#JamesDonaldson on #MentalHealth – #PeopleOfColor face Significant Barriers To #MentalHealthServices

#Racism and #stigma make it harder for people of color to get services, and it’s gotten worse during the #coronavirus #pandemic.

By Kristen Rogers, CNN

Richelle Concepcion still remembers the name she was called after trying to stop a #White kid who was picking on younger peers on the swim team in high school.

“Shut the f**k up, you Oriental b*tch!” that kid yelled at her so many years ago.

Though Concepcion, a Filipina American, wasn’t the only person teased by that kid at her school in San Francisco, she was the only one called a #racial slur.

“After that event, I spent time ruminating on the experience and went over scenarios in my head about what I could have said back, whether I was indeed what he called me, etc.,” said Concepcion, now a psychologist at Tripler Army Medical Center in Honolulu, via email.

The racially motivated event and long-term subjection to stereotypes were two of many experiences “that inspired my work, as I tend to be very cognizant of the experiences of my #patients who identify as #peopleofcolor,” she added.

#Mentalhealthissues affect everyone, but #peopleofcolor — #Black, #Latinx, #Asian and #NativeAmerican people — have higher rates of some #mentalhealthdisorders and face greater disparities in getting help than #White people. Those issues are primarily due to lack of access to services resulting from institutional discrimination, interpersonal #racism and #stigma — which can all harm the psyche of people of color in places where they are not the majority.

Such disparities have existed for decades, but “what we’re seeing is that some of the stresses that are associated with being a member of a marginalized group have been exacerbated during the #pandemic,” said Brian Smedley, the #AmericanPsychologicalAssociation’s chief of psychology in the public interest and acting chief diversity officer.

43% of US #adults with #mentalhealthconditions are estimated to receive treatment; the figure is 33% for #Hispanic and #Latino #adults.

Source: 2018 National Survey on Drug Use and Health

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

During the #pandemic, many people have experienced #mentalhealth stressors such as unemployment, sick and lost loved ones, disrupted social lives, insecurity about the future and a lack of internal peace — all of which threaten people’s socioeconomic status and #stress levels. And #minorities already disproportionately experience those misfortunes.

“There’s a high likelihood that (the #pandemic) is also affecting #mentalhealth and well-being for these populations as well,” added Smedley, who leads the APA’s efforts to apply the science and practice of psychology to the problems of human welfare and #socialjustice.

Why some #peopleofcolor are in such distress

The mother of Maximino Avila — or Wachinhin Ska (“White Plume”) in Lakota, the eponymous language of the #NativeAmerican tribe — “died an addict on Market Street” in San Diego when White Plume, now 33, was a #child.

“My first introduction into intergenerational trauma was realizing that’s what (my drug addiction stemmed from) after I got sober,” White Plume, who is an activist in his community, said. “I didn’t realize I had been experiencing it my whole life coming from my mother.”

Intergenerational trauma describes how oppressive events “that impacted one generation tend to be carried over, as far as feelings, in later generations,” said Jacque Gray, a research associate professor in the University of North Dakota’s department of population health and associate director of the Center for Rural Health for Indigenous programs. Belonging to a minority can come with numerous sources of stress.

#NativeAmericans have higher rates of substance abuse and #depression (PDF) in comparison to other races, Gray said.

“#AmericanIndians have been through multiple traumas over the last 500 years,” she added, including loss of land and culture. They’ve had to abstain from wearing their traditional clothing, eating their traditional foods and speaking their established languages.

A history of alcoholism, drug addiction, poverty, homelessness, #isolation and sexual harassment haunted White Plume and his family. That trauma and the need to dissolve the dissonance between reservation and mainstream life led him to experiment with alcohol and other drugs.

“It made me feel superhuman,” White Plume recalled. “That roller coaster really made me feel like I had a sense of power and awakening and that I could really change the reservation with my hands. And I didn’t have to change the reservation through my hope.

“It just made me feel like I didn’t have to go through the trouble of actually getting well and sober and OK with who I am.”

Modern political developments that encroach upon the lands and rights of #NativeAmericans are traumatizing, Gray said. And on average, less than 50% of #NativeAmericans finish high school — education is one of the determinants of the quality of one’s #mental and physical health.

#Latinx people also face discrimination, in their case based on their languages, ethnicity and class, said Jasmine Mena, an assistant professor of psychology and affiliated faculty in #LatinAmerican studies at Bucknell University in Lewisburg, Pennsylvania.

“The impact on their #mentalhealth is never positive,” Mena said. “It impacts self-esteem and substance use, and it’s associated with many (negative) outcomes.”

Political events and discourse regarding immigration can be harmful to #mentalhealth even for those who are documented, because they still become targets, Mena said.

#Black people have higher rates of #depression, #anxiety and sleep and digestive problems, studies have found. Racially discriminatory events have led #Black people to be in a state of high arousal — which means a heightened level of situational awareness and vigilance, said Helen Neville, a professor of educational psychology and #AfricanAmerican studies at the University of Illinois at Urbana-Champaign.

“Racial battle fatigue,” Neville explained, is the burden that results from regular exposure to prejudiced information; prodding regarding #racial events; and people invalidating their experiences.

That means they’re anticipating discriminatory encounters based on their race before such events happen. The daily instinct to interpret social situations and decisions through a #racial lens is stressful, and that awareness is just one form of #racial trauma experienced by #Black people.

“#Racial battle fatigue” is the burden that results from regular exposure to prejudiced information; prodding from people regarding #racial events or wanting to become educated or allies; and people invalidating their experiences, Neville explained.

Microaggressions cumulatively take their toll, and so do emotional and physical responses to vicarious and direct experiences with #racial violence and #racism. Centuries of #racial terror, violence and oppression have also left an indelible mark on the #Black psyche.

The most common sources of #stress for United Kingdom-based people of color are social and economic, said Eugene Ellis, a psychotherapist and the director of the #Black, #African and Asian Therapy Network in the UK.

“#Peopleofcolor (are) more likely to experience poverty, have poorer educational outcomes, higher unemployment, contact with the criminal justice system and challenges accessing and receiving appropriate professional services,” Ellis said via email.

#AsianAmericans are discriminated against for their looks, languages and culture. They also face a great amount of family and social #stress by having to represent their family well and embody two cultures: that of their heritage and “#American” in the US or “British” in the UK.

“Your success is reflective upon your family’s success,” said Concepcion, the clinical psychologist, who is also president of the Asian American Psychological Association.

Lack of access to crucial services

The #mentalhealthprofession has been underfunded and difficult to access for decades, Smedley said, and #communitiesofcolor face additional geographic and financial barriers to getting help.

#NativeAmerican communities that are geographically disconnected are often forgotten or underserved, Gray said, and it takes time to train and implement providers who specialize in treating #NativeAmerican people. It’s also taxing on time and money for both providers and #patients to travel to and from reservations.

“#NativeAmericans are so overlooked all the time,” White Plume said. Although he sought addiction treatment near his South Dakotan reservation, he knew San Diego was the more viable option.

“It just makes me feel like I’m really invisible and to the point where it feels comfortable being more invisible,” White Plume added. “Hence the strong, silent type. The whole manifest destiny feels like it’s … been in action against me since I was born.”

#NativeAmericans also have the highest rate of poverty in the US in comparison to other races. Due to location and lower-income status, #Black people sometimes lack access to #mentalhealthservices. #Latinx people might also if they’re under- or uninsured, Mena said, especially if they’re undocumented immigrants.

Can #psychologists who don’t look like you understand you?

Martin Diaz, a Mexican American university student from Fontana, California, has long struggled with #depression and #anxiety, but has never felt comfortable seeking help from his campus #mentalhealthservices. One hang-up was that the predominantly White psychologists might not be able to empathize with his experiences as a Latinx person.

“I went in there, but then I got overwhelmed by just seeing a bunch of #White faces. So I quickly left,” Diaz said. “It was nothing new to me, the same old thing whenever I would try to access a resource. I feel if there’s more inclusivity within these services, especially at a school that prides itself for being diverse … that would’ve been so much better not just for myself, but for other marginalized communities as well.”

86% of #psychologists in the US workforce were #White in 2015.

Source: APA’s Center for Workforce Studies, 2015

Diaz’s perception of his local #mentalhealthservices is accurate, according to data that shows that the #mentalhealth workforce doesn’t look like the rest of the population. In 2015, 86% of psychologists in the US workforce were #White.

The UK, too, is facing a “desperate shortage” of #mentalhealthproviders of different races and ethnicities, Ellis said.

Language and cultural barriers are almost greater deterrents to getting help than inadequate access. Some #peopleofcolor want to be treated by people who “get them,” and many #mentalhealthprofessionals aren’t trained in cultural humility, Neville said. That means that they don’t have the openness to realizing that the #patient is knowledgeable about his experiences, so they can actually learn from and sympathize with him.

“Cultural humility also impacts your awareness of structural issues that might impact your client’s life outside of the therapy room and how that might impact their current presenting concern,” Neville added.

In the US, there are federal efforts in the works to diversify the #mentalhealthprofession, Smedley said. The #USSubstanceAbuseandMentalHealthServicesAdministration funds the American Psychological Association’s Minority Fellowship Program that reduces barriers to opportunities for training.

Well-meaning family members can do harm

Underlying Diaz’s #anxiety and #depression was unintentionally perpetrated #mentalabuse by family members who also had unchecked #mentalhealthissues.

The #stigma influencing the family’s resistance to talk about their problems and get help “stems from a conservative outlook,” Diaz said. “From the colonization and how there were forced ideals on us.”

Overcoming the challenges of immigration has created “false stories that we’re hard workers and that there’s nothing wrong with us,” he added. “It’s very taboo for older generations to discuss their emotions and everything. That just creates more generational trauma.”

Diaz’s family members aren’t alone in their reticence. A history of #stigma has made speaking up about #mental struggles difficult for most people. But the intergenerational traumas experienced by #peopleofcolor have led to rigid perceptions of both the reality of #mentaldisorders and how they should be resolved. Consequently, sometimes both the source of #mental troubles and the barrier to getting help come from within a person’s own home.

#AsianAmericans are often burdened with appearing as the “model minority” and representing their family well, so they’re less likely to speak up about their #mental struggles. They report fewer #mentalhealthconditions than their #White counterparts, but are more likely to consider and attempt #suicide.

#AsianAmericans are “very invested in working on it through self or kind of saving face, because we are a very collectivistic community,” Concepcion said. “When you think about a person in a family or community unit experiencing #behavioralhealthissues, it’s almost deemed as if you are bringing down the community if it comes out that you’re seeking help.”

#Religion and #stigma can be both coping mechanisms and the solutions others imply will fix #mentalchallenges.

“There is that belief that you leave it in God’s hands,” Concepcion said. “If you’re having an issue, you don’t talk to a #behavioralhealthprovider. (You) pray to God or see the rosary or something like that … and God will take it off your shoulders.”

A #pandemic brings new challenges

The all-encompassing nature of the #pandemic has aggravated disparities for communities that were already vulnerable. They don’t have the same safety net that has allowed some to work from home, care for their #children and maintain wellness.

Unemployment triggered by the outbreak has disproportionately affected #peopleofcolor. At the same time, they largely comprise the people who are considered essential workers — they’re faced with the #stress of being at risk for contracting #coronavirus but being unable to provide for themselves and their families if they don’t work.

“Seeing the devastation of the #pandemic in #Black communities reinforces past #racial traumas I have experienced,” Neville, who is #Black, said. “It’s been hard to shake.”

These communities strained by job loss, essential work, school closures and unavailable #child care might suffer a multigenerational impact, Mena predicted. That’s because adults need time and energy to keep #children educationally engaged and thus have a chance at future educational and occupational success — which can partly influence one’s #mentalhealth. In comparison to #White people, #Black, #Latinx and #NativeAmerican people have higher rates of serious illness and death from #Covid-19.

During this #pandemic, #AsianAmericans have been dealt a unique subset of discrimination — since #coronavirus outbreaks began in #China, some people have blamed them for the crisis.

Staying well while systemic change is underway

The onus for eliminating #mentalhealth disparities is on the profession and institutions. But there are things #peopleofcolor can do to keep upright in environments that make #mentalwellness a challenge.

Diaz paints and writes poems to express his emotions.

Neville gets involved in social activism, saying it can help #peopleofcolor to tap into their sense of agency and change the environment in which they experience #racism. It’s a “promising pathway to improving health” on an individual and community level since it pushes to create greater societal equity and promotes health more broadly, Neville said.

Older generations “have not only survived, but they have thrived,” Neville said.

She also relies on her “support system for affirmation and nurturance.” As a psychologist, Neville knows that sharing experiences allows people to understand the valid #socialissues causing their pain and express how they’re responding to them. Open dialogue can also educate people about #mentalhealth, which is crucial to eliminating #stigma. Instead of signifying weakness, openness can be a demonstration of strength and possibly encourage others to ask for help.

The parents and elders of #peopleofcolor have likely experienced discriminatory treatment, and more severe forms of it, that affected their health. Asking the older generations how they dealt with it and how they think #peopleofcolor can move forward — if they are willing to share their experiences — “can instill a sense of hope for a better tomorrow,” Neville said. Older generations “have not only survived, but they have thrived.”

Developing a sense of pride in one’s heritage and what it has contributed to the world can also boost well-being, Neville and Concepcion said.

“‘Wellbriety’ and coming to the idea that I had to get back to my spirituality was the No. 1 thing to start healing myself and my tribe,” said White Plume, who has been sober for three years and spends his time serving his #NativeAmerican community. “Now I help myself and my tribe way more than I ever did in any of my addiction.”

If your loved ones aren’t supportive, know that you’re not alone, Concepcion said. In addition to professional help, there are organizations, Facebook groups and online wellness spaces created by other #peopleofcolor who are waiting to take individuals under their wings.