At the Intersection of Race and Mental Health

Family gossip.  Religious predispositions.  The stigma of having a diagnosis.  There are many reasons why an individual might be timid to approach CAPS, or counseling and psychological services on the UNC campus.  The new Active Minds initiative is created in order to present an alternative solution for individuals who are having a difficulty going to CAPS alone: they’re offering company on the journey to the building.

While this initiative is great… what about the “extras” that might go into making a person nervous about perusing help with mental diagnoses?  Minority individuals have a more challenging time gaining the courage to approach psychologists because of additional stigmas surrounding what it means to ensure mental heath.

In her presentation “Mental Health Stigma in the African American Community”, Pre-doctoral psychology intern Ciera V. Scott hypothesized that there are unique stigmas and stereotypes within the African American community that prevent African Americans from deciding to access stable mental health:

“Black people don’t get depressed” is a stigma within the community that, according to Scott, could be attributed to the lack of education of what is involved in a mental health condition.

“I don’t trust the doctor and/or treatment” is a valid stigma that stems from narratives that have been passed down from the late 30s and early 40s when medical professionals took advantage of the African American community to perform heinous experiments on them.  These narratives cause individuals to hesitate in becoming engaged with healthcare professionals and could attribute to current tensions that cause individuals to feel afraid of health care professionals who are different from them.

“You don’t need a doctor—it will go away, or just pray.”  While spirituality and religious faiths have been instrumental in the coping strategy of many individuals in the African American community and others alike, it is not for everyone.  A member of the church might have assaulted an individual or the individual might not feel that God is not their thing.

        “Going to therapy = airing you and your family’s ‘dirty laundry’”

         “Going to therapy is what white people do.”

According to Scott, African Americans may pride themselves on being strong and resilient and may view going to therapy as a sign of weakness.  This is why there is such an important in having the presence of African American and diverse practitioners in the medical field who may understand the some of the unique stories and backgrounds between practitioner and patient.  Multicultural competence in the medical profession should be the most important aspect of training and considerations.  People in leadership in counseling centers are appreciative and aware that patients might be in different stages of their personal identity development or are experiencing a different level of multicultural competence.

Mae Lynn Reyes-Rodriguez, a PhD and associate professor in the center of excellence for eating disorders spoke on Latinas in the United States experiencing eating disorders.   Reyes-Rodriguez began her presentation about the worldwide barrier of a misconception that the only individuals who experience eating disorders are white, upper middle class women.  A statistical breakdown of eating disorders in Latinas in the United States showed that there was estimated service utilization for lifetime eating disorders for 61.65% of Latinos versus 75.8% of Caucasians.  This was broken down into a prevalence of 0.08% of Latina women and 0.03% of Latino men with anorexia; 1.9% of bulimia in women and 1.3% in men; and of binge eating disorder in 2.3% of women.  Reyes-Rodriguez stressed a model of intervention that starts small and expands to include the whole healthcare system.

Patient: Personal success in overcoming the stigma of having an eating disorder.  Latinos/as think that eating disorders are something for Caucasians and it seems weird in their community.  Latinos/as often might not understand the severity of the damage caused by an eating disorder because of a lack of knowledge or availability of resources.

Family: By teaching family members how to aid a member with an eating disorder and explaining the knowledge behind eating disorders, individuals suffering from these mental health conditions could be encouraged to seek help and feel more comfortable approaching the situation.

Providers: The necessity for health care providers to be aware of eating disorders in the Latina population and a background on assessment and treatment for diverse cultures will ensure that treatment is more effective.  Bilingual services are a necessity in order to bridge cultural gaps between providers and patients.

System: Practical support between members of communities and assistance with transportation and child care can make it possible for Latinas to access the heath care they need.  The provision of flexible business hours for treatment expands the numbers of potential patients.  There should be some sort of sliding scale for patients who do not have insurance, and a preventative program for eating disorders in the primary care setting.

Reyes-Rodriguez also called for a culturally sensitive approach that acknowledges a possible lack of health insurance, the mental health stigma, migration issues, previously developed treatment and recognition of disorders that has only been focused on an Anglo population, and the early dropout rate from treatment.

The last speaker of the evening, Doctoral Candidate in Developmental Psychology Vanessa V. Vlope presented “Doing Better: Culturally Centered Practices and Programs that Support Mental Health Thriving.” Vlopes presentation incorporated a variety of information in order to explain solutions to de-stigmatize mental health issues for minority groups including African Americans and Asian Americans.

Represent and De-stigmatize: The Black Health Student Association at UC Berkeley had a mental health campaign on campus that de-stigmatized mental health issues and were at the forefront of representation for minority communities.  Support venues, like twitter, support resources in a way in which college students prefer to engage [Black Health Lab @ UNC].  Specific physical spaces are necessary to support students where they have a place that they are supported, and where they feel that they belong.

Mental Health is not Culture-Free: Taking into account indigenous healing practices and working with members of the communities in which students of color are immersed (families, campus, and faith-based organizations) should be minimum requirements in the support services available to students of color.   Here it is important to remember that individuals seeking care for mental health should have priority in choosing what method of support and care.

Informal Support Networks: The African American Student Network (Dr. Tabitha Grier-Reed) is an informal networking group composed of students, faculty, and staff of color.  Individuals in the group experience observable therapeutic benefits for the mental health of thriving black students in predominantly white institutions.  Students who participated reported feeling safer, more connected, validated, empowered, and intellectually stimulated on campus. The University of North Carolina at Chapel Hill has such an institution known as the Men of Color Engagement Retreats Program.

Emotional Emancipation Circles: These support networks emerged after the national events in Baltimore and Ferguson to recognize the incorporation of national and local community events in mental health.  They have an impact on student’s health, increased rate of recognition of the role of national events in the mental health of students by institutions, and help to relieve racial battle fatigue.

Vlope wanted to ensure that students have a voice.  “Whose mental health is it anyway?” she asked.  With proper training, students of color should be actively involved in mental health education and support as community and organization leaders.

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