BIPOC experts turn their gaze toward achieving equitable mental healthcare.
Where do BIPOC communities fit into the mental healthcare space? How can practitioners work to create more access and availability for people of color? Tina Martin, Associate Professor of Journalism at Boston University and host of WORLD Channel's LOCAL, USA, spoke with industry experts Shawna Murray-Browne, LCSW-C, Dr. Dan Foster, Dr. Sidney Hankerson and Paul Hoang, LCSW to talk about the obstacles plaguing BIPOC mental healthcare and what steps have been taken – and what more must still be done – to create far-reaching accessibility.
During the one-hour conversation, the panel touched on how an individual’s culture can play a huge part in how they respond to mental health treatment; what role faith has played in the mental health space for centuries; what they are optimistic about as mental healthcare evolves; and more. Here are just a few key points these practitioners shared about how they’re creating change within their communities.
On the universality of mental health...
Paul Hoang, LCSW: Mental illness does not discriminate. When mental illness manifests, it’s how we interpret it, it’s how we respond to it. It can lead either to a preventative phase or early intervention phase; it can lead to healing, or it can lead to a disconnection, where people get marginalized, get pushed aside.
Dr. Dan Foster: The circle of life is essential to balance. You can have health even with sickness; health is not the absence of disease. Health is the presence of balance and relationship. What’s most important to me is to establish a relationship, not just with the person, but with the person’s belief, with the person’s thoughts, with the person’s aspirations.
On the role of faith...
Paul Hoang, LCSW: Prayer is a relationship – prayer is how you open up a channel of communication between you and the spiritual world. That being the case, in the Catholic faith there’s also a saying: Prayer should lead to action. You don’t just sit there and do nothing and expect God to come in and change your life and give you what you need. Prayer is empowering to be open to the solution, be open to the resources, be open to the spirit working with you, through you and around you so that you can take all of that to lead toward change.
Dr. Sidney Hankerson: Faith has a central role and has been a central aspect in providing support and access to care for folks in the Black community. Pastors, pastoral counselors, are really frontline mental health professionals. There was a landmark study that came out nearly 20 years ago that showed that in the United States, regardless of a person’s racial or ethnic background, when people are experiencing a mental health condition, they first are more likely to seek help from their faith leader...more so than they’ll initially seek help from a psychiatrist or general medical provider. Our faith leaders...have really been informal mental health professionals for centuries.
In communities of color, the role of spirit, the connection to our spiritual being and the relationship to our community is such an integral part of who we are.
As it relates to the Black community in particular, mainstream psychiatry has often been very confrontational to people’s faith and spiritual beliefs...The pastor, the deacon, the choir director – they’re folks that people know, they trust and they listen to, and so the bulk of my work...is in partnership with churches and trying to work with houses of worship to identify ways for them to identify support and then really be systematic in their support of the emotional needs of their congregates.
On Black identity and its impact on seeking care...
Shawna Murray-Browne, LCSW-C: The experiences of colonialism and of chattel slavery, histoical trauma, that happened even more drapetomania was uplifted really still has a present-day impact on the way that African Americans view themselves and have to struggle with their relationship between what a mainstream society would like to say is OK or suitable for African Americans to be able to contend with versus really reconnecting to our own original wisdoms and healing journey.
When we’re talking about the impact of racism societally, oftentimes African Americans the way that we cope is different, we're coping by internalizing these things in our physical body, we contort and conform ourselves to white societal standards that might not be easily aligned to the value system in our society.
Dr. Sidney Hankerson: As we talk about mental health and the black community, so much of it is rooted in structural issues and specifically structural racism. The term drapetomania was coined by a renowned psychiatrist as a mental health condition that was ascribed to slaves who wanted to run away. They were given this term drapetomania as if wanting to escape slavery was somehow a mental illness. So in the Black community, issues around mental illness and the healthcare system are intimately intertwined with racism. It’s a very fraught relationship, historically, that brings up issues around distrust with the healthcare system.
How culture affects the perception of mental health…
Dr. Dan Foster: For [American Indians], the most important part of life is spirit and relationship, spiritual relationship and connection: that which is past; that which is future; that which is here right now. Balance is what matters. So I could have a mental illness and still be very healthy – not in dominant society. If I have a mental illness I’m going to be marginalized, because my value is in what I do. In the culture that we come from, your value is in your being and your relationship in that being, which is so different [from] the dominant society.
Shawna Murray-Browne, LCSW-C: I’m always asking, “How have Black folks historically healed in the face of oppression, in the midst of enslavement, how is it that we are still here?” And inevitably it goes directly to...our spiritual practices, communing with the earth, utilizing herbs, connecting with our ancestors. And oftentimes and one of the huge impacts of colonialism, present-day, even, is the disconnect that African Americans have from even our pre-colonial experience. By illuminating some of the richness of how we survived and resisted continually, we can bring that into present-day.
Paul Hoang, LCSW: Oftentimes within [the Vietnamese] culture, stigma is so high within mental illness. When I have conversations with those individuals, I don’t push the topic….Are you aware of the impact of your situation right now? You have things all over the house, for example: It’s unsafe, it’s unclean. How are you feeling with that? Are you OK with that? And when did this happen?...Then try and reconnect them to themselves and to the community, instill hope in them, reassuring them that there are resources available, there are people who generally care who are able to work with them to lead towards healing.
On what's next and how to achieve equity…
Shawna Murray-Browne, LCSW-C: Rooting [the practice] in how we reconnect with the community that is allowing and illuminating of [cultural mechanisms] is what I think is the pathway to decolonize mental healthcare, where we’re not relying on these institutions specifically to be able to address it, but we are honoring and amplifying... what richness comes out.
Dr. Sidney Hankerson: One of the conflicts with mental health and with folks of color and with African Americans in particular is that it’s been difficult oftentimes for traditional mental health interventions, whether that’s psychotherapy or adding medications, to be able to integrate some of those traditional Afro-centric values...Too often we take a reductionist and individualist approach to mental healthcare, and folks of color are community-focused, we’re family-focused and we’re relational-focused, so I think integrating some of those traditional healing practices with some other practices that have more quote-unquote evidence is really brilliant.
Shawna Murray-Browne, LCSW-C: If we’re seeking to ground in equity and not equality, then we have to do a power analysis, getting really clear: What are some of the things we’re perhaps not interested in losing? Practicing authenticity in the way that we communicate with the folks and community is important, and supporting the folks in the community to advocate for themselves, maybe being aligned and connected with you at these tables where we’re advocating...so that we’re not speaking for people in the community that may not be in the same levels we are.
Dr. Sidney Hankerson: One of the silver linings that we have experienced over the past year because of the COVID pandemic as well as because of America’s racial reckoning is that I fear that the next crisis upon us is a mental health crisis because of the grief, depression and anxiety we have endured over this last year. Because of that, there’s actually tremendous momentum to make sure that mental health services are increased, especially in traditionally under-resourced communities.
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