Author: Jahmal Miller, Chief Administrative Officer, Mercy Medical Group (CommonSpirit Heath) & Board Member, The California Endowment
Abstract
Stigma associated with mental health has been a global issue, as mental illness and behavioral health challenges affect people from all corners of the world. Particularly in American culture, inequities and disparities that disproportionately affect the African American community causes mental health stigma to worsen already adverse conditions. At the root of these disparities is transgenerational trauma and to solve for such deeply rooted issues, this paper illustrates the uniquely important role that African American men play in healing of themselves, thereby their respective communities. The power of communication and storytelling through dynamic conversation from trusted advisors and cultural brokers is modeled in this paper. The 51st annual legislative conference hosted by the Congressional Black Caucus Foundation was the setting, and this inaugural panel, which focused on Black men and mental wellness, resulted in identifying sustainable solutions that are essential to meaningfully addressing stigma and mental health. The solutions explored in this paper include public policy, partnerships, media, healthcare access as well as culturally appropriate care providers, and the important role these respectively play in addressing stigma and mental health in the African American community.
Black men in America have a unique story pertaining the intergenerational and traumatic impact that the American experience has had on us. Even as it has thwarted our potential and creates seemingly insurmountable challenges, I contend that we remain the envy of the world and have a great opportunity ahead of us to realize our strength through vulnerability – the essential first step of vulnerability required to addressing the stifling impact that mental and behavioral health issues continue to have. We have an opportunity to be exemplars, who demonstrate the importance of self-care, on our way to healing ourselves, each other, and thereby, our respective communities across the country.
At such an important time in our country, I recently had the privilege of curating a dynamic discussion entitled “Black Men & Mental Health: Resilience & Wellness to Overcome Trauma” at the 51st annual legislative conference hosted by the Congressional Black Caucus Foundation in Washington, DC. Featured as part of this interactive panel and conversation were thought leaders, clinicians, executives and experts from across the country who discussed healthy, honest and innovative ways to cope with challenges like anxiety, stress, depression and trauma on the way to overcoming. More than 150 conference registrants attended our session and listened in on this spirited discussion about how we approach the distinctive challenges facing Black men in modern America. Of the many session objectives aspired to, the conversation contributed to efforts across the country focused on reducing ethnic-racial disparities in key indicators and, ultimately, contributed to disrupting the reproduction of inequities caused and perpetuated by systemic racism.
The problem we as panelists collectively explored is the longstanding unjust and unfair reality that American men and boys of the African diaspora face a complex set of challenges as we try to maintain our mental health and wellness. On top of universal issues like depression, stigma and economic stress, Black and African American men and boys deal with racism, health inequities and the systemic effects of Jim Crow segregation every day. As the conversation got underway, the aforementioned problem is what kick-started the panel discussion. The well-regarded panel featured:
- Kentucky State Senator Gerald Neal
- Kevin Dedner, Founder & CEO of Hurdle Health
- James Burroughs II, Senior Vice President & Chief Diversity Officer, Minnesota Children’s Health System
- Cedrick Barrow, Psychiatrist, California Medical Facility
- Walter Jones, Talent Acquisition Consultant & TV Personality
- Dante Allen, Executive Director, CalABLE
- Myself, Wm. Jahmal Miller, Chief Administrative Officer, Mercy Medical Group (CommonSpirit Heath) & Board Member, The California Endowment
Although the objective criteria of inequities in health are far too common and well-known, we took time discussing and reviewing key statistics, such as:
- In 2016, the imprisonment rate for Black and African American men (2,417 per 100,000 Black male residents) was more than 6 times greater than that for white men (401 per 100,000 white male residents);
- Black and African American men are particularly concerned about stigma.
- Only 26.4% of Black and Hispanic men ages 18 to 44 who experienced daily feelings of anxiety or depression were likely to have used mental health services, compared with 45.4% of non-Hispanic White men with the same feelings;
At the conclusion of this conversation, it was evident that the 60-minute session was not nearly enough time for us to penetrate the surface of such an important conversation on mental health. The Q&A line of people excitingly hoping to comment and query was over a dozen people long when we were required to conclude the session, which was truly a sign of interest, satisfaction and hunger for such an important topic to be addressed within and by the African American community. Even with the time constraints, there were key solutions and lessons learned that crystallized for us as panelists, especially as we consider how we prepare to continue action and dialogue throughout the year 2024.
Public Policy & Advocacy
Most issues in our society, especially those that touch upon civil and human rights, evolve through policy change, and specifically, the same goes for inequities, as they exist in mental health. One of my favorite yet lesser known quotations of Dr. Martin Luther King, Jr. is the following:
“Morality cannot be legislated, but behavior can be regulated. Judicial decrees may not change the heart, but they can restrain the heartless.”
Healthcare transformation, while advancing social justice and racial equity across private and public sector institutions, is key to sustainable change. Fulfilling this mission requires institutional, structural and systemic change that is only realized via meaningful, well-executed and sustainable public policy and advocacy efforts that will have lasting implications. At the core of Dr. King’s quotation is his understanding of the importance of structural change to foster optimal health, mental health and well-being for our “beloved community”.
Strategic Partnerships & Collaboration
I have the honor of serving on the board of directors for The California Endowment, which was a strategic partner and funder of this inaugural panel discussion. The panel highlighted the stories of experts, practitioners, politicians and influencers seeking emotional healing and wellness, and to provide thought leadership and valuable information for attendees. Working collaboratively with the Endowment as well as with the Congressional Black Caucus Foundation models the importance of developing and implementing processes that foster public and private partnerships for all appropriate strategic priorities, including governmental, corporate, educational, research, and philanthropic institutions.
Media & Entertainment
Multimedia and myriad entertainment platforms inform popular culture and our social environment. There’s a great deal of responsibility and opportunity to leverage on these platforms. Unfortunately, research studies note the connection between use of social media and its undesirable outcomes that increase incidence of anxiety, stress, depression, body image concerns, violence and loneliness in teens and young adults. On the other hand, the impact of cultural genres like hip hop, the arts and the like can help destigmatize and foster improvements. The ultimate goal of integrating positive messages and approaches to mental health via media and entertainment is it can cultivate a level of consciousness, thus empowerment through healing feelings of shame, insecurity, and low self-esteem. Particularly for genres like hip hop, open dialogue and empowering approaches can help foster equal access to health, security, and self-sufficiency.
Equitable Access to Care
Improving and increasing access to care, quality of care, and positive mental health outcomes for racial, ethnic, and cultural communities remains an ongoing priority and need. Essential to realizing racial and health equity, specifically as it pertains to mental and behavioral health needs in underserved communities, is access to health insurance as well as linguistically and culturally appropriate care.
Lastly, supporting health care institutions to partner with health allies to develop policies and programs that improve access to health, mental health, and health care services is imperative to sustainable equitable access that ensures equitable outcomes.
Culturally Congruent Care Providers
A diverse, inclusive and representative clinical workforce is also an essential response to the growing need to address mental and physical health in primary care settings, where most low-income minorities, especially African Americans, first seek help for emotional problems. Clinical workforce development efforts that are underway across the country are focused on increasing the numbers of physicians and allied health professionals who come from underrepresented or culturally diverse backgrounds and plan to work in underserved settings and be future residency directors, policy makers, and thought leaders. Research shows that underrepresented minority physicians are more likely to work in health workforce shortage areas and to care for medically underserved populations, patients of their own ethnic group, and Medicaid recipients. Efforts like this are also aligned with federal government priorities that support the expansion of the National Culturally and Linguistically Appropriate Services (CLAS)
Standards, including assessment, technical assistance, and training.
In conclusion, racism still takes a tremendous toll on our health, including mental health. Now is the time to activate and marshal the best of advocates, experts, icons, executives, clinicians and cultural brokers to foster needed change. There remain far too many reminders of why violence, trauma and stress must be mitigated to put a stop to an epidemic of mental and behavioral health issues in the African American community. Better nutrition, social supports for families, life skills, access to health and social services are needed. I believe that a road can truly be paved in this far too familiar wilderness.
