'Bear Our Pain': The Plea For More Black Mental Health Workers

Jun 25, 2020
Originally published on July 6, 2020 11:24 am

Two decades of life experience made a mental-health activist of Kai Koerber. When he was 16 and a student at a Parkland, Fla., high school, a gunman killed 17 people, including one his friends.

"I really did suffer a domestic terrorist attack, and that's not something that happens to you every day," Koerber says.

But as a young Black man growing up in the South, Koerber had already faced threats of racial and police violence routinely, and those experiences, too, shaped his relationship with the world. He's coped with that stress, he says, through a lifelong practice of meditation. And after the school massacre, Koerber also sought emotional support from a therapist with a deep empathy for his personal traumas.

"Finding a Black therapist really saved me some time, and there was more connection, in terms of the kinds of struggles that I might feel or the the kinds of ways I might think about certain scenarios," Koerber says.

Now a rising sophomore at the University of California, Berkeley, Koerber says having access to good mental health care is critical to both preventing and dealing with the after-effects of violence.

Racism's burden

The need for mental health support is more evident than ever, especially among Black Americans, say people who study and experience the burden of racism. People of color were already dealing with heavy loads from a pandemic that continues to claim a greater proportion of Black, Latino and Native American lives and a greater share of jobs. Now there's the emotional reckoning following George Floyd's murder, which has stirred up a kind of collective trauma.

Meanwhile, the economic barriers to accessing mental health care have only increased.

Dr. Rhea Boyd says many members of the Black community feel emotionally raw and tapped out.

"We haven't been asked to publicly bear our pain as frequently as we are now, and we haven't had to witness other Black folks publicly baring their pain about it as frequently as we are now," says Boyd, a Bay Area pediatrician who studies the effects of police violence.

She says racism's toll threads through the psyche, manifesting in many ways, and shaping the youngest of brains. She worries most about Black girls, for whom suicide risk is increasing — not just among teenagers, but among preteens as well.

The need for mental health support, in other words, is great. But the history of meeting that need is not, says Dr. Ruth Shim, a psychiatrist at the University of California at Davis. The American system's abuse of African Americans spans generations — from forced experimentation to committing black civil rights activists to mental institutions.

Misdiagnosis prevalent

Misdiagnosis of Black people, Shim says, is still prevalent today — often by non-Black doctors who misread emotional cues like anger.

"We look at these things and call them 'disruptive behaviors,' we misdiagnose young people with things like 'conduct disorder' instead of the result of chronic trauma from racism," because many physicians haven't experienced it, Shim says.

For many Black patients, access to mental health treatment often comes in places of last resort: Jails, schools, emergency rooms. And studies show that African Americans tend to be given psychiatric diagnoses that are incorrect or especially severe or less treatable — such as schizophrenia instead of depression or bipolar disorder — and that can lead to inappropriate treatment. So, not surprisingly, Black patients who do get treatment tend to fare worse than white counterparts.

"I do think changing the workforce and changing the face of the workforce is probably the most critical thing that we can do now to start to address some of these issues," Shim says.

The scarcity of Black mental health professionals in the U.S. is now an acute problem, says Dr. Altha Stewart, a Memphis psychiatrist who became the first Black president of the American Psychiatric Association two years ago.

"I get calls from people right now asking, 'Can't you refer me to a Black psychiatrist?' And because there are so few of us, I'm limited in how many of those people's referrals I can make to their satisfaction," Stewart says. And that contributes to a lack of faith in health care among African Americans.

Stewart sees some signs of hope. In recent years, Black celebrities in sports and entertainment — like former NBA star Ron Artest, radio personality Charlamagne Tha God and actress Taraji P. Henson — started openly advocating for the importance of mental health screening and support. She says more Black faith leaders in churches and mosques are partnering with programs that help them connect congregants to treatment.

But at the moment, Stewart says, in the aftermath of the killing of George Floyd, the need is simply too great. "This was one bridge too many, one act too many, one heinous crime too many. It's something too much."

Copyright 2020 NPR. To see more, visit https://www.npr.org.

RACHEL MARTIN, HOST:

The pandemic has exposed the racial disparities that exist when it comes to medical care in this country. But Black Americans also face long-standing barriers for mental health treatment. NPR's Yuki Noguchi reports.

YUKI NOGUCHI, BYLINE: Two decades of life experience made an activist of Kai Koerber. He was 16 and a student at Parkland High School when a gunman killed 17 people, including one of his friends.

KAI KOERBER: I really did suffer a domestic terrorist attack and that's not something that happened to see you every day.

NOGUCHI: But routine threats of racial and police violence also shaped him. He copes, he says, through meditation. But after the school massacre, Koerber also sought emotional support from a therapist with a deeper understanding of his personal traumas.

KOERBER: Finding a Black therapist, you know, really saved me some time. And there was more connection in terms of the kinds of struggles that I might feel or the kinds of ways I might think about certain scenarios.

NOGUCHI: Koerber is now a rising sophomore at the University of California at Berkeley and advocates against gun and police violence. Access to mental health care is critical, he argues, for both the prevention of violence and dealing with its after effects.

KOERBER: The common thread is mental health.

NOGUCHI: The need for mental health support is more evident than ever. Black Americans already bear the burdens of a pandemic that claimed more of their lives and a greater share of their jobs. The economic barriers to accessing mental health care, in other words, just got higher. And now there's the emotional reckoning following George Floyd's murder, which has stirred up a kind of collective trauma. Rhea Boyd is a Bay Area pediatrician who studies the effects of police violence. The Black community, she says, is emotionally triggered and tapped out.

RHEA BOYD: We haven't been asked to publicly bear our pain as frequently as we are now. And we haven't had to witness other Black folks publicly bearing their pain about it as frequently as we are now.

NOGUCHI: Boyd says racism's toll threads through the psyche, manifesting in many ways and shaping the youngest of brains. She worries most about Black girls, for whom suicide risk is increasing, not just for adolescents but shockingly among preteens, as well.

BOYD: Even Black preschoolers had the highest increase in their rate of suicide attempts.

NOGUCHI: So the need for mental health support is great. But the history of meeting it is not. The American medical system's abuse of African Americans spans generations, from forced experimentation to committing Black civil rights activists to mental institutions. Ruth Shim is a psychiatrist at the University of California at Davis. Misdiagnosis of Blacks, she says, is still prevalent today, often by non-Black doctors who misread emotional cues like anger.

RUTH SHIM: We look at these things and call them disruptive behaviors. We misdiagnose young people with things like conduct disorder instead of the result of chronic trauma from racism.

NOGUCHI: Shim says for many Black patients, access often comes in places of last resort - jails, schools, emergency rooms. And studies show they're given wrong or more serious diagnoses and therefore often inappropriate treatment. So not surprisingly, they fare less well than white counterparts.

SHIM: I do think changing the workforce and changing the face of the workforce is probably the most critical thing that we could do now to start to address some of these issues.

NOGUCHI: Altha Stewart agrees. Stewart became the first Black president of the American Psychiatric Association two years ago.

ALTHA STEWART: I get calls from people right now asking, can't you refer me to a Black psychiatrist? And because there's so few of us, I'm limited in how many of those people's referrals I can make to their satisfaction.

NOGUCHI: Which, she says, contributes to a lack of faith in health care. Stewart, who is based in Memphis, sees some signs of hope. Black stars in sports and entertainment are openly advocating for mental health, for example. More Black faith leaders in churches and mosques are finding resources for congregants to access treatment. But at this moment, Stewart worries about her community.

STEWART: This was one bridge too many, one act too many, one heinous crime too many. It's something too much.

NOGUCHI: And the needs are just too great. Yuki Noguchi, NPR News. Transcript provided by NPR, Copyright NPR.