Mental health concerns often go unaddressed in communities of color, and particularly in the Black community. Issues such as lack of access to culturally relevant mental health services, experiences of interpersonal and systemic racism, and the traumatic history associated with the medical field contribute to a lack of mental health services access and treatment.[1] Paradoxically, these experiences not only contribute to a lack of treatment, they contribute to the prevalence of mental health conditions in the Black community. For example, racism is associated with anxiety, depression, and psychological distress.[2] Racism is both the cause of many mental health concerns and the deterrent to seeking treatment. Racism can decrease opportunities for people of color to receive services from wellness providers and organizations,[3] which could serve as alternative and supplementary approaches for achieving well-being and promoting mental health.
Another barrier to service utilization is stigma. Just as there is stigma to be navigated in the mental health space, broadly, there is stigma in the Black community. Stigma in the Black community is unique as it is compounded by the lack of culturally relevant providers, racism, and the history of trauma and distrust associated with the medical system. This stigma is also cultural, as mental health concerns can be viewed as highly stigmatizing.[4] One study found, for example, “for both men and women, higher levels of Afrocentric values were associated with greater perceived stigma about counseling and a greater likelihood of withholding sensitive information in the mental health context.”[5]
However, we are experiencing a number of atrocities and painful events that elevate and underscore the pre-existing and longstanding need for culturally relevant, trustworthy, and effective mental health interventions for the Black community and other communities of color. Black and Latinx populations are experiencing incredibly disproportionate impacts from the coronavirus, with the likelihood of contracting the virus being three times more likely for these groups than their white counterparts; and a likelihood of death from this virus that is two times higher.[6] It is important to point out that these disparities are not inherent to the ethnicity of those exposed to the virus. The morbidity and mortality rates are manifestations of systemic racism. The pandemic is a traumatic experience for people around the globe, and this trauma is prevalent among individuals in communities of color.
In addition to the pandemic having an undeniable impact on mental health, Census data indicate that depression and anxiety increased among Black people following the murder of George Floyd: “The rate of [B]lack Americans showing clinically significant signs of anxiety or depressive disorders jumped from 36 percent to 41 percent in the week after the video of Floyd’s death became public. That represents roughly 1.4 million more people.”[7] There is an added layer of trauma, stress, secondary traumatic stress, and additional realities being experienced by Black people that impact mental health on both individual and community levels.
Amidst all of these experiences, I had the opportunity to interview Gordon Hakim Collier, LMSW, founder of Beyond Living, on topics related to Black mental health and well-being, therapy in the time of a pandemic and a movement, and the value of self-care.
Q. As a therapist and from your experience, what do you think are some of the barriers that prevent members of the Black community from seeking out mental health treatment?
As a therapist who started out as a case manager, helping people living with HIV and AIDS get connected to mental health services, I’ve observed that access and stigma have been two barriers in the Black community. Both access and stigma have layers within the community. Access can mean access to a therapist who is culturally sensitive and trustworthy. From my experience, access also means access to language in talking about mental health problems. This can be connected and impacts stigma on three levels: public stigma, self-stigma, and systemic stigma. Each type of stigma impacts how someone views themselves and creates or influences a core belief or paradigm as it relates to mental health and treatment.
Q. You mentioned three levels of stigma. Let’s dive a little deeper here. What are your thoughts on mental health stigma in the Black community, and how we can continue to do anti-stigma work to promote care- and service-seeking?
Stigma can be debilitating because it can keep can easily be connected to shame. Shame has much to do with a thought of, “there’s something wrong with me.” I am a firm believer in addressing stigma both on the public and personal levels by really being intentional with our language. How we talk about it is often how we think about it. Growing up in my community, we had so many words to describe mental health problems that perpetuated shame and stigma. This language likely stripped people from feeling safe to talk about trauma, anxiety, and depression. In changing our language and challenging friends, family, and other community members to do the same, we have an opportunity for vulnerability and to normalize discussions around emotions and mental health diagnoses.
Q. One of the spaces where people are vulnerable and seek to improve their mental health and well-being is therapy. In addition to barriers caused by stigma, language, and provider shortages, the price of mental health services like therapy can be challenging for many to navigate. We know the cost of therapy can be a deterrent for people with limited financial means. Can you tell us about the recent subsidy you received and how it is intended to remove this barrier for people seeking services?
Self-Care Is For Everyone started a campaign “Black Mental Health Matters,” partnering with nine Black clinicians around the United States, donating funds to each one in an effort to make therapy more accessible to the Black community. We received donations that totaled $10,000 worth of therapy sessions. This helps us to offer different payment options for those we serve, like a sliding-scale option for those need services, yet don’t have the financial means to pay for standard session pricing. This is an effort to make therapy more accessible for members of the Black community. And, with almost 900,000 Instagram followers, the campaign really had an impact. I received a few emails asking questions, requesting services, and even offering donations. This is an extraordinary effort and initiative because it allows more exposure and visibility to Black therapists in the communities we serve, but also exposure and access to the conversation as it pertains to mental health.
Q. There is a perfect storm, so to speak, that is having severe impacts on mental health in the Black community.[8] One element in this storm, of course, is the pandemic. As a result of distancing requirements that have been in place in New York State, you’ve been practicing teletherapy. The new connections made through the campaign would be first-time visitors of yours, yet you engaged with them virtually rather than in your physical service space. That can be a different experience when compared to sitting down with someone in person for the first time. Can you share a little about what that experience has been like, shifting from in-person to online?
I’ve had tele-health as a service, so it was an easier transition for me compared to some of my colleagues. I think, as a result of the pandemic, I wanted to be more flexible for my clients and practice transparency. I think it was important to be flexible because so much is happening at once (the perfect storm), and many of my clients are Black. Many clients asked to increase their number of sessions, and others asked to decrease for similar reasons–it was, and is, too much to really process. The amount of loss is daunting at times. As a person enduring and witnessing the same things alongside my clients, transparency was important. In a therapeutic way, I share my experiences with them around grief, loss, self-care; it became imperative that I practice what I preach.
Q. In addition to your formal therapy practice, you offer various supports to the community online, such as your biweekly self-care conversations on Instagram. What type of an impact do you think these social media avenues offer as far as supporting Black mental health and well-being? What role do you see them as playing, compared to more traditional interventions, for promoting positive mental health outcomes?
I think as a result of COVID-19, the lockdown, and the All Black Lives Matter Movement, so many have turned to social media for connection and community. As a result, I think there’s a shared experience that we can visibly see that allows many benefits for communities online. I believe social media has increased awareness and decreased self-stigma. The traditional interventions weren’t accessible to so many community members, so the innovation and creativity that has emerged on social media are really beautiful.
The “Self-Care Conversations” on Instagram, which I co-host with Chelle Pean, LCSW, co-founder of Root3d, provide a safe space for people to connect with one another and talk about various healing strategies and practices for self-care. In what appears to be chaos, it is important to take care of and ground ourselves. We gather together in our “virtual living room,” as we call it, and talk about the various forms self-care takes, for mind, body, and spirit, as well as what it means both collectively and as a community to take care of self. This is a donation-based, pay-what-you-can gathering that takes place every other Wednesday at 7:15 p.m. ET from the Root3d IG Live (@root3dhealing). People come together and share experiences, support one another, learn from each other, and, together, we co-create a safe space to explore self-care and well-being.
Q. Do you have any tips for self-care and promoting well-being during these particularly precarious times? Also, as someone who identifies as a Black queer man, how are you maintaining your self-care and well-being currently?
Self-care is a topic I love talking because it calls for self-compassion and giving yourself permission to pause. When you pause, it’s important to ask yourself, “what do I need?” During this lockdown, there has been time—time where we can reflect and feel our many emotions. When we feel the emotions, self-care allows us an opportunity to meet our own needs. Do we need to disconnect from social media and the news? Do we need to connect more to family and loved ones? Do we need to go outside and feel the sun against our face? Once we find out what our soul needs, we can tend to the need, really showing ourselves compassion. I’ve been intentional with my self-care practices. Lately, my self-care has included practicing boundaries in relationships, the news, and social media and taking a break away by going out into nature (hikes, mindfulness walks, etc.). During this time, I’ve been really intentional about endurance and joy. How do I find the balance between being present during the lockdown and the revolution while finding joy? Some days are easier than others, but I find joy is important to maintain my courage and strength for my endurance.
Q. I am so delighted that we got to connect on these important topics and can’t thank you enough for sharing your expertise and experiences. On a personal level, I am grateful for all that you offer the community as far as safe spaces, mindful dialogue, and de-stigmatizing messages. Thank you so much. Do you have any closing thoughts you’d like to share?
I’d like to say thank you for this opportunity. It brings me great joy when there’s an endeavor or initiative to share light and awareness coupled with hope, especially during these times. Thank you for this opportunity!
Biography
Gordon Hakim Collier, LMSW, is the founder of Beyond Living. Gordon received his Master’s in Social Work from the University at Albany and has experience working with individuals living and coping with HIV/AIDS, mental health needs, and substance use. Gordon also serves as an adjunct professor of Social Work at Siena College, where he leverages his experience as a social worker, and his experience as a young scholar of color to teach his students to lead with an open mind and an open heart. Gordon enjoys hanging out with friends and family, engaging in intellectual conversation, and offering an open ear to anyone in need. Beyond Living is a practice that offers individual and group counseling, organizational training, and consultation.
References
[1] Vance, T. (2019). Addressing mental health in the Black community. Retrieved from https://www.columbiapsychiatry.org/news/addressing-mental-health-black-community
[2] Paradies, Y., Ben, J., Denson, N., Elias, A., Priest, N., Pieterse, A., Gupta, A., Kelaher, M., & Gee, E. (2015). Racism as a determinant of health: A systematic review and meta-analysis. PLoS ONE, 10(9): e0138511. https://doi.org/10.1371/journal.pone.0138511
[3] Lee, A. K., Corneille, M. A., Hall, N. M., Yancu, C. N., & Myers, M. (2016). The stressors of being young and Black: Cardiovascular health and Black young adults. Psychology & Health, 31(5), 578-591. https://doi.org/10.1080/08870446.2015.1127373
[4] Ward, E. C., Wiltshire, J. C., Detry, M. A., & Brown, R. L. (2013). African American men and women’s attitude toward mental illness, perceptions of stigma, and preferred coping behaviors. Nursing Research, 62(3), 185–194. https://doi.org/10.1097/NNR.0b013e31827bf533
[5] Wallace, B. C., & Constantine, M. G. (2005). Africentric cultural values, psychological help-seeking attitudes, and self-concealment in African American college students. Journal of Black Psychology, 31(4), 369–385. https://doi.org/10.1177/0095798405281025
[6] Oppel Jr., R.A., Gebeloff, R., Lai, K. K. R., Wright, W., & Smith, M. (2020, July 5). The fullest look yet at the racial inequity of coronavirus. The New York Times. https://www.nytimes.com/interactive/2020/07/05/us/coronavirus-latinos-african-americans-cdc-data.html
[7] Fowers, A. & Wan, W. (2020, June 12). Depression and anxiety spiked among black Americans after George Floyd’s death. The Washington Post. Retrieved from https://www.washingtonpost.com/health/2020/06/12/mental-health-george-floyd-census/?arc404=true
[8] I’m preparing a manuscript on this topic. Please contact me with any inquiries or for additional information: cbrandow@prainc.com.