these times. In fact, minority groups who value close networks have been found to use family and friends rather than counselors when seeking help (Vogul et al., 2007). African American youth tend to use a family member more often than White American youth when experiencing a problem (Vogul et al., 2007). I hear you when you wonder why someone would want to pay a person to listen to his or her problems, but I promise we have a lot more to offer than our ears. Although each client is unique and each culture has its differences, through research and experience, providers have and will gain the knowledge necessary to assist minorities if you let us.
One thing we don’t see enough of is our own people offering these services. As a member of a non-dominant population, it can be hard to relate to, or expect to be related to, a person of the dominant population, especially when some of their actions have contributed to your suffering. I remember expressing my despondency regarding my relocation to a predominantly White area. Nothing wrong with White friends, I just missed my people. Speaking with a White male, he compared it to his relocation and having to adjust to fishing for a different type of fish than he was used to. I get the analogy, but c’mon now, I’m a person not a fish. Insensitivity has a huge impact on the needs of minorities seeking services and may in fact contribute to why we tend to run the other direction. However, there are issues much bigger than this that are causing us so much pain that it’s worth the exploration to find someone who you can relate to. As much as this profession is growing and expanding, the rate of ethnically diverse providers is struggling to keep up. With this in mind, it’s important for all practitioners to be culturally sensitive to the problems brought to therapy. This is important for clients to know too that they may need to provide a more in depth explanation of their struggles, and it may take some time to find someone they’re comfortable with. Cultural sensitivity can have many interpretations, but here it’s referring to awareness of unique differences that impact treatment. For instance, some symptoms may be misinterpreted in certain cultures as something other than a mental health issue. As an example, the National Alliance on Mental Illness notes that numerous African Americans struggle to identify symptoms, underestimating the impact that it may be having on a person’s life. Take depression, it may be written off and referred to as “the blues” when in reality it is a common mental health disorder experienced among African Americans more often than White Americans.

Anybody out there familiar with the TV series A Different World? I recently began binge watching it again on Netflix, and there was an episode where Whitley attended one therapy session when her feelings for Dwayne and Julian were conflictual. Her one take away was “relax, relate, release”, and I’ve noticed in future episodes that she repeats that same phrase in times of stress. Though comically expressed through Jasmine Guy’s overly dramatic character, it was a great example of one of the many benefits therapy has to offer: the things you learn can be applied to different areas of your life and used over and over again. This is especially true due to the fact that the likelihood of African Americans currently receiving services decreases if there was past service (Broman, 2012). I was pleasantly surprised at even the slightest mention of the subject of therapy in the late 80’s/early 90’s. Psychological distress doesn’t necessarily mean a diagnosable disorder; it simply refers to your mind feeling overloaded with what life has thrown at you.

There has also been a lot of discussion around medication that is offered in conjunction to therapy. True, it can be helpful, but it’s also costly in the long run of continuously having to refill prescriptions. Therapy is about activating tools that you already have within yourself to work through troubling situations. Let me tell you something, the old me was against this ‘hoopla’, as it’s often referred to, at one point too. I’ve experienced things in my life where therapy crossed my mind, and just as swiftly I kicked it out. I won’t sugar coat it, it’s a very vulnerable process; sharing your personal story with a stranger, anticipating judgment and backlash for what you have to say, expecting to be misheard and misunderstood. But for your own good, sometimes you have to take that chance. Speaking from personal experience, it’s a necessity. Just like your doctors and dentists appointments, hair appointments, even the popular need for retail therapy and other personal care appointments, this mental health check-up is just as, if not more, important.

Cost is something that can also contribute to this suffering. Many people think that all these services are offered at an unreasonable price, and that just isn’t true. There are numerous community health clinics that offer these services to individuals with or without insurance and on a sliding scale fee. Sometimes these places also have interns, who are training in the field under the supervision of a licensed professional, and offer these services free of charge. This can also be found on college campus’ that again, offer services on a sliding scale fee and sometimes free of charge. All this requires is a little research, whether it’s through the Internet, word of mouth, or asking other health care providers for referrals.

With all of the discrimination and injustice present in society, because unfortunately it doesn’t seem to be going anywhere, why not strengthen your mind so that we can continue to fight back. When will the media talk about the possibility of a black mans actions being attributed to mental health issues? When we find the motivation in ourselves to take control of our lives and stop being afraid to acknowledge that we need help. Suffering in silence is more detrimental than allowing someone who is qualified to return you to your most empowered state.

Alysha Thomas is a native of Newton, MA and a current resident of Hattiesburg, MS. In the fall she is relocating to California to obtain a Doctorate degree in Marriage and Family Therapy and is looking forward to serving in an urban community to increase the level of ethnic participation in mental health care. Alysha enjoys cooking, being outdoors, and almost everything social.

Sources:

Broman, C. L. 2012. Race differences in the receipt of mental health services among young adults. Psychological Services, 9(1), 38-48.

Snowden, L. R. & Yamada, A. 2005. Cultural differences in access to care. Annual Review of Clinical Psychology, 1, 143-166.

Vogul, D. L., Wester, S. R., & Larson, L. M. 2007. Avoiding counseling: Psychological factors that inhibit seeking help. Journal of Counseling & Development, 85, 410-422.

http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=61

https://www.nami.org/Find-Support/Diverse-Communities/African-Americans

Suffering In Silence: Mental Health Conversations in Communities of Color

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