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African Americans Negotiate Mental Illness, Black Pain

Posted: Jan 30, 2013

 HARTFORD – The scars are still visible on Michelle Baxter’s arms.

She was a chubby six-year-old when she first started slashing her arms with razor-sharp fingernails. Baxter, 35 and now a licensed social worker, theorizes that the cuts—one of about 15 types of coping strategies and non-suicidal injurious behavior—is a way to numb the pain in moments of self-doubt and self-hate. With a series of deep cuts, she says, she becomes unaware of her surroundings—or what she calls “missing in awareness.”

Baxter’s family-centered parents were frightfully aware of their daughter’s pain but perplexed by the novel marker of insanity. So they cloaked themselves in denial and shame. Her parents, immigrants from Barbados, grew up in a time when they had little access to mental health services. After they migrated to the U.S. in the early 1960s, they wilted under Jim Crow segregation in New York.

“My parents didn’t know what to do, or who to turn to. So they worked it away with two or three jobs. Or prayed it away,” said the Brooklyn-born mental health advocate, who lives with her husband in Hartford. “They feared my illness would bring deep, biting shame to the family.”

Baxter’s parents are not alone in their pain and shame. Although African-Americans have the same rate of mental illness as whites, nearly 60 percent do not receive care, according to a 2004 Mayo Clinic study.

Only about 30 percent seek counseling, and they tend to be overrepresented among inpatient or residential treatment patients and underrepresented in outpatient care, according to the U.S. Department of Health and Human Services report. In 2010, 19.7 percent of blacks 18 or older had a mental illness. And 4.4 percent of blacks ages 18 or older suffered from a serious mental illness.

The implications are far-reaching and grim. Societal factors such as high homicide rates, high school dropout rate, high unemployment nationwide, and even higher in urban communities, are indicators that increase African Americans’ chances of developing mental illness, according to a 2009 Health Disparities report by the Connecticut Department of Public Health.

African Americans also tend to be in poorer health than the larger society because they lack access to, or do not seek, adequate preventive services. Physical health, the report says, is linked to mental health and wellness.

Additionally, there tends to be a higher level of stigma and misunderstanding about mental illness in the black community, and it serves as a barrier to achieving mental well-being. That’s because many blacks fear icy sarcasm and further marginalization in an already racist and sexist society. African Americans and Afro-Latinos who decide to reach out often seek help much later after symptoms first manifest, said Dr. Gretchen Chase Vaughn, one of the few black private practice psychologists in Connecticut.

“It’s not just the stigma. All communities have that stigma. I think the stigma for us is a fear that the mental health system might not treat us well,” Vaughn said. “Often we get the image of the angry black man or the angry black woman when in reality our people are hurt or depressed by a society that tells them they are less than.”

Indeed, there are also other reasons people are hesitant to reach out for help, said James Siemianowsk, a former social worker and spokesperson for the Connecticut Department of Mental Health and Addiction Services.

“Mental illness is portrayed negatively. We have stereotypes of people who commit crimes. The reality is most people with mental illness are often victimized,” he said. “Another reason is that they won’t be employed. So the fear is justified.”

Baxter’s parents eventually overcame their fears and reached outside the family for help when they found their daughter sitting in a pool of blood that had flown out of her cuts. At first, close relatives and mental health professionals reacted with blank expressions or bewilderment that a black girl cut herself. Self-mutilation, they thought, happened only in the white community. It doesn’t. Baxter cut herself to numb the pain when she got depressed because of past traumas and present realities: repeated sexual abuse, verbal abuse and the reverberations from society’s racist and sexist perception about dark-skinned women.

“When most people talk about self-mutilation, they often think of movies like Girl Interrupted. They think of it as something that happens to white girls,” said Dr. Kevin Chapman, a professor at the University of Louisville’s Center for Mental Health Disparities. “The response she’s getting from a cultural perspective is mostly related to how we put mental health on a hierarchy of symptoms. Depression and anxiety are sanctioned. But when we talk about symptoms that aren’t popular in the black community, it is labeled as crazy. And that’s problematic.”

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