Black Mental Health Isn't the Same as White Mental Health
Dr. Michael Lindsey of NYU's Silver School of Social Work shares his views on the state of mental health within the African-American community.
Dr. Michael A. Lindsey is an associate professor at the Silver School of Social Work. Dr. Lindsey is a child and adolescent mental health services researcher, and is particularly interested in the prohibitive factors that lead to unmet mental health need among vulnerable youth with serious psychiatric illnesses, including depression. Dr. Lindsey has received research support from the National Institute of Mental Health (NIMH) to examine the social network influences on perceptual and actual barriers to mental health care among African American adolescent males with depression. Dr. Lindsey’s current research, funded by NIMH and the Annie E. Casey Foundation, involves the development and test of a treatment engagement intervention that promotes access to and use of mental health services among depressed adolescents in school- and community-based treatment. Dr. Lindsey is a member of the Ford Foundation Scholars Network on Masculinity and the Wellbeing of African American Males; the Emerging Scholars Interdisciplinary Network; and the Mental Health Education Integration Consortium. His published research has appeared in the American Journal of Men’s Health, Journal of Adolescent Health, Clinical Child and Family Psychology Review, Journal Clinical Child & Adolescent Psychology, Journal of Black Psychology, General Hospital Psychiatry, Prevention Science, Psychiatric Services, and in the journal Social Work. Dr. Lindsey is currently a standing member of the NIMH Services Research Committee, and a board member-at-large for the Society for Social Work and Research.
Dr. Lindsey holds a PhD in social work and MPH from the University of Pittsburgh; an MSW from Howard University; and a BA in sociology from Morehouse College. He also completed a two-year postdoctoral fellowship in public health at the Bloomberg School of Public Health, Johns Hopkins University.
Michael Lindsey: When you look at the historical experience of African-Americans in the United States, you'd have to start with the experience of slavery and the vestiges of slavery in terms of the trauma associated with it. And I think that blacks continue to experience trauma in certain ways and certainly with respect to those who live in urban communities that are sort of infested with drugs or that are particularly violent. Those are traumatic situations that they experience on a daily basis. Certainly, as we've seen in recent events, interactions with the police can be, again, particularly traumatic. So when you talk about mental illness in the black community, I think you have to begin with the experience of trauma and how trauma continues to abound in their experiences, in their daily lives.
I think that what happens for a lot of individuals is that they suffer in silence with respect to having a mental illness. And so what I mean by that — in the greater society there's certainly a lot of stigma associated with mental illness. It's sort of antithetical to the American ethic, which is to be strong and courageous; to pull yourself up by the bootstraps; to weather the storm, et cetera.
I think the second part of that point is what's happening at the community level or the society level. And I think what happens is that within the black community, I think that, again, that ethic about what it means to be strong and courageous is particularly pronounced because of trying to combat those forces like discrimination or racism and it just adds to the burden of sort of what it means to survive. And so then the person who's struggling with the mental illness is perhaps not embraced or warmly accepted because of their struggles.
I remember, as a young person growing up, I used to hear about the person who was "sent down south" and I used to wonder what that meant. And it wasn't until I got older that I became more knowledgeable of the fact that that person was struggling with a mental illness or perhaps substance abuse.
So from a historical perspective there's been a lot of emphasis in the black community particularly in black families on keeping your problems close to the vest, in the home. You don't share what's going on with outsiders. No one can treat you as best as your family can. You bring all your burdens and your problems to your family. And if you do take it to any entity outside of your family, it's the black church.
The church is really important in the black community. Make no mistake about it. It's a source of sort of salvation and healing. And there's the whole collective support you get from your fellow churchgoers and that sort of thing. But I think also what has historically happened is that the church has been defined as the place to sort of relieve your symptoms or to address your burdens and so it stops there. And what I think needs to happen is that first of all I think pastors and lay ministers can be more trained in the signs and presentations of mental illness, but I think that the church can be sort of a triage unit, if you will, such that it identifies those who have needs and it's that sort of first step in the sort of entrée into care, but it shouldn't stop there.
I believe that culturally competent care is critical to everything. If patients perceive that providers are inauthentic and do not care about their unique circumstances, then they're likely to be turned off. At a baseline, providers should understand the history of their neighborhoods, for example, or the history of the experience of African-Americans and Latinos such that they can put the clinical presentation into context and understand what unique factors are in play with respect to the clinical presentation and how that person is seeking to survive and live in the world as an African-American or Latino. And so I think that the onus is on the provider to understand that context and to understand what it means for that person to live in that context.
Big Think and the Mental Health Channel are proud to present Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.
You can't have a frank discussion about mental health within the African-American community without confronting issues related to social trauma. Uncomfortable (and sometimes dangerous) encounters with a distrusted police force. Drugs and crime infesting a neighborhood. The institutional scars of slavery and segregation. These are all issues our contemporary black population must deal with each and every day.
Dr. Michael Lindsey of NYU's Silver School of Social Work sees signs of debilitating trauma throughout black America. He points to two key reasons for this. First, mental illness is unfairly stigmatized in these communities, just as it is throughout American culture. Second, cultural definitions of strength and courage are dictated by efforts to work against institutional ills such as discrimination. How one reacts to these ills, coupled with the community's response to said reaction, adds a lot of tension other Americans don't necessarily have to deal with.
Finally, Lindsey speaks to the value placed on authenticity, a major reason why many sufferers in the black community internalize their strife rather than share it with the outside world.
Can dirt help us fight off stress? Groundbreaking new research shows how.
- New research identifies a bacterium that helps block anxiety.
- Scientists say this can lead to drugs for first responders and soldiers, preventing PTSD and other mental issues.
- The finding builds on the hygiene hypothesis, first proposed in 1989.
Are modern societies trying too hard to be clean, at the detriment to public health? Scientists discovered that a microorganism living in dirt can actually be good for us, potentially helping the body to fight off stress. Harnessing its powers can lead to a "stress vaccine".
Researchers at the University of Colorado Boulder found that the fatty 10(Z)-hexadecenoic acid from the soil-residing bacterium Mycobacterium vaccae aids immune cells in blocking pathways that increase inflammation and the ability to combat stress.
The study's senior author and Integrative Physiology Professor Christopher Lowry described this fat as "one of the main ingredients" in the "special sauce" that causes the beneficial effects of the bacterium.
The finding goes hand in hand with the "hygiene hypothesis," initially proposed in 1989 by the British scientist David Strachan. He maintained that our generally sterile modern world prevents children from being exposed to certain microorganisms, resulting in compromised immune systems and greater incidences of asthma and allergies.
Contemporary research fine-tuned the hypothesis, finding that not interacting with so-called "old friends" or helpful microbes in the soil and the environment, rather than the ones that cause illnesses, is what's detrimental. In particular, our mental health could be at stake.
"The idea is that as humans have moved away from farms and an agricultural or hunter-gatherer existence into cities, we have lost contact with organisms that served to regulate our immune system and suppress inappropriate inflammation," explained Lowry. "That has put us at higher risk for inflammatory disease and stress-related psychiatric disorders."
University of Colorado Boulder
This is not the first study on the subject from Lowry, who published previous work showing the connection between being exposed to healthy bacteria and mental health. He found that being raised with animals and dust in a rural environment helps children develop more stress-proof immune systems. Such kids were also likely to be less at risk for mental illnesses than people living in the city without pets.
Lowry's other work also pointed out that the soil-based bacterium Mycobacterium vaccae acts like an antidepressant when injected into rodents. It alters their behavior and has lasting anti-inflammatory effects on the brain, according to the press release from the University of Colorado Boulder. Prolonged inflammation can lead to such stress-related disorders as PTSD.
The new study from Lowry and his team identified why that worked by pinpointing the specific fatty acid responsible. They showed that when the 10(Z)-hexadecenoic acid gets into cells, it works like a lock, attaching itself to the peroxisome proliferator-activated receptor (PPAR). This allows it to block a number of key pathways responsible for inflammation. Pre-treating the cells with the acid (or lipid) made them withstand inflammation better.
Lowry thinks this understanding can lead to creating a "stress vaccine" that can be given to people in high-stress jobs, like first responders or soldiers. The vaccine can prevent the psychological effects of stress.
What's more, this friendly bacterium is not the only potentially helpful organism we can find in soil.
"This is just one strain of one species of one type of bacterium that is found in the soil but there are millions of other strains in soils," said Lowry. "We are just beginning to see the tip of the iceberg in terms of identifying the mechanisms through which they have evolved to keep us healthy. It should inspire awe in all of us."
Check out the study published in the journal Psychopharmacology.
We were gaining three IQ points per decade for many, many years. Now, that's going backward. Could this explain some of our choices lately?
There's a new study out of Norway that indicates our—well, technically, their—IQs are shrinking, to the tune of about seven IQ points per generation.
An ordained Lama in a Tibetan Buddhist lineage, Lama Rod grew up a queer, black male within the black Christian church in the American south. Navigating all of these intersecting, evolving identities has led him to a life's work based on compassion for self and others.
- "What I'm interested in is deep, systematic change. What I understand now is that real change doesn't happen until change on the inside begins to happen."
- "Masculinity is not inherently toxic. Patriarchy is toxic. We have to let that energy go so we can stop forcing other people to do emotional labor for us."
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