October 10th is marked as World Mental Health Day. According to the World Health Organization or the WHO, the overall objective of World Mental Health Day is to raise awareness of mental health issues around the world and to mobilize efforts in support of mental health. The Day provides an opportunity for all stakeholders working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people worldwide. Being aware of a day to focus on mental health raises an issue for me personally. Is it possible to have a serious conversation about the state of mental health in the Black Community?
I was engaged in a conversation with another friend about the internet sensation Kevin Samuels. He has a YouTube show where he mostly takes calls from other black women and deals with their issues of wanting a man and not getting one or their lofty ideas of a man that is not tenable in my opinion. He has also been accused of being misogynistic, a chauvinist, an opportunist and objectifying Black Women in a sensational manner to increase his viewership. I have watched some of his content but I am not prepared to completely acquiesce to these claims per se. He has a tendency to be blunt, abrupt, sharp, insolent and quite harsh. Although this is the case, he will also display aforementioned behaviors to his Black Men callers as well. My biggest issue with this is not so much the behavior towards his callers, rather the content that is clipped and propagated. The calls that are mostly shared are the ones with Black Women saying something problematic and Kevin tearing them a new hole. This raises a lot of issues for me. I, being a Black Woman, instantly want to defend my sisters as much as possible. Although this is my first reaction, I can’t help but to think upon what are the driving forces behind my sisters saying or behaving the way they do on this show. I believe this is a symptom of a more systemic problem that is very prevalent in the Black Community but no one wants to address let alone discuss.
Behavior can be a nebulous contrivance. Behavior or behaviour is the actions and mannerisms made by individuals, organisms, systems or artificial entities in conjunction with themselves or their environment, which includes the other systems or organisms around as well as the physical environment. In psychology, behavior consists of an organism’s external reactions to its environment. Other aspects of psychology, such as emotions, thoughts, and other internal mental processes, don’t usually fall under the category of behavior. In dealing with the subject of behavior in the sense of the actions one has in conjunction with their environment, I don’t necessarily think it would be such a mental leap that some of these behaviors that are witnessed on Kevin’s show is the manifestation of Black Women’s behavioral health state. Black men are also not exempt from these manifestations. The behaviors just show up differently.
This leads me to incite a discussion on the mental state of the Black Community. Overall, mental health conditions occur in Black and African American people in America at about the same or less frequency than in White Americans. However, the historical Black (Freedmen) and African American experience in America has and continues to be characterized by trauma and violence more often than for their White counterparts and impacts emotional and mental health of both youth and adults.
- 13.4 percent of the U.S. population, or nearly 46 million people, identify themselves as Black or African American and another 2.7 percent identified as multiracial
- More than 1 in 5 Black and African American people in the U.S. lived in poverty as of 2018.
- Black and African American people living below poverty are twice as likely to report serious psychological distress than those living over 2x the poverty level
- Adult Blacks and African Americans are more likely to have feelings of sadness, hopelessness, and worthlessness than adult whites.
- Blacks and African Americans are less likely than white people to die from suicide at all ages. However, Black and African American teenagers are more likely to attempt suicide than White teenagers (9.8 percent v. 6.1 percent).
- Sixteen percent (4.8 million) of Black and African American people reported having a mental illness, and 22.4 percent of those (1.1 million people) reported a serious mental illness over the past year.
- Serious mental illness (SMI) rose among all ages of Black and African American people between 2008 and 2018.
- Despite rates being less than the overall U.S. population, major depressive episodes increased from 9 percent-10.3 percent in Black and African American youth ages 12-17, 6.1 percent to 9.4 percent in young adults 18-25, and 5.7 percent to 6.3 percent in the 26-49 age range between 2015 and 2018.
- Suicidal thoughts, plans, and attempts are also rising among Black and African American young adults. While still lower than the overall U.S. population aged 18-25, 9.5 percent (439,000) of Black and African American 18-25-year-olds had serious thoughts of suicide in 2018, compared to 6 percent (277,000) in 2008. 3.6 percent (166,000) made a plan in 2018, compared to 2.1 percent (96,000) in 2008, and 2.4 percent (111,000) made an attempt in 2018, compared to 1.5 percent (70,000) in 2008.
- Binge drinking, smoking (cigarettes and marijuana), illicit drug use and prescription pain reliever misuse are more frequent among Black and African American adults with mental illnesses.
At face value, learning these statistics that ties in Black American position in the US when it comes to poverty and the state of mental health in our community is quite sobering. Still there is a very present issue of not really addressing the topic because stigma is very real. In a New York Times article entitled The Extra Stigma of Mental Illness for African-Americans, they highlighted Shaun J. Fletcher, a professor at San Jose State University whose research covers health disparities among African-American men. He gave a 2018 TEDx Talk on how African-Americans communicate about their mental health issues. He said, “…much of the way African-Americans deal with mental health, or choose not to, is based on how we are socialized. We are raised to believe that we have to walk outside with a tough skin at all times to survive in the world.” The author’s article goes on to say that “…our culture has taught us that we do not have the privilege of being vulnerable like other communities; it has taught us to find strength in our faith. Our history has shown us that the medical field cannot be trusted with Black bodies.”
I have to say that I have to somewhat agree with the author from the New York Times. In my own experience, mental health was not part of the conversation in my home as it should have. Being a product of divorced parents, I remember going to counseling when I was young with my family, but the sessions did not last long. It was not until I was 14 that I found myself in therapy because it was very apparent how depressed I was and it started to affect my physical health. Since then, I have found myself taking advantage of some form of mental health assistance when symptoms of clinical depression start to reassert itself.
According to a study conducted by Ward, Wiltshire, Detry, and Brown in 2013:
- Black and African American hold beliefs related to stigma, psychological openness, and help-seeking, which in turn affects their coping behaviors. The participants in this study were not very open to acknowledging psychological problems, but they were somewhat open to seeking mental health services.
- Black and African American men are particularly concerned about stigma.
- Cohort effects, exposure to mental illness, and increased knowledge of mental illness are factors that could potentially change beliefs about symptoms of mental illness.
- Participants appeared apprehensive about seeking professional help for mental health issues, which is consistent with previous research. However, participants were willing to seek out some form of help.
In 2016, 12.3 percent of Black and African American adults who had a doctor’s office or clinic visit over the past year had difficulty getting needed care, tests or treatment compared to 6.8 percent of white adults. While the implementation of the Affordable Care Act has helped to close the gap in uninsured individuals, 11.5 percent of Black and African Americans, versus 7.5 percent of white Americans were still uninsured in 2018. In 2018, 58.2 percent of Black and African American young adults 18-25 and 50.1 percent of adults 26-49 with serious mental illness did NOT receive treatment. I have to say I am one of the fortunate ones. I was lucky to have medical insurance for the majority of my life so I was able to access mental health care. As you can see, that is not the overall story for many Black Americans.
So what is the solution to address this quite serious issue in the Black American Community? I would have to say it is a two fold solution. The first thing that has to be addressed is the long and pervasive stigma that exists in our community when it comes to mental health. There is a saying that we often use – Black don’t Crack. Is that true? Although this saying is used mostly to illustrate Black people have a way to preserve a more youthful look because we generally possess more melanin, that has nothing to do with what is happening in our minds. Dr. Peter Sealy who is a columnist from Pride News wrote, “Oh what a mask we wear, of bright smiling faces and gloomy aching hearts. The mask that we wear is as true as its lie”. He goes on to say, “Many Black men and women go on for years, wearing a mask that lies and belies how they are really feeling. But all the while something bad is happening to them. It is the depression that begins to grow and take root.” We cannot honestly think that we can allow the collective mental health of a community to deteriorate without acknowledging that the problem is there.
We also need resources that address our mental health in a holistic manner. While human beings can suffer similar medical and behavioral concerns, Black Americans, especially Freedmen Descendants, have a compound historical trauma of racism and disenfranchisement. If you are not from the community, you will not properly understand the community. There are more organizations that are starting to emerge to be that resource, but we need more.
- African American Wellness Project: https://aawellnessproject.org/
- SAMSHA: https://www.samhsa.gov/behavioral-health-equity/black-african-american
- National Alliance of Mental Health (NAMI): https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Black-African-American
- National Institute on Minority Health and Health Disparities (NIH) : https://www.nimhd.nih.gov/programs/edu-training/byomm/toolkit.html
I wish that I had a list of resources that was just as long as this blog post, but that is an example of how this issue needs way more attention than it gets. Freedmen must be more aware of this topic and not shy away from it. We also have to be more proactive in working to make the mental state of our community change. Mental Health is important and it deserves consideration, but we cannot wish it would until we consider it at home.
Cynthia McDonald – Medical Case Manager, Health and Political Advocate
Resources
- The Extra Stigma of Mental Illness for African-Americans – New York Times, Dana Givens, Aug. 25, 2020 https://www.nytimes.com/2020/08/25/well/mind/black-mental-health.html?.?mc=aud_dev&ad-keywords=auddevgate&gclid=Cj0KCQjwnoqLBhD4ARIsAL5JedJIm9B9XRL0iaGkMpzHmhj05IDlCwTxEXIK73tlUD3mL1ghFOcB-kMaAlMvEALw_wcB&gclsrc=aw.ds
- Addiction & Mental Health Resources for the Black Community – https://www.safeproject.us/resource/black-community/?gclid=Cj0KCQjwnoqLBhD4ARIsAL5JedJefx6uiB0QV6qqP2cOWpU9077h7WFJdimYG5zVsjOjKKm7uTFy-4saAjOsEALw_wcB
- Black And African American Communities And Mental Health – https://www.mhanational.org/issues/black-and-african-american-communities-and-mental-health
- Time To Recognize Depression In Black Men And Women – Dr. Peter Sealy – Pride News – May 5, 2016 http://pridenews.ca/2016/05/05/time-recognize-depression-black-men-women/
Freedmen Health and Wellness 