Magazine article The Crisis

Mind over Matter

Magazine article The Crisis

Mind over Matter

Article excerpt

A Conversation About African American Mental Health

"Moody." "Scatterbrained." "The blues." These descriptions are often used to diminish or dismiss mental illness, but in reality, conditions like depression, anxiety or psychosis can be as disabling as heart disease or cancer, studies show.

Mental health problems affect all aspects of life, from relationships, to school and work. Depression, the most common mood disorder and the one most often linked to suicide, is often the least understood. Every year an estimated 200 million work days are lost due to depression.

More than 20 percent of American adults and children have mental health disorders, but only one-third of them get the care they need, according to U.S. government estimates. As in other areas of health care, Blacks face huge disparities in diagnosis, treatment and even research. In certain populations where Blacks are overrepresented, like the poor, those in foster care and in prison, Blacks are more likely to suffer from mental disorders, but less likely to get help. Add to these barriers the stigma often attached to mental illness, and it is clear how millions of troubled Black Americans suffer needlessly in spite of major recent advances in diagnosis and treatment.

Fomer U.S. Surgeon General David Satcher, M.D., sounded the alarm for all Americans to be more aware and responsive when his office issued its landmark report on mental health in 1999. The report noted that overall rates of mental illness for African Americans appear similar to those for Whites, but that "differences arise when assessing the prevalence of specific illnesses." Blacks are less likely to suffer from major depression, for example, but more likely to have phobias. Today, as the ranks of jobless, homeless and incarcerated swell with disproportionate numbers of African Americans who are mentally ill, the need to eliminate barriers to effective treatment is urgent.

To examine critical mental health issues facing Black Americans today, The Crisis convened experts Annelle Primm, M.D., M.P.H., associate professor of psychiatry at Johns Hopkins School of Medicine in Baltimore and director of Minority and National Affairs for the American Psychiatric Association in Alexandria, Va.; and John Head, an award-winning journalist based in Atlanta, whose new book, Standing in the Shadows: Understanding and Overcoming Depression in Black Men, masterfully merges his personal experience with depression and insightful commentary and reporting.

Journalist Robin D. Stone led the following conversation covering everything from the impact of racism on emotional health to overcoming the stigma associated with mental health disorders to the role of faith in healing.

THE CRISIS: What does it mean to be mentally healthy?

DR. ANNELLE PRIMM: It's the capacity to be able to function from a cognitive standpoint, from a relationship standpoint, from an emotional standpoint in one's various roles, whether that be as a student or parent or spouse. It's being able to cope with and adapt to Stressors that are part of life - to maintain balance in the face of adversity.

People talk about the hazards of living while Black, and John, in your book, you describe one expert's example of the day-to-day, micro-insults that we live with-assaults on character or intelligence or sense of propriety or ethics. What kind of toll does this take on mental health?

JOHN HEAD: It's been established that stress increases the risk for mental disorders, like depression. And what Dr. Carl Bell [head of the Community Mental Health Council in Chicago] talked about is just the stress of everyday life of confronting racism. He gave the example of his own experience of going to a doctor and having the receptionist ask him if she could have his Medicaid card. The woman probably was not consciously doing this. But that unconscious insult can weigh on people.

PRIMM: I think that living while Black has a major impact on people's psyche. …

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