The state of New York recently passed an unprecedented law requiring that all students from elementary to high school learn about mental health. Some key points that these classes must cover include, identifying signs of mental health problems, resources for health and support, and the negative stigma that surrounds mental health. What New York State has done is not only incredible for the progression of mental health awareness in this country; it is groundbreaking and an absolute necessity. According to the National Alliance on Mental Illness, around 13% of children ages 8 to 15 experience a severe mental disorder as well as 21% of teenagers from 13-18. Some data also suggests that up to 50% of mental health disorders can be recognized as early as age 14. This highlights an important point, that mental disorders can manifest itself at an early age, yet because of its stigma and lack of understanding, many young people do not get the appropriate help and support that is needed. Over time, if these signs are not recognized they will only get worse and increase the impact of the disorder. The World Health Organization identifies that 1 in 3 college freshmen may suffer from some sort of mental health disorder. This indicates that most people experience disorders yet continue to carry them through childhood, and eventually through adulthood. There is great optimism that more states can follow New York’s lead and pass similar legislature, which will bring mental health to the forefront of this country’s consciousness. This year, Virginia has passed a law that requires that 9thand 10thgraders be taught mental health lessons in school. Now more than ever, mental health has become as apart of the national dialogue as politics, sports and entertainment. It is important that the momentum continues and the important work continues to be done. The fight to remove the immense stigma surrounding mental health is an essential one, and must start with the younger generations in order to make necessary changes. Teaching the youth how to recognize signs and symptoms of certain disorders and educating them will help increase the understanding of mental awareness and normalize it even more in the future. Many times, people identify “needing help” as a weakness. Society has often times isolated and ostracized people who may be suffering from mental health disorders. These mandatory classes will go a long way in the fight to break the stigma and continue conversations that are needed for the increased awareness and progression of mental health in this country. Young people will not be afraid to come forward and talk about issues that many generations who came before them have not. Already because of the widespread impact of social media, many people are coming forward and sharing their experiences and struggles with mental health, and as mandatory classes become apart of national curriculums across the country, I anticipate that this will become more of the “new normal”. In the future, not only will children learn about the arts and sciences, they will be educated on emotional wellness and the importance of mental health awareness, which will have great impact on the emotional wellness of this country.
“Drifting on a melody… Ain’t no place I’d rather be, than with you.” When Mr. Washington, a 71-year-old US Army veteran from Waco, TX heard these lyrics from The Isley Brothers, it instantly took him back to a simpler time, when he and his wife would spend Sunday’s in the park, eating snow cones and talking about their future lives together. Today, Mr. Washington suffers from dementia, but for that brief 5-minute period that those lyrics drifted from the speakers, it was as if he was transferred back to his youth, and all was right with the world. Music therapy is one of the most effective forms of dementia and Alzheimer treatment in healthcare. The Music & Memory Organization is a non-profit organization that provides iPods to senior citizens in order to “vastly improve their quality of life.” They are most famous for the viral YouTube clip of a man named Henry who barely spoke but upon listening to music from his era, erupted with life. So how does this happen? Why does music somehow reignite a person’s learning ability, communication, and overall happiness? According to Dr. Laura Mosqueda, Director of Geriatrics at the University of California, Irvine School of Medicine, “music affects so many parts of the brain that it touches areas that may not be damaged by the disease and brings those pathways to the forefront.” When this happens, it is as if a light switch is turned on, and an “awakening” occurs. Synapses and pathways that were once thought to be lost are suddenly rediscovered. In senior living communities, residents are often encouraged to engage in musical activities and more social interaction. These patients are therefore happier, have fewer behavioral issues as well as have reduced usage of anti-psychotic and anti-anxiety medication. They also show improved energy, increase cognition skills and higher self-esteem. Sometimes seniors who suffer from dementia or other mental health issues have trouble communicating thoughts or expressing their feelings. This often times leads to perceived behavioral issues, which may not be the case. Music has the ability to act as a key that unlocks memories and helps these seniors be able to engage and recall what may have been previously lost. For most people music is not only important, it is essential. During every key moment or memory in life there is usually music associated with it. The song that a mother sings to their young child; Or the first song that a husband and wife dance to at their wedding. These things are embedded in our memory banks forever, and often lead us back to a happier time or specific moment. No matter what, whenever I hear “Never Too Much” from Luther Vandross, or “As” by Stevie Wonder, it takes me back to Saturday mornings, cleaning the house with my mother and sisters. Dancing and singing the whole day away without a care in the world. As we age, these moments become even more essential and necessary for our mental, emotional and physical well-being. These are the moments and memories that we draw to when times become difficult and life becomes stressful. This is even more critical for our senior citizens, as they are already dealing with the natural decline of their health due to age. So, for people like Mr. Washington, music is not only something to listen to and enjoy, it is the bridge to a once-forgotten life.
Talk about the impactful work that you are doing in the community when it comes to your “Doing it Well” movement?
I come from an under resourced area outside of New Orleans, and I saw how beautiful it was, even though the media and outsiders tried to tell me that it was not. I had a dream of becoming a physician, but I knew that I wanted to redefine what it meant to be a doctor. I wanted to know what it meant to become a doctor for my people, and there’s not a template for that. I wanted to take medicine and deliver it in a palatable, respectful way and make my community feel like they were special just like everybody else. So, my goal is to create impactful community oriented mental health programs and be creative with it. I’ve always had a love of art, music and creativity and I wanted to merge all three together to create healing. I have traveled all over the country, talking to kids about coping skills and improving the mental health literacy of kids in under resourced communities. I’ve made a hip-hop relaxation album with my buddy Mike Brown and also have done a yoga video with my friend James Woods. I created a hip-hop mentorship program, which used hip hop as a springboard for kids to exercise critical thinking and to address mental health in a positive safe space which was super dope and fun. I think for the first time in my life I was inspired to not only come up with ideas but follow through. My goal is to help those who live in a space that is constantly defined as negative, be able to take hold of their own narrative and define themselves.
What are your thoughts about the current state of mental health stigma in our community? Where did it come from in your opinion?
First, we have to talk about white supremacy and acknowledge that its real. The social identity of being white historically has been looked at as being better than, smarter than, and prettier than black. This permeates through medicine. This notion leads to why there’s disparity in health, education, etc. as well as identifying that there is an unbalanced power dynamic that heavily favors white social identity. Minorities who are in these underserved areas have traditionally been viewed as less than if they don’t adhere to the White standard. In my opinion, these people in these neighborhoods are beautifully human; just because they wear their hair a certain color or dress a certain way does not mean that they are bad or wrong, it’s just different. It’s a subculture, and subcultures are supposed to be different. We have to expand the notion of what it means to be beautifully human, to appreciate the urban culture and to connect with it.
Let’s talk about the difficulties that minorities have when discussing emotional wellness and mental health… Why do you think that is? What can we do to change that stigma?
Going back to the white supremacy argument, there is a distrust in America because of Black people’s horrible experiences with medicine in America, particularly in psychiatry. Even some governing bodies in psychiatry have said horribly, racist things about black people. So black people historically are not comfortable with medicine and discussing mental health in America. During one of my TED talks, I talked about how the Tuskegee Experiment lasted from the 1930s to the 1970s! That was not that long ago. I mean think about it, they were being dishonest and letting people die from a disease that was easily treated. Racism in medicine is a problem. However black America, has a role in the stigma as well. In our society, historically since blacks have always been looked at as less than, we have to overcompensate and look like we are extra strong. If society is telling us that we are less than, we have to be like “oh were stronger and I don’t need help! I don’t have no mental health problems!” Sometimes that even carries over to asking for medical help as well. When you live in a society that tells you that you are weak it is easy to become overly sensitized and hesitant to ask for help. I believe we must stop being reactionary to societal biases; We must stop internalizing the idea of white supremacy and to begin to value ourselves and our lives even more. Be more supportive of one another and treat each other with respect and value as well. Medicine needs to be more respectful of our community as well. If people begin to have better experiences with doctors, they will become more willing to ask for help.
Discuss the importance of minorities, accepting themselves in relation to their own mental health and success?
I recently wrote an article in Blavity, stating how it is important for people to bring their “whole selves” to work in spaces that weren’t designed for that. For example, in many professional spaces, whether its school or work, those places were designed at a time where people of color were not thought of. So, if you go to work in a finance agency, the cultural boundaries of those places were primarily made with white men in mind. If you go to an ivy league school, only white men designed the spaces. Minorities in general have done a good job getting into these spaces, but the spaces themselves have not transformed. So, we have to “code switch” to fit into these places, and if I have to do that when I am in these environments, it’s harmful to mental health. It’s almost like we are admitting that we are less than. You lose yourself every time you have to code switch and not be who you are. If I go to school at Yale, and I think that the only way I can be excellent is to transform into what a person at Yale is supposed to be like, that image is inherently wrong because it was created at a time when only white men were in mind. In order to fight this, we as minorities must identify our own source of excellence. See black excellence as just excellence, see Latino excellence as excellence. Our own brilliance should be enough for us to succeed no matter where we come from. We must recognize that when we “code switch” it’s because we are adapting to the current power structure, not that it is only the true example of excellence. I tell people that it is risky to come into these spaces being their “full selves” because it’s a threat to the power structure, but it’s gotta be done. In the past folks couldn’t wear their hair a certain way, or dress a certain way, but now you see people wearing dreadlocks and bringing culture to work. It’s a risk, but it’s a risk worth taking. When you can be your full self, I think you will be more productive, more engaged and more successful.
What can health care professionals do to encourage people to break the stigma in our community?
Medical professionals need to gain cultural sensitivity. So, if we are serving a group of people, we need to, regardless of ethnicity, go into those communities. Go eat in those communities, volunteer, and experience it. We need to gain a reverence and appreciation for the community. That will help reduce some of the biases that get us into trouble. Also, white doctors working with minorities should help make their patients feel more comfortable. This means letting patients know that you may have “blind spots” in helping treat them because of the cultural differences; and that you are open to learning what those things are in order to help treat the patient. Make sure that your patients feel heard, that they are connected and respected. Have them ask questions, and make sure they have a full understanding of their diagnosis. Ask about medication compliance and things that may inhibit them. Even as black doctors don’t assume that you have all black culture figured out. Black culture in Southside Chicago, is different from black culture in South Central LA. You still gotta do the work just like your white colleagues have to work. You have to do the work to appreciate a group of people and maximize the potential to make an impact on their lives.
Gun shots in foreign battlefields thousands of miles away. The sound of screams and wails piercing the sky. A soldier comes home after a long stint at war overseas and has trouble readjusting to the life that he once knew. These are usually some of the first images that most people are accustomed to when the term PTSD, or post-traumatic stress disorder is brought up. However, what most don’t realize is that PTSD and anxiety occur regularly within our own communities. Every day in America, people of color experience societal “microaggressions” and traumatic experiences that shape beliefs which then may be passed down through the generations. Recently, there have been many examples of microaggressions, whether it is the police being called on African-Americans barbecuing in a park in Oakland or reporting a young black child “illegally” selling water in San Francisco without a permit. Although microaggressions are considered subtle hints of racism, they along with socio-economic inequality and overwhelming traumatic experiences, contribute to the overlying issue of PTSD and anxiety within minority communities. Spend 10 minutes watching the local news and you can be assured that there are going to be stories about a young black or brown person being killed or involved in either a criminal or violent offense. As a result, the community becomes deeply affected and its residents develop paranoia and distrust of outsiders or authority figures. For 4 years, I worked in East Flatbush, Brooklyn often considered one of the most dangerous and crime ridden parts of New York. Although I loved my time there and became deeply connected to the culture and local community, the evidence of PTSD and anxiety throughout was evident. Many residents are of Caribbean descent and live on fixed incomes in areas that can be prone to violent crimes. There are less job opportunities and more overcrowded subsidized housing. These factors breed highly stressful environments which can lead to trauma, anxiety and depression. According to the National Comorbidity Survey, 48% of men and 49% of women who were diagnosed with PTSD also suffered from depression. In dealing with these stresses, many may also turn to alcohol and substance abuse to cope. These experiences are then transferred throughout the generations and become cyclical. As a result, our neighborhoods may feel like an urban battlefield; Navigating lack of resources, higher crime activity, substandard housing and higher negative police encounters can be comparable to a soldier walking through a minefield trying to avoid trip wires and explosives. That nervous feeling that occurs when a police officer drives by, or the paranoia that arises when a black person is suddenly in an all-white environment, are very real characteristics and mindsets that have been learned and repeatedly hammered home by society. We also must identify that these experiences are not limited to simply being “poor and black”. Many minorities from all different backgrounds experience varying amounts of trauma. Although I am a health care professional with a doctorate and no criminal record, I too have been harassed while visiting friends in nice neighborhoods, as well as being questioned as a suspect because I “fit the profile”. I have gone to the funerals of childhood friends who have been lost to gun violence and visited family members who are serving life sentences. When I see flashing blue and red lights in my rearview mirror, my chest tightens, and adrenaline flows with anticipation of what may happen next. I drive with my wallet in my cup holder, so that just in case I get pulled over, I won’t be mistaken for reaching for a weapon. My story is not unique, as there are many other minorities who experience the same, if not greater levels of psychological stress. This illustrates that it is important to acknowledge that being a black or brown person in American can be a traumatic experience. That no matter what your socio-economic status, it is still possible for anyone to be affected, and accepting this fact is another necessary step in continuing to battle the mental health stigmas in our communities.
Comedian Dave Chappelle once stated, “The worst thing to call somebody is crazy. Its dismissive, I don’t understand this person so he’s crazy. That’s bull***, these people are not crazy, they’re strong people but maybe their environment is a little sick.” Crazy. The buzzword that raises eyebrows and makes people cringe. Being associated with “crazy” or “mental illness” is like wearing the Scarlett Letter, and in minority communities this idea is even more prevalent. For most minorities, mental health is treated as a taboo subject; the giant elephant in the room that is almost never talked about. In most of these neighborhoods, depression was seen as a “white issue” and being bipolar meant that you were just crazy. Having suicidal thoughts meant that you were weak-minded. Growing up, I was taught that the sole treatment for most mental issues was going to church and relying solely on prayer. The stigma of mental health was like that faded stain in your favorite shirt; no matter how much you try to scrub it and clean it, it still shows up. 1 in 5 Americans will experience a mental health issue, yet most will not seek treatment. According to the National Alliance of Mental Illness (NAMI), the leading mental health advocacy organization in the country, African Americans and Hispanic Americans only seek treatment at half the rate of their White counterparts. However due to the recent alarming increase of mass shootings and celebrities making controversial, shocking statements, mental health is now in the consciousness of most Americans, and more specifically the black community. The key is treating mental health just as one treats diabetes, hypertension or any other chronic condition. Mental wellness is a large, complicated issue and it may require treatment from mental health professionals (i.e. therapists, psychiatrists) who can help diagnose symptoms and develop successful treatment plans similar to a person with heart issues going to visit a cardiologist or having a cavity and going to visit the dentist. Normalizing the idea of mental health treatment through education not only helps the affected person, it teaches society how to treat them as well. Social acceptance, general encouragement and support from friends and family may help keep people on the right track as well. Making mental health normal is not only necessary, it’s the first step in erasing the myth that you have to be a certain skin color or belong in a selective tax bracket to be affected. In addition, most people who are struggling with mental illness feel alone. They feel isolated and disconnected from society. It is a huge burden for a person to carry and can only lead them further down the rabbit hole. These individuals should be encouraged to share their experiences with others who are going through the same illnesses. During my senior year in high school, my 3-year-old nephew was shot and killed in an accident and as a result, I struggled with depression for several months. Blaming myself for his loss. I hardly slept and could barely eat. It felt like I was sleepwalking through life, trapped in a constant fog of sadness, helplessness and anger. Why did it happen? Why didn’t I do more? I had questions that I felt no one could answer. It was only after talking with others who experienced the pain and heartache of loss, as well as going to therapy with an open heart and mind, that I was able to recover and release. Confronting my emotions and doubts instead of burying them. I had to reteach my brain that accepting help is ok and that we are all vulnerable sometimes, and that sometimes your greatest strength comes from being weak. I had to unlearn lessons which my community taught me; That as a black man, you keep everything inside and show no emotions. Our community must learn that talking about mental health is not a “white thing”, or a “rich people” or a “woman” thing, it needs to be for everyone, regardless of where you come from or the color of your skin; and this is the first step that we can take to not only break the stigma, but permanently delete the stereotype.