(The Root) — Lisa Nicole Carson, the former star of Ally McBeal and Jason's Lyric, seemed poised to address rumors swirling about her alleged battles with mental illness during her mysterious, decade-long absence from Hollywood. When asked directly by Essence Magazine in 2009 about rumors that she battled either bipolar disorder or schizophrenia, she replied, "Honestly, it isn't something I wish to discuss at this time, but I will say that it's always been important for me to be a positive role model. I'm very rooted in the community and a child of the universe, so I definitely have to speak for my people.
"That was so negative and I never anticipated it. It just made me want to pull away. I couldn't handle it. It was such a mess, and at one point trying to do battle with that and fight that war, I just couldn't. Instead I chose to retreat so that I could realign myself and get a grip."
Though Carson is certainly entitled to set boundaries regarding what she shares related to her own health, according to experts the unwillingness of black Americans to openly acknowledge and discuss mental-health issues is having a toxic impact on the entire community. But conversations with experts in conjunction with Mental Health Awareness Month (May) raise an even more startling possibility: that racial disparities in mental-health treatment have a direct impact on financial and educational disparities between racial groups, too.
"We treat it as a badge of shame," said Terrie Williams, an African-American mental-health advocate, while white Americans "treat it as a badge of honor."
The most common mental disorders involve depression, with nearly 20 million Americans suffering some form of major or mild depressive disorder. According to the National Institute of Mental Health, "Most likely, depression is caused by a combination of genetic, biological, environmental and psychological factors." Additionally, "Some genetics research indicates that risk for depression results from the influence of several genes acting together with environmental or other factors. In addition, trauma, loss of a loved one, a difficult relationship or any stressful situation may trigger a depressive episode."
With black Americans leading the country with troubling statistics in areas like unemployment, child abuse and neglect, and domestic violence, all of which can exacerbate stress, it is perhaps not surprising that the community leads the country in mental-health struggles. According to the Centers for Disease Control and Prevention's Office of Minority Health and Health Disparities, African Americans are still "more likely to experience a mental disorder than their white counterparts" but "less likely to seek treatment," though Psychology Today recently noted that there has been an increase in the number of black Americans seeking treatment for ailments such as depression over the last decade. Men are less likely to seek treatment than women, regardless of race, meaning black men are among the least likely to seek treatment overall.
One of the main reasons African Americans are less likely to seek treatment for mental-health woes is the same reason black Americans are less likely to seek treatment for other health problems: economics. More than 20 percent of black Americans are uninsured. According to the American Psychiatric Association, "For those with insurance, coverage for mental-health services and substance-use disorders is substantially lower than coverage for other medical illnesses such as hypertension and diabetes." But besides cost, one of the greatest barriers keeping black Americans from seeking treatment for mental illness may be history.
"The distrust of the medical community," said Dr. Jeff Gardere, a practicing therapist who is black, when asked to name the top reasons black Americans are less likely to seek mental-health treatment than their white counterparts. "Think Tuskegee experiment."
Gardere was referring to the now infamous experiment in which the United States government intentionally left hundreds of poor black men with syphilis untreated to monitor the progression of, and their ultimate demise from, the disease. The experiment, which was exposed in 1972, lasted decades and also left a lasting impression on many black Americans. Williams, who was a celebrity publicist before becoming a leading mental-health advocate, also cited the Tuskegee experiment as a deterrent to more black Americans reaching out for mental-health treatment.
But Gardere explained that overcoming this trust hurdle, and ultimately diversifying the patients seeking mental-health treatment, also requires diversifying the medical professionals treating them. "[There are] not enough black mental-health professionals who look like their patients," he said.
Another hurdle cited by Gardere and Williams is the church. According to the American Psychiatric Association, "In one study, approximately 85 percent of African-American respondents described themselves as 'fairly religious' or 'religious' and prayer was among the most common way of coping with stress." The challenge, however, comes when individuals coping with severe mental-health issues decide to try to pray them away instead of seeking medical help, a disconnect that doesn't exist to the same extent when it comes to diagnosing and treating physical ailments. But, Williams stressed, "It's not enough to just pray. God puts the right people in your life."
But Williams noted that in recent years, the church has begun to take a leadership role in addressing mental-health issues, much like it has in other important issues affecting the black community through the years. More churches have started establishing mental-health counseling on the premises.
"Church-based care increases access; you're working with ministerial staff, which builds trust, and the stigma gets reduced," said Williams. She applauded pastors who have begun mentioning their own experiences with counseling, further reducing stigma. Gardere added, "To the credit of our churches, not only do they have religious counselors who are trained to give spiritual advice, but they are also getting these counselors to retrain themselves to work in a more secular manner. As well, I can tell you there are many church groups who put me on their Rolodex or speed dial and refer church members. So right now we are really in a good place with the partnership of the church, spiritual counseling and secular counseling all coming together to meet the mental-health needs of their congregants and community."
The Larger Impact
Aside from the health benefits associated with mental-health treatment, Gardere cited other benefits that may be more tangible, at least in the eyes of some. When asked if he believed those who embrace mental-health treatment have an advantage in life over those who do not, he replied, "This is actually a great question. Communities that embrace mental-health services and mental wellness, sexual equality, basically anything that results in thinking intelligently and out of the box, will give you an advantage in life." He continued, "The point is the mental relief and edge you get from therapy puts you ahead of the pack in dealing with life's challenges. The person who is self-actualized is the one who will always be ahead of the pack."
Williams concurred, explaining that particularly in the black community, we have become accustomed to coping with severe trauma — such as violence — and then continuing with our lives as if nothing has happened. "Then we wonder why we can't concentrate at work or school," she said.
Williams was speaking from firsthand experience. She was one of the most powerful publicists in the country when she had what she described as "a breakdown." At the time, she was representing some of the biggest celebrities in America: Eddie Murphy, Miles Davis and Anita Baker. She began struggling just to get out of bed each day. Eventually friends coaxed her to a psychiatrist, who immediately diagnosed her with clinical depression. Her quality of life improved significantly upon beginning treatment. But her life was truly changed when she went public with her story. While appearing on a panel airing on C-SPAN, she surprised herself and viewers by opening up about her mental-health experience.
She was inundated with letters from others who had been suffering in silence. "People are smiling, but dying inside," she told The Root. She authored the book Black Pain: It Just Looks Like We're Not Hurting, about her own journey and the black community's struggle to confront mental-health issues head-on. Since the book's publication, she has been contacted by thousands of readers, some of them prison inmates who open up to her in ways they haven't to anyone else. Some tell her that for the first time, they understand that what they failed to address mentally and emotionally years earlier made them explode physically with violence, resulting in their incarceration. This reinforces what Williams has long considered one of the greatest impediments to community healing: diagnosis.
"We haven't even named our pain," she said. "We don't know what it looks like, feels like or sounds like. And it's everywhere we turn. The violence that we see in our streets every single day is all symptomatic of all of the unresolved pains, wounds, traumas and scars from our childhood." Williams explained that helping people make the connection between their personal pain and the widespread pain seen throughout the community is why she considers discussing this issue and sharing her own story with as many people as possible not only important, but lifesaving.
In the last few years, other prominent black Americans have gone public with their stories, including Destiny's Child member Michelle Williams and Danielle Belton, the former head writer for T.J. Holmes' BET talk show, Don't Sleep. Before coming to prominence with her popular blog the Black Snob, Belton struggled with bipolar disorder. In 2010, she began sharing her story publicly, seeing it in some ways as a responsibility to help others.
"After many, many years of struggle I made a promise to myself that if I reached a point of stability, I would talk about my illness, if only to give others who were like me some hope that if they stick with their treatment and keep trying, they could learn how to cope and live with this disease as well," she told The Root. "That they wouldn't have to give up their dreams and desires and wants and give them over to this illness. That they can find a way to live with it and not let it define them."
Like Terrie Williams, Belton said the stigma in the black community that depression and other mental-health disorders are simply a sign of weakness or something that one can snap out of remains one of the greatest obstacles to more people receiving treatment. In the meantime, Williams worries that more people will continue to suffer unnecessarily.
"It's the stigma that prevents people from getting help. It's a deep mark of shame. People are reluctant to talk because they think they are the only one," Williams said. "By 2020, depression will be [a] leading cause of disability behind heart disease because people get up, go to work, and they cannot function. They are not functioning. That's why with every breath of my body I'm going to talk about it."
Keli Goff is The Root's special correspondent. Follow her on Twitter.
Keli Goff is The Root’s special correspondent. Follow her on Twitter.