America's racial reckoning is putting a spotlight on Black mental health - NBC News

Posted: 26 Sep 2020 12:00 AM PDT

As a child, Reginald Howard struggled with destructive visions, moments where he imagined destroying the shelves at the corner store or pushing another child down, but when he tried to identify what was happening, his mother attributed it to his "Howard blood."

"At that point, I probably should have been in therapy but because there's such a stigma behind therapy in the Black community, and around the world but I'll start within my community, I really didn't get the help that I needed," Howard said.

His father also struggled with mental illness, a situation that led Howard's grandmother to refer to him and his sister as "demon children."

Howard's mental health went unaddressed as a child and he continued to struggle with mental illness into adulthood, which led to a crisis point in 2011.

Out of work at 20 years old, he learned his now-fiancé was pregnant. The anxiety of impending fatherhood triggered a depression in Howard, whose own father was in and out of his life.

"That really started making me spiral out of control, which led me to text few close family members and friends to say, 'Take care of my son, I don't want to be here anymore,'" Howard said.

Friends and family were able intervene during two separate suicide attempts by Howard, but he didn't get into therapy for the first time until 2018, he said. His crisis points led Howard to do research and seek help, which allowed him to finally manage his own mental health problems.

It was his own journey to healing that inspired Howard to become more vocal about the benefits of therapy, inspiring him to become a mental health advocate and to create the "Black Mental Health Podcast" to let others know they're not alone.

"I think the Black community has a language and the mental health community has a language," Howard said. "And my purpose is to combine those languages together. I think this is two different languages but they speak the same truth."

The mental health of Black Americans is under strain as 2020 unravels, bringing to light racial disparities across the country. Notable Black celebrities, such as Michelle Obama and Gabrielle Union, opened up in recent weeks about how racial strife in America has affected their own wellbeing.

Union, who has been vocal on social issues and her own experiences, said in an interview with Women's Health that she was suffering from post-traumatic stress.

"The combination of a pandemic and this racial reckoning, alongside being inundated with (images of) the brutalization of Black bodies, has sent my PTSD into overdrive," she said. "There's just terror in my body."

A global pandemic and a series of Black American deaths at the hands of police have placed the spotlight once again on the ways racism can pervade institutions unnoticed. The deaths of George Floyd and Breonna Taylor have become recent rallying points for protests against racist structures over this past year.

Racism and the coronavirus pandemic have collided

And it's not just police departments.

Black communities have been disproportionately affected by the coronavirus, according to an April study from the Centers for Disease Control and Prevention. The pre-existing conditions that put most people at higher risk of dying from the virus, such as high blood pressure or diabetes, are more prevalent in communities of color, in part due to health disparities stemming from racial and socio-economic status.

A Washington Post poll conducted in June found that one in three Black Americans personally knew someone who died from Covid-19, the disease caused by the coronavirus.

June 30, 202002:37

As these disparities were being revealed and discussed, America was also reconciling what the American Psychological Association has dubbed a "racism pandemic."

These compounding issues — ones that come with uncertainty and old traumas — have psychologists looking at a "mental health tsunami" in the Black community, the APA's chief of psychology in the public interest and acting chief of diversity Brian Smedley told NBC News.

"The combination of physical distancing, economic anxiety, and for people of color, the very real stress from the racism pandemic means that we will have a lot of unmet mental health needs unless we can dramatically shore up the mental health infrastructure and address workforce shortages," Smedley said.

These shortages are especially dire for communities of color, which a fragmented mental health system already has trouble reaching. A number of factors have contributed to the limited access to basic mental health care for people of color, including language barriers, stigma and underfunded public health programs, Smedley said.

But the disparity in mental health care can be particularly dangerous for Black communities, where generations of racial trauma have contributed to more general physical disorders, experts say.

"We know that racism is associated with a host of psychological consequences, including depression, anxiety and other sometimes debilitating conditions," Smedley said. "Post-traumatic stress disorder and the stress caused by racism can contribute to the development of cardiovascular disease and other physical diseases."

Racial trauma on the body

Racial trauma encompasses the physical and emotional reactions to racism that causes stress, which could overwhelm a person, according to Ashley McGirt, a licensed therapist who specializes in racial trauma. Triggers range from the visceral to the tedious — anything from viewing a video of police brutality to an act of everyday racism, often described as a microaggression.

"So racial trauma is watching George Floyd have a knee to his neck for eight minutes and forty six seconds. Racial trauma is watching Ahmaud Aubrey be gunned down while jogging. That's what racial trauma is," McGirt said.

The experience of racial trauma, which can recur throughout a Black person's lifetime, can cause a number of mental health issues such as anxiety, depression, hypervigilance and fear that have the potential to impact physical health.

An estimated 67 percent of Black adults cite discrimination as a significant source of stress in their lives, according to the APA's Stress in America survey released in July. And 78 percent of Black adults surveyed agreed that being Black is difficult in today's society.

Studies have shown over the years that stress is a significant factor in overall physical health. Unchecked stress can contribute to disorders such as high blood pressure, heart disease, obesity and diabetes, according to the Mayo Clinic.

Even going to the doctor can be a source of stress for Black adults, who fear discrimination in the medical system through misdiagnosis and a dismissal of their symptoms. Black women in particular, who have high maternal mortality rates in the U.S., have contended with racial bias from health practitioners.

As someone who saw her own family members suffer physically from their mental health disorders, McGirt wants to help other Black families heal and extend their own lives. Change also has to occur, however, in acknowledging how the racist history of the mental health field has contributed to stigma and lack of access to care for Black people, McGirt said.

"As mental health clinicians ourselves, we have to be doing our own work," McGirt said. "As a Black therapist, I definitely have to work ten times harder because I'm having to find creative and unique ways to treat my clients because this system was not designed for us."

The industry's problem with race

The mental health field is currently struggling to bolster its availability of therapists, counselors, and psychiatrists of color to address the overwhelming need of culturally competent professionals. About 4 percent of psychologists are Black, 6 percent are Hispanic and 4 percent are Asian, according to 2018 data from the APA's Center for Workforce Studies.

While therapy and mental health support is stigmatized in many communities, Black communities also contend with fear of misdiagnosis and institutionalization due to the field's racist past, Dr. Jonathan Metzl, director of medicine, health and society at Vanderbilt University, said.

"I think the mistrust of the mental health community is well founded," Metzl said. "And certainly it's because there is a lot of history of the mental health framework being used to oppress black people."

"The Protest Psychosis: How Schizophrenia Became a Black Disease," written by Metzl in 2011, outlined how Black men were disproportionately diagnosed with schizophrenia in the 1960s and 1970s. The book outlined how Black men who were in the Black Panthers and the Nation of Islam were diagnosed and hospitalized in way that essentially mirrored imprisonment, Metzl said.

A 2001 study by the Department of Health and Human Services found that "feelings of mistrust and stigma or perceptions of racism" have largely kept African-Americans away from seeking care. African-Americans are also even less likely to receive mental health treatment than the general undertreated population of undertreated Americans, the study found.

The psychology and psychiatric fields have to go far beyond cultural competency to address the wider structures that contribute to mental illness, Metzl said.

"It's not just 'come to my therapy office'...really if you want to gain trust, address the structural drivers of mental illness and really take on racism, and poverty, and income inequality," Metzl said.

Fragmented public health systems and community-based clinics that have been chronically underfunded for years contribute to leaving people of color on the fringe of mental health care, Smedley said.

"Our infrastructure with regard to health and mental health services in communities of color has been frayed," Smedley said. "Community health centers do a fantastic job of providing high quality care, often under difficult circumstances. And many provide excellent behavioral and mental health care. But they're too few and far between and still chronically underfunded."

Sept. 8, 202010:00

Removing barriers to mental health care bolsters Black communities

Though Howard, of the "Black Mental Health" podcast, only started therapy two years ago, he feels his life has improved by finally being able to understand and verbalize his issues. He has championed the community program that allowed him to find free therapy services, Black Men Heal, an organization that pairs men with a therapist of color.

Howard was one of the inaugural "cohort" of men who received eight free sessions with a therapist of color with the organization.

Black Men Heal began as an entirely volunteer service where clinicians donated an hour a week to men in need, Zakia Williams, one of the co-founders of Black Men Heal, said. The organization is something of a dating service for mental health, pairing men up with clinicians who look like them and are able to meet their needs.

"What we do is we take away the barriers and the variables that cause men to not go to counseling," Williams said. "So we take away finding them a black therapist. You know, if they go to their insurance and they tell them to look on the back of their card. Well, that's not going to pair them with a clinician of color."

About 65 percent of men who have gone through the eight free sessions have stayed on with the therapist paired to them through Black Men Heal, Williams said. And beyond that, like Howard, many of the men stay on to help promote the program.

Black Men Heal has grown through word of mouth — a caveat of the program is that all the men who go through their services must recommend the program to a number of friends. The organization, based in Philadelphia, is also trying to grow to other cities in its second year.

The pandemic has pushed Black Men Heal to use telehealth services, but also to use the platform to create a virtual peer support group every Sunday called "King's Corner," where men from all over can come together and talk to each other about their traumas or struggles.

"Our entire motto for the program is called 'healed men, heal men,'" Williams said. "And just putting these healed men back into the black home, back into the black community is going to create a positive change for us."

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.

Your ballot has arrived. Now what? - Bennington Banner

Posted: 04 Oct 2020 07:06 PM PDT

Look what came in the mail today — my very own official Vermont general election ballot!

How do you use it? Town clerks across Southern Vermont want to help you. And we want to help them help you.

First off: If you haven't received a ballot in the mail, reach out to your town clerk right away.

Detailed instructions come with the ballot. But we also received step-by-step instructions from Manchester Town Clerk Anita Sheldon. Here's what we learned from Sheldon (in our own words), and what you need to know to make sure your vote counts:

1. Please read the instructions on the ballot and the envelope! Perhaps you skipped that step the last time you bought a vacuum cleaner. Not this time. You want your vote to count.

2. In private, using a black pen or pencil to fill in the ovals, vote for candidates of your choice on the double sided ballot. Under each race, there will be instructions on how many candidates you may vote for. In the Bennington and Windham state Senate races, for example, you are free to vote for none of the candidates, or one, or two. Do not vote for three. Five is right out.

3. Fold the ballot and place it in the VOTED ballot envelope.

4. Seal the certificate envelope.

5. SUPER IMPORTANT STEP: Read the instructions on the VOTED ballot envelope. You must print your name clearly, print your town name clearly, and then sign and date the envelope, or your vote will not count.

Signing and dating the form affirms that you voted in private, you did not allow anyone to observe you voting, you were not assisted (except by those authorized to do so), and you were not influenced by another person while voting.

The signature also affirms the information on the form is "true, accurate, and complete to the best of my knowledge," under penalty of perjury.

In case you were curious, or tempted: Perjury is a felony. The Vermont General Statutes say "A person who ... commits perjury shall be imprisoned not more than 15 years or fined not more than $10,000.00, or both."

There are better ways to get your name in the paper.

6. Place the VOTED ballot envelope with ballot sealed inside (and affidavit of no ballot cast if applicable) in the return envelope addressed to the Town Clerk's office.

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TIME IS OF THE ESSENCE

Here's where the timing matters a lot.

If you're mailing your ballot, there are two things to keep in mind:

1. The Secretary of State has already paid the postage, so you do not need affix stamps.

2. In Vermont, an Election Day postmark on your ballot means nothing. The ballot must be in the possession of the clerk's office when the polls close, or it does not count.

So: If you're going to mail your ballot, mail it early, allowing at least seven to 10 days for mail delivery. The Secretary of State's website advises Saturday, Oct. 24 as the mailing deadline.

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If you've missed that date, or if you're feeling unsure about mailing your ballot, call your town clerk and learn how and when it can be delivered in person by Monday, Nov. 2. Many towns have a secure drop box for ballots that you can use, or you can bring it to the office, if open (please call ahead).

Or, you can bring your ballot with you to the polls on Election Day, Tuesday, Nov. 3, and hand it to your friendly neighborhood poll volunteer. You can even bring it with you blank and vote at the polling place.

And you can vote in person on Election Day.

A lot of effort has been expended by the Secretary of State's office and by your town clerk to make this happen. A little attention to detail is all it takes for you to do your part and have your voice be heard. Your town clerk is ready to help if you have questions, and here's a complete list of town clerks if you need it.

MEANWHILE, IN MONTPELIER ...

With attention firmly focused on the election, now less than a month away, there's another chapter to the Great Endless 2020 Session of the Vermont General Assembly. And it starts with Gov. Phil Scott's pen.

On Friday, Scott signed the $7.15 billion budget the Legislature passed a week ago into law. That's not a surprise, as the spending plan didn't raid emergency funds or raise new taxes and fees. (Lawmakers agree the FY 2022 budget will pose a tougher challenge.)

But the budget is just the beginning of bills on Scott's desk. And the Legislature did not provide for a veto session in its adjournment resolution. Whatever happens next with all those bills -- from police use of force to marijuana policy to Act 250 reform on forest fragmentation -- is up to him. Any bill he vetoes would have to start the process over in January.

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Here's a sample of what's left:

- Hazard Pay: S. 352 expands the state's hazard pay program for front-line workers who stayed on the job at the height of the pandemic, and also provides $12 million in additional restart grants to summer camps, afterschool programs, and child care providers.

- Town meeting: S.354 allows Australian ballot votes for municipal meetings in 2021, since the pandemic will still likely be with us in March.

- Marijuana: When the smoke cleared last month, the Legislature had finally passed a compromise on a framework for selling and taxing cannabis products. No one got everything they wanted, and both chambers gave a lot to produce a bill Scott would sign, including a saliva test (with a warrant) that many lawmakers still oppose.

One of the concerns about S. 54 was that the bill doesn't do enough to address decades of marijuana prohibition, and its significant impacts on Vermonters of color. So it's interesting to note that former state Rep. Kiah Morris, formerly of Bennington and now politics director of Rights & Democracy, an advocacy group, on Friday urged Scott to sign the bill.

Morris called the bill "one of the most comprehensive and forward-thinking attempts" at repairing the damage done by the war on drugs. While it isn't perfect, she said, "We support this with the full expectation that no one will be left behind."

The Vermont ACLU has also asked Scott to sign the bill.

- Act 250: H.926, which passed both chambers at the very end of the session, did so as a shadow of its former self. The once exhaustive Act 250 reform bill was stripped down to two sections: Exemptions for recreational trails, which everybody liked, and protections against forest fragmentation, which some oppose for very different reasons.

A number of lawmakers were disappointed that the House's more ambitious version of the bill, passed before the COVID-19 pandemic, had been left on the cutting room floor; others were critical of the bill not providing state regulators with more resources to do the work it requires.

- Police bills: The Legislature passed a package of bills addressing use of force standards, the makeup of the Criminal Justice Training Council, and hiring in the state Department of Corrections. Law enforcement stakeholders had expressed concerns about S. 119, but an amendment offered by the Senate extends the bill's effective date to July 1, 2021, giving police more time to learn the new standards.

Scott's own executive order addresses many of the topics in these bills, and the Vermont ACLU is calling on Scott to sign them.

"The Vermont legislature has presented Governor Scott with a series of historic bills at a pivotal moment in our history," ACLU of Vermont Executive Director James Lyall said.

"While considerable work remains to create a more fair and equitable state, the ACLU and our supporters are grateful to the many legislators who worked to advance meaningful reform legislation and we are committed to supporting continued, cross-partisan progress in the next biennium. In the meantime, the ACLU and its supporters are calling on Governor Scott to do the right thing and sign these bills into law."

If you'd like to leave a comment (or a tip or a question) about this story with the editors, please email us. We also welcome letters to the editor for publication; you can do that by filling out our letters form and submitting it to the newsroom.

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