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Talking About Black Mental Health
There’s no shame in asking for help
Gabrielle Pascal
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One night when I was 14, I sat my parents down at the dinner table and told them there was something they needed to know. A silence fell over the room; I could hear the rattle of the fridge, birds chirping, and grasshoppers humming outside. I held my head down, terrified my parents would look at me and see a cracked glass, falling apart at the slightest touch.

“I don’t know why, but I’m sad and angry all the time,” I finally said. “I’m tired, lonely, and I don’t ever want to do anything. And it’s getting worse. I thought that I could handle it on my own, but I don’t think I can.”

Saying these words felt like taking off a heavy bag that had been weighing down my shoulders. But my parents remained silent. I worried my feelings were a burden to them, and that they wouldn’t love me anymore.

My mouth started to tremble and tears fell down my face. My mother’s hands cupped my cheek. Then she wrapped herself around me and hugged me tight.

“It’s OK, Gaby. There’s nothing wrong with you, you’re gonna be fine. Me and Daddy will make sure, I promise.”

At the time, I knew nothing about mental health. I certainly didn’t know what depression was, or that my constant exhaustion and lack of interest in things I once loved could be symptoms. All I knew was that the color had disappeared from my life, and I was stuck living in monochrome.

Breaking the Silence

Opening up to my parents didn’t automatically fix everything, but it helped me start feeling better. They didn’t think I was crazy or broken, but they did begin to ask me how I was doing each day. We decided that unless I started feeling worse, I didn’t need professional help.

Why was it so difficult to talk with my parents about mental health even though my father is a psychologist? I suspected it had something to do with being black. I spoke to my cousin and some friends who are also black and Caribbean and learned that their families didn’t talk about it either. I went to Google and found similar stories from many other black people.

According to the Health and Human Services Office of Minority Health, black Americans are 10% more likely to report serious psychological distress than whites, but many don’t receive the help they need. Misconceptions and deep-rooted stigma surrounding mental illness often keep black people from seeking treatment.

Many black communities, in my case Haitian-American, emphasize recovery through faith and spirituality rather than medication and therapy. Whenever I was sad, upset, or facing any kind of an emotional issue when I was growing up, I was taught that prayer would solve the problem. As a Christian, I can attest to the benefits of prayer; it plays an integral role in my life. However, it shouldn’t dissuade people from seeking additional professional help if necessary.

When black people do get professional help for mental health issues, they often see white therapists and counselors. Many black patients worry that white mental healthcare providers will not understand them.

I talked to Dr. Sarah Vinson, a therapist in Atlanta and the editor of Ourselves Black, a magazine about black mental health, about why it’s important for black patients to have the option to see a therapist of the same race.

“Sometimes, a black therapist is going to be more understanding when black people talk about microaggressions or discrimination,” Dr. Vinson said. “They’re not going to be dismissive, because they understand that on an experiential level.”

Dr. Vinson has designed her website to show clients who she is. “The home page is literally a picture of me,” she said, noting that it shows off her natural hair. “Not because I’m some diva, but because I wanted [to reach] people who wanted a black therapist.”

Can We Trust the System?

I also learned about how racism affects black people’s experiences with health care. I spoke to Pauline Gordon, a social worker and mental health advocate who currently works as a Child and Family Specialist at the NYC Administration for Children’s Services. She says many black people don’t trust doctors and the health care system in general because “History has shown us, throughout the years, that medical racism does exist.”

Consider the Tuskegee experiment, which ran from 1932 to 1972 and aimed to determine what would happen when syphilis was left untreated. The researchers did not inform the subjects, black males, of the nature of the study or its possible dangers. Even when scientists discovered penicillin would cure the disease, the subjects weren’t treated, and as a result, at least 28 men died.

On top of this, due to the history of racism and violence against black people in the United States, we have adopted the idea of needing to be strong to overcome our own suffering and survive. However, the focus on black people’s inner strength becomes a problem when it frames mental health issues as a lesser struggle.

Kathryn De Shields, a writer in Atlanta, talks about this in an article for BuzzFeed that describes her struggles with depression. She recounts holding all of her pain inside under the guise of being a “strong black woman.” “As powerful as the label is, it can also become a burden when you’re not feeling particularly strong,” she writes. “It becomes yet another perception to uphold, until the pain you bottle up compounds over time, like a festering wound you keep putting a Band-Aid over. And then, suddenly you aren’t strong anymore. You’re angry and bitter. You’re unstable and weary.”

The “Strong Black Woman”

I can relate to feeling like I have to be “strong.” My parents immigrated from Haiti in the 1980s. I grew up hearing stories of how hard they worked to create a beautiful life for our family. My dad held jobs as a taxi driver and security guard while he studied to become a psychologist, and my mother took care of her five sisters from a young age.

My whole life, I’ve worked as hard as I could so I wouldn’t add to the pressures my parents face. I got good grades, loved God, and kept up good behavior. So when I first started to feel depressed at 14, I tried to hide it.

For instance, when I first started having panic attacks, I would hold my hands over my mouth so no one would hear me hyperventilating. If I started crying, I would bury my face in my knees, sitting in the corner of my bedroom, hoping I’d calm down before anyone came inside. The door of my room was always closed, and eventually I started calling it my “fortress of solitude.” Depression was a chip in the mold of perfection I’d worked so hard to cultivate, and I desperately hoped no one could see it.

Talking to my parents that night brought some relief, but it also felt like I was losing what made me strong. Back then, strength meant displacing myself from all I was feeling, locking it in a safe box in some distant, dark corner of my mind. If that lock were to open, it would mean that I was weak and a burden. So when my parents saw I was having a bad day, I’d say, “I’m just tired,” or “I’m OK, don’t worry about me.”

On rare occasions, I confided in my older brother when I was sad, angry, or frustrated with school. Talking to him made me feel better, but leaning on him to fix all of my problems was unrealistic. Almost every time, he’d plead with me to speak to our parents.

“Let them in,” he would say. “They’ve lived a long life and know things that I don’t, Gaby.”

A New Definition of Strength

It wasn’t until a conversation with my father last summer that I realized my definition of strength was wrong. We were sitting on my parents’ bed, talking about my feelings about my coming senior year, when he caught me by surprise.

“A father knows his daughter,” my dad said. “There’s something going on with you, girl. I see it on your face when you come home from school, when you’re at the dinner table. How you lock yourself in your room all the time.”

He was trying to pry open my safe box. I didn’t want him to.

“Dad, come on, there isn’t anything wrong.”

image by YC-Art Dept

“Gaby, if you don’t talk to anyone, how are you going to deal with whatever it is you’re not telling me?”

He waited for me to respond, but I stayed silent. The rumblings of the air conditioner, the creaking of the floor downstairs, and the blaring radio suddenly seemed unbearably loud.

“Please, whenever you’re ready, just tell us what’s wrong so we can help,” he continued. “Your mom and I aren’t going anywhere, OK?”

I saw the concern in his face. I’d been so afraid of making my parents worried about me, I hadn’t even noticed they already were. I was about to end the conversation and go back to my room, but then I realized my dad was right.

“I’m so sad all the time, Dad,” I finally said. “I can’t handle holding it in anymore. I’m scared of what might happen if I do.”

I looked him straight in the eye, preparing myself for what I was going to ask. “I need help, Dad. I think I need to see a therapist.”

“OK, we can arrange that,” he said.

I’m Not Alone

My parents are now finding me a therapist. I don’t know how I feel about starting therapy, though talking to Dr. Vinson for this story and reading stories similar to my own has eased some of my worries. Being open about my feelings is still new for me, but I think therapy will help.

I think the main reason I didn’t open up for so long is the same one that keeps many black people from seeking professional help: the feeling that I had to be strong. As the daughter of immigrants who have sacrificed so much for me, I felt guilty for being in pain, and I hated myself for feeling the way I did.

Even writing this story scares me. But wiping my tears away and pretending to be happy was exhausting. If I had continued living like that, I don’t think I would be here writing this now. Having a mental illness or any form of emotional struggle doesn’t make you weak. You are not crazy, strange, or any less of a person. Suffering in silence will only hurt you more. If you need help, don’t be afraid to ask for it.


Working Toward Better Black Mental Health
Three professionals in the field answer our questions

I spoke to three black mental health professionals about how racism impacts mental health and how to get help. Responses have been edited for length and clarity. —Gabrielle Pascal

Dr. Sarah Vinson, MD, psychiatrist

Why is mental health stigmatized in black communities?
As a member of a minority group that has been traumatized, marginalized, and caricatured in a very negative way, you feel as if you have to be better. If you’re already dealing with racism, you don’t want to deal with the stigma of a mental health issue as well.

I do think that we’re beginning to see a shift. I think more black people are seeing the value of mental health, and I think people are talking about it more. My generation of psychiatrists is more community- and social-justice oriented. Things are getting better, but we’ve got a long way to go.

Dr. Isaiah Pickens, PhD, licensed clinical psychologist

How does faith influence perceptions of mental health?
Religious institutions and other spiritual settings have been safe spaces for the black community to deal with their problems. At the same time, these spiritual havens have also had unspoken rules: that if someone is dealing with mental health problems, then some suggest it is possible their spiritual faith is not strong enough.

How can racial violence affect your mental health?
It is particularly important for black teens to be aware of how situations like police shootings of unarmed black people or other issues related to the black community are impacting them. These situations can be emotionally draining and cause plenty of fear and anger. It’s OK to find someone to talk with about these feelings and let them out in a healthy way.

Pauline Gordon, MSW, Community Coordinator/Child & Family Specialist at NYC Administration for Children’s Services

Black people are legitimately afraid of how police respond to a black person behaving erratically. How can New Yorkers get support in a mental health crisis?
There are mobile crisis teams throughout New York City that can help when a person is experiencing a mental health crisis. Rather than calling 911 and having a police officer respond, these teams tend to be more sensitive and knowledgeable about mental health. Initiatives like these are helping reduce the stigma around mental health and increasing awareness within the community.


(If you or someone you know is in need of one of these mobile crisis teams, contact NYC Well at 1-888-NYC-WELL.)


Different Types of Therapy

Counseling or therapy is a process where people explore their feelings, behavior, and what’s going on in their lives. People go to counseling because they want to find ways to feel better and be more effective in their lives. (This kind of counseling is often called therapy or psychotherapy, or psychological counseling to show that it’s different from something like job counseling.) Here are the various types:

Individual Therapy: In individual therapy, you meet one-on-one with a counselor, usually at his or her office. You usually meet regularly, at least once a week, for anywhere from a few months to a year or longer, depending on the issues you’re working on. You play an active role in defining the goals of your therapy with your counselor.

Group Therapy: A group of people who are dealing with similar issues, such as depression or anxiety, meet regularly with a therapist to talk about their struggles. In this way, teens can support and learn from each other as well as the therapist. Many people find that group therapy helps them feel accepted and less isolated.

Peer self-help groups are one kind of group counseling, and they exist for many different issues, including substance abuse. These groups may be self-directed, or led by a former participant who has recovered. In a formal setting like a drug treatment facility, groups are usually led by a mental health professional. Alcoholics and Narcotics Anonymous and Alateen (for teens who have family members with alcohol problems) are some of the most well-known self-help groups.

Family Therapy: Two or more members of a family meet together and separately with a counselor to discuss conflicts, issues, and communication in the family. The counselor helps the family members deal with important issues without taking sides.

Hospitalization: If you have severe emotional or mental health problems, such as strong feelings of hopelessness or that you may hurt yourself or someone else, or that you’re losing control, or that you cannot quit drugs without more structure and support, you may want to be hospitalized or referred to a drug rehab center.

Hospitalization (which is also called “in-patient” treatment because you stay in the hospital) gives you a chance to get intensive services. For example, you may participate in individual, group, family, or peer counseling every day, as well as be given medication, to see what helps you most.

Once you leave the hospital, or instead of staying there, you may be referred to outpatient or day treatment services. That means you’ll get similar intensive services, usually at a hospital or treatment center, but without having to stay there overnight.


Excerpted from I'm Not Crazy.

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(NYC-2019-01-09)

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