July is recognized as National Minority Mental Health Month. In some areas it is referred to as BIPOC Mental Health Month. For the purposes of this post, I will use National Minority Mental Health Month because that is the name it was established as. It is also the name NAMI (National Alliance on Mental Health) uses. NAMI includes Bebe Moore Campbell in the name. More on her later. National Minority Mental Health Month is intended to recognize the unique mental health experiences, challenges, and strengths of people from racial and ethnic minority communities. At the same time this month encourages equitable access to mental health care.
July was formally recognized by the U.S. Congress as National Minority Mental Health Month in 2008. The month also recognizes Bebe Moore Campbell. She was a writer and advocate who worked to reduce stigma and improve access to culturally responsive mental health services. As a result of Bebe Moore Campbell’s work, conversations about race, family, and mental health entered the mainstream. She worked in Black communities to reduce stigma surrounding mental illness. Her work included several books. Bebe Moore Campbell worked to make mental health care compassionate, accessible, and responsive to diverse communities.
Before I discuss ways that we can get involved to help reduce stigma and make mental health care accessible and culturally responsive for diverse communities I want to share some personal experiences. As a white woman I have privilege that others may not have. Mental health care has always been accessible to me as an adult. I did not have access to mental health care as a teenager, but that was more a reflection of the time and ignorance of the adults in the school system at the time. My point is that I do not need to worry about receiving the care I need. I have the insurance to cover the costs of my care and treatment. I have the financial means to pay for what insurance doesn’t cover. I am fortunate. That fact is not lost on me. It is part of why I am so grateful to my mental health care providers. Of course, my providers are amazing as well. Is that part of my privilege? I do not need to rely on care from government funded providers. I have the best of the best. That being said, I cannot overlook the struggles of others. As someone who has access to the mental health care I need, I feel I should make efforts to help others.
I have witnessed stigma and the lack of access to culturally relevant mental health care or any mental health care. As a teacher in the inner city for almost 30 years, I have seen students from diverse backgrounds struggle with their mental health. I have seen them face a lack of mental health care. Often, the only mental health support they receive is from a school counselor, who is overworked and responsible for more than the mental health of students.
I remember going with a school counselor to a government funded office to try to get services for a five-year old with childhood schizophrenia. I remember waiting in a long line only to fail to get the services in place. This little boy needed help so badly. Yet the support he was given laid mostly in my hands as a special education teacher and a school counselor. His parents were young, from a minority group, and had no resources. They had no way to fight for better services for their child.
Countless times I have had to reach out to school personnel when a student expressed suicidal ideation or made direct statements about taking their lives. Often, an administrator who had less training than me would take the student to their office. Sometimes the student would be taken on a psychiatric hold, but often the parents would be called and told to follow up with care. The thing is the parents were given no direction, no contacts for support. They had no access to resources. Other times the student would simply return to class. The administrator deeming there was no crisis.
One last story from my teaching experience. I had a student who was of Hispanic background. He was in the class for students with emotional disturbance that I taught. He was 18. He was diagnosed with schizophrenia but was not receiving care. His parents knew he was struggling but they feared asking for support. They were not citizens, and they feared that if they tried to push for services for their son, who was a citizen, they would be detained or sent back to the country they left. I remember the father would come every day to talk to me. We did what we could. We tried to help their son. There was a specialized counselor who came once a week to talk to my students. It did not help. He and my other students would make fun of the young, white counselor who did not “get” them. I remember them referring to her as a dead fish. The counseling lacked cultural relevance and awareness.
Then I started noticing my student’s symptoms worsening. He was laughing inappropriately at odd times. I could actually see him experiencing visual and auditory hallucinations. Several times I reached out to the school’s psychiatric social worker, who would call the district’s emergency psychiatric unit. Each time she was told they would not come to the school because my student was “not in crisis”. I was helpless as I watched his hallucinations worsen. I was left wondering if my student lived in one of the more affluent, less diverse areas of the district, help would come to the school without waiting for him to be in crisis.
One morning he came into the classroom in crisis. He was suicidal and suffering from the symptoms of his schizophrenia. This time the psychiatric unit said they would come but we would need to wait for them to get there. That wait was about three hours. A student in crisis was left alone with me and assistant for hours before mental health care providers came to take him to a psychiatric unit. Again, I wondered if he hadn’t been a minority in a low socio-economic area, if things never would have reached this point.
My point in sharing these experiences is to show how being a minority can affect the mental health care a person receives. I have witnessed it firsthand. The disparity is real. The disparity is unfair. The disparity is wrong. I am sure my examples are just a couple of countless incidents that minorities face when in need of mental health care.
What I have shared is part of the reason we need this month and why we need to work to improve access to mental health care in minority communities. It shows how racial discrimination, racism, and other social factors can affect access to care. It also demonstrates how financial, geographic, and insurance-related issues can affect mental health care in areas where people from ethnic minority groups live.
My students experienced delays in receiving care. Often, they did not receive high quality care. That is not intended as a criticism of professionals I worked with. They were often not trained as much as was needed. They also had caseloads that were overflowing what any individual should be expected to carry.
What Can We Do?
I think one of the most important things we can do to improve access to culturally responsive mental health care is talk about it. We need to use our voices to raise awareness. The more we talk about mental health, the more we improve care. This cannot be done in isolation. We need to reach out into all communities. We can ask questions about how discrimination, language barriers, cultural stigma, and unequal access affect different communities. We can work with groups such as NAMI to bring resources to diverse and disadvantaged communities. We can bring mental health information into these communities. This might include organizing events such as talks, mental health and wellness fairs, webinars, and community discussions into these communities. NAMI has programs for different communities held in different languages. Encouraging people to attend these events and programs is crucial. It takes more than a sign or post on social media. We need to get out into communities and talk to people.
Representation Matters
It is important that people from minority groups who have received mental health care share their experiences. In some groups, there is a stigma attached to mental health and mental illness. If people from these groups who have had positive experiences receiving mental health care can share these experiences, it helps to break down the stigma. It is important that we amplify the voices of mental health professionals, advocates and people with lived experience from underrepresented communities. It makes a difference to hear from people who are like oneself.
Holding mental health fairs in these communities with people from different minority groups participating as leaders can make a difference. Again, NAMI gets out in the community and has diverse participants, leaders, and programs.
We can also promote mental health careers in schools with underrepresented populations. A career fair at a high school is a great place to encourage students to go into mental health careers.
Check-In on Others
One of the most important things we can do is to check in on others. This includes checking in on people from diverse backgrounds. Ask others how they are doing. Go deeper than the “okay” that is the response most of us give. Ask what okay means. Then have a discussion. If someone is struggling offer support. Maybe it is just being a listening ear for someone else. We need to normalize talking about mental health in all communities.
Current Times
Right now, we are experiencing increased racism in the United States. This makes it even more important that we check in on the mental health of people from racial minority groups. Experiencing racism can seriously impact one’s mental health. All of us should be checking in on others and helping others. This may mean being a listening ear. It may also mean helping someone find accessible, culturally responsive mental health care. The 988 Lifeline would be a good starting place. NAMI (National Alliance on Mental Illness) is another resource.
Not Just July
It is important to support the mental health of people from underrepresented minority groups throughout the year. July is an opportunity to increase our efforts, but this work should never be limited to one month. Every person deserves accessible, high-quality, culturally responsive mental health care. We need to keep working until that becomes the norm.
I know there is more that I can do in this area. Can you? Awareness is where change begins, but action is what makes equitable, compassionate mental health care a reality for everyone.
