The CDC reports that anxiety and depression are up compared to this time last year. Americans are dealing with COVID-19, unemployment, police shootings, unrest, hurricanes, wildfires, and a high-stakes presidential election. Young people and people of color are particularly affected — they suffer from higher anxiety, depression and suicidal ideation.
KCRW talks about mental health and stigma in the Black community with clinical psychologist Dr. Alduan Tartt , plus Shaun Fletcher , professor at San Jose State whose research focuses on health disparities among African American men.
KCRW: Alduan, the CDC says that anxiety and depression are increasing. What does it look like specifically in the Black community?
Alduan Tartt: “The need for mental health services is at an all time high. So you look at systemic racism, which is front and center. You look at being in the middle of a recession. So you're talking about layoffs, you're talking about stress and strain. Especially if you're talking about African American men, their profession is the core of their ego.
And so when you combine a recession with COVID-19, and a pandemic of racial inequality and police brutality, you see that throughout social media, you see African Americans getting a double and triple dose of stress.
And so what we see is an all time high need for mental health services. So there's not a psychologist that I know who was not booked thoroughly because of the need in the African American community.”
Psychologists are booked with existing patients or new patients or both?
Alduan Tartt: “Both. So I've had clients that we've treated successfully, have come back in because … they see what's happening in the news, and so it's lit something inside of them. So it's caused them anxiety, depression and anger.
But also their kids. So the children are saying the same things on Instagram, on TikTok. And so their kids are now outraged, asking questions. So we see a double dose of not only clients coming in, but also their kids asking for mental health services, and how to deal [with] what's going on in this country right now.”
Shaun, I understand that you have suffered from stress, anxiety, panic disorders/attacks. Can you talk about how you personally have dealt with mental health crises?
Shaun Fletcher: “Sure. It is something that's near and dear to me. And I and I spoke about it in a TED talk . … It’s very important to challenge the stigmas that surround it. First, I had to deal with it myself that it was nothing to be ashamed about. That it was something that I could deal with. That it was countered to many of the different narratives that I grew up with, as how I was socialized in viewing mental health as being a sign of weakness.
I had to challenge those stigmas. And that then allowed for me to go and seek the advice, the professional services that are available that Dr. Tartt just mentioned. And it allowed for me to first reshape my thinking and then move forward and take the myriad of resources that we have in our community to deal with mental health in a very healthy way.”
What was the stigma you grew up with surrounding mental health?
Shaun Fletcher: “I grew up in the Bible Belt. I grew up in St. Louis, Missouri. And there's a very healthy tension that existed between white and Black community. … Oftentimes we only heard about therapists when there was some clinical, psychological or neurological disorder that was taking place. And we viewed mental health as something that we either needed to move to some of our institutions, meaning church, religion, community. Some of these institutions that quite frankly, we did not see a professional in the bunch. However, those were many of our mechanisms to cope.
Mental health and mental health resources was [sic] oftentimes viewed as something that the white community took advantage of. You know, folks who lived in a plush existence, who lived a very charmed life, they would go and talk to their therapist about charmed life problems, champagne problems, as we called them. We didn't see that as something that was attainable for us. And then many of us were underinsured or not insured at all.”
So some people would think, “Counseling and mental health, that’s for them, not for us. We deal with our problems in the church?”
Shaun Fletcher: “In many respects. And not just the church. Our communities. We look to one another as safe havens.”
Alduan Tartt: “Yeah, a different experience. But me being a psychologist for 21 years, I have the pastors, the deacons calling me on a regular basis to actually help out. So the beauticians, fire and police, psychiatric hospitals, pastors, and those over marriages — those are the ones that are contacting psychologists on a regular basis and also me being trained in community mental health.
I was trained out in Los Angeles. … I'm from Atlanta, but when I went to Los Angeles, mental health services were kind of the norm. Even if you were in an impoverished community, there was a mental health clinic on every corner. Matter of fact, there were two psychologists posted in each school just to deal with mental health needs.”
I'm not sure that exists anymore in schools because of budget cuts.
Alduan Tartt: “Every school system has a bevy of school psychologists, in addition to licensed clinical social workers, in addition to two to three counselors per school. And [it’s] still not enough to meet the mental health needs of kids on an elementary, middle, high school and college level.”
Shaun Fletcher: “And the interesting part about that … there tends to be cultural barriers to taking advantage of many of these resources that do exist.”
Alduan Tartt: “That's true.”
Is that still the case?
Shaun Fletcher: “I find it to still be the case by and large, yes. I think we're absolutely lightyears away from how we view mental health in the African American community than when I grew up around the 70s and 80s. Especially with the younger generations, they view it differently.
Alduan Tartt: “The big issue is trust. And so we need more professionals. I think it's only 4% of African Americans are psychologists. And you start talking about African American male psychologists, I mean, you might be in the .005%. All right, so if you're in Atlanta, yeah, you can find African American psychologists. It’s still difficult, but it's much more difficult in San Jose. So when we start talking about access, it's really a trust issue.
So I know that I have some mental health issues, and I want to talk to someone. But by and large, we want to talk to people who relate, who connect and get our experience, especially in what's going on in 2020 with the Trump administration.
People don't want to have to explain racism. They don't want to have to explain sexism. They don't want to have to explain what's going on in current America and have their realities invalidated. They want to start with someone already getting their reality. And that's a big obstacle: trust and having more visible African American therapists and therapists of color, and also therapists trained to work with people of color who understand culturally where they're coming from.”
The CDC just released a
survey
of young people aged 18 to 24 years old; 25% of them answered yes when asked if they had seriously considered suicide in the past 30 days; 63% reported they had either anxiety or depression. Aludan, what are you seeing in your practice with young people?
Alduan Tartt: “Let's look at it from a developmental standpoint. You're coming out at 18-24 trying to find employment, either you're going to college, you're entering the workforce. And then oftentimes that means that you're moving away from your family for your first job.
And so we couple unemployment, being in a college, being away from home, having financial strain, racism, and then trying to be able to connect in the middle of a pandemic, to where all of your social things that you would do for wellbeing — the gym, maybe going to a club, connecting with fraternities or a sorority, hanging out — all those things are gone. Even church in-person is gone.
So it does not surprise me that that base, while trying to find themselves, not only find their social network, but also who they are, would be experiencing high degrees of depression and suicidal ideation.”
You both have young kids. How do you talk to them and monitor their mental health?
Shaun Fletcher: “I have a 7-year-old daughter, Mackenzie, and a 4-year-old son, Caleb. Just this weekend, case in point, my daughter asked me why so many Black people were being killed. She had just seen a spot that I was on, talking about, ironically, about Chadwick Boseman’s passing. But she yet saw another Black person dying. With tears in her eyes, she asked my wife, ‘Why are so many Black people dying?’ Men in particular, she asked.
A memorial with a poster, card for the Boseman family, and flowers are left at the front door of T.L. Hanna High School in Anderson, S.C., Monday, August 31, 2020. Photo credit: Ken Ruinard/staff via Imagn Content Services, LLC
… I had to and my wife had to in the moment, we had to try and figure out a way to have a conversation with a 7 year old that would not jade her for the foreseeable future about the world that she’s about to grow up in, and hopefully be, if it’s up to us, be a contributing, healthy member of society.
… We ensured that we were safe, that daddy is safe, your uncles are safe, your little brother is safe. Her little brother's too young to process this, but she needed reassurance.”
But you don’t know that all the Black men in your life are going to be safe.
Shaun Fletcher: “We don't know that. Our institutional loved ones, parents, relatives, teachers, so on and so forth, who helped shape our worldview, they didn't know either. They had no assurances that the world was going to be what they said it was going to be. But they gave hope. There's no substitute for hope.”
Alduan Tartt: “Yeah, they need to see tangible things. … They need to understand — look around you, outside you see the cops coming by, you don't have to be afraid of the cops. You see your father, you see your uncle, you see your grandfather, you see the men in your life, they're still there. So what you see on TV is not necessarily your reality.
And so for kids, you have to be able to help ground them. They'll catastrophize. And so be able to give them a base. You help them understand that is one Black man. That is happening in Minnesota, but there are thousands of African American men in Minnesota, in Milwaukee, in Atlanta who are safe. But unfortunately, the ones that you see were mistreated.
But by and large — and you take them for a drive sometimes — do you see those people walking? Do you see him walking? And then that helps them to be grounded in reality and it takes them off of social media and allows them to be able to see what's going on in their own community.
I also want to add — earlier you talked about kids. I see a lot of young kids. It's three things that young kids are worried about. That's the population that we're not focusing on and we should be. We should be focusing on kids six to 18. Those are the kids that are the most stressed.
What are they stressed about? Believe it or not, one, they’re stressed about grades. All right, that is something that most parents really underestimate. The number one stressor for kids is grades.
Number two … disappointing their parents. Parents are flabbergasted. They don't think that kids care, but kids care about disappointing their parents.
And then number three, which is real time, a disappearing [of] and a lack of a social life and social connection. Social media is not enough. And so now that they don't have access to their peers because many are learning from home, kids are complaining about grades, disappointing parents, and lack of connection and a social life.”
This has gone on for a lot longer than anyone anticipated. Could this be defined as a crisis of hope? How do you hold onto the idea that things will get better or could get better — when things look bad right now and could stay that way even when there’s a vaccine?
Shaun Fletcher: “I think it starts with the nucleus. There takes a core nucleus of people that you trust, who shape your beliefs and values, and only they can reinforce it. Not as Dr. Tartt mentioned, social media influencers that you consume so much. That's why we limit screen time for our daughter, because you should get those messages from us to where if you look without, you're going to see hopelessness. At best, you'll see hopelessness. If you look within, meaning the core nucleus of our cultural defining norms and values and belief systems, that is your true source of hope.
And for many it differs. I am a believer. My family, we are believers. We are strong people of faith. So that is part of our core nucleus. We love family. We believe in that. We believe in mental health outlets. We believe in all of the things that will make us healthy — mind, body, and soul.”
Alduan Tartt: “You mentioned a protective factor when it comes to hope. It’s faith. It’s belief in God. I mean, that is why you have the lowest suicide rates with African American females, because they have the highest level of religiosity. So when we start talking about faith, you're talking about African American women in church. And you can lean on the fact that God has seen pandemics before. And so we start talking about the faith community, and we start going to churches and being part of discipleship groups, and being connected, leaning on faith, especially for people of color, is a protective factor.
And so that is why we have to instill this in our children, 18 to 24, to help them understand how to sustain during times of stress. That God is still on the throne, you can find the silver lining in a dark cloud.
Like for instance, we talked about Black Lives Matter. Now people of color have more power than they've had as far as being on social media and bringing truth to light and actually getting the media to respond.
But companies are afraid. Companies are aligned. Look what the NBA has done because of the players union galvanizing. Look at women's rights and the women that are in [the] Senate and changing the face of politics, all right? And we're seeing that. That is coming out of this. That change.
We can't just have a racist America because now we're in a crisis. We have to diversify. So if you can find the silver lining in the dark cloud, if you can find the positives — families coming together, marriages being built, families spending more time than they ever had because mom and dad were traveling — if you can find a silver lining and lean in your hope in God, you can have hope for the future.”
— Written by Amy Ta and Danielle Chiriguayo, produced by Angie Perrin