Having The Hard Talk

This post was originally published on Sacramento Observer

By Nicholas Ibarra | OBSERVER Staff Writer

Schea Cotton, a former basketball phenom, was in his early 20s when he first contemplated suicide. Every time he would drive across the Vincent Thomas Bridge in Los Angeles, he would go back and forth several times, contemplating his actions.

“I could just veer the car to the right and drop 500 feet down and be dead on impact,” Cotton said. “But I said to myself, ‘What would I leave behind? Who would I hurt? What would I lose in the process?’”

Cotton never jumped the bridge, and used his struggles with mental health to become a motivational speaker and trainer, sharing his journey with Grant Union High School students and staff in October.

Cotton, 43, said listening to mentors, reading self-help books, praying, staying close to family, and fighting through the darkness when he was alone helped him escape that depressive mental state.

“It’s not about who you are in a crowd of people,” Cotton said. “It’s about how you handle your losses when you’re by yourself, how you feel at night when you’re going to sleep, and what you’re thinking about when you wake up in the morning. You have to own the day. Do something for yourself to wire your mind to promote positivity.”

Talking about mental health is not easy. Many people bottle their feelings deep inside until it’s forgotten, which can lead to problems within the self and relationships.

Public health officials see this in the rising rates of suicide in Black youth. A study from the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) looking at Black youth suicide and the current trends and precipitating circumstances that are causing it found that from 2003 to 2017, Black youth experienced a signifcant upward trend in suicide. Mental health problems, relationship problems, interpersonal trauma, life stressors, and prior suicidal thoughts and behaviors were the most common characteristics and circumstances.

Mental health is so important because it’s “unseen” compared to physical health. If someone breaks their arm, it’s very apparent. Mental health often produces no physical symptoms. The average person is not trained to know or recognize the many symptoms that present before or during a mental health episode. Untreated physical and mental health conditions can become very pervasive and prevalent over time.

Where The Stigma Is Rooted

Kristene Smith, 52, a mental health consultant for over 25 years and a partner with Brother Be Well — a health and wellness website promoting the importance of mental and physical health — says the problem is rooted in many things, but starts with a “what happens in this house, stays in this house” mindset, which was predominant generations ago. “There was embarrassment and shame if someone was different or had some issue that really needed to be treated,” Ms. Smith said. “Families didn’t have proper education and would fixate around the shame felt in the family if there was something awry with one of their members.”

Ms. Smith said some cultures don’t believe in mental health. They don’t have a word for it or a response to it — as if it doesn’t really exist. It’s considered demonic or taboo, so it’s not discussed. The afflicted person stays in the house and the family deals with it.

Ms. Smith said those cultures need to be educated, adding that cultural stigmas are attitudes rooted in historical perspectives that need to change, such as toxic masculinity, which she defined as “the ability or inability of men to accept a certain role, a male dominated role that’s been accepted by cultural or social norms.”

“Toxic masculinity exists in most male cultures,” she said. “Men from most cultures experienced some type of stigma related to mental health or the expression of their feelings.

“The truth is, everybody has something. We have to be more understanding and accepting of one another.”

He referenced Blacks learning resilience by withstanding subjugation, whether through the transatlantic slave trade or racism in North America. While generally a good quality, studies show that resilience in the Black community results in an inability to identify when difficult feelings and emotions arise, or when one should seek help.

Jacobs says stigma among Black men stems from the idea of voicing emotional issues and concerns to a stranger, such as a counselor. “Black men have difficulty doing that with their spouses and loved ones, let alone to a stranger,” Jacobs said.

He cites Black Americans’ history of being dehumanized, oppressed and victimized by violence as having cultivated “a uniquely mistrustful and less affluent community experience.”

“Historically, Black and African Americans in America have continued to be characterized by trauma and violence more often than their White counterparts, which impacts the emotional and mental health of both the youth and adults; therefore, Black people don’t suffer the same way as their White counterparts,” Jacobs said. “The stigma is specific for all men of color, but for Black men in particular, they are affected much differently.”

There’s a myriad of disparities, including inadequate access and delivery of care in the health system, lack of access to culturally competent therapists, and affordability.

Making Change

Statistically, mental health issues occur in Black and White Americans at the same rate. That does not, however, account for unreported cases due to lack of available services and/or services not being utilized.

To change stigmatized perceptions, Jacobs said the media, schools, and the community must look inward and assess how they present and handle the subject.

“Unfortunately, most people are driven by celebrities’ actions and what’s on TV,”
Jacobs said. “Right now, you see a flux of ad campaigns through the NFL, Naomi Osaka (tennis), and the NBA where they’re promoting transparency and explaining, ‘I cannot do my job because of my mental health condition.’”

Jacobs said celebrities’ disclosures of their mental health battles does help address the problem by humanizing the celebrity, which can help alleviate people’s apprehension about sharing their struggles and experience.

“It starts with people not being afraid to share their struggles and their experience,” Jacobs said. “The attitudes follow the progression of programs, services, and funding.

“Education outreach teaches the Millennials and Gen Z’s how to access affordable care and culturally competent therapists; education outreach — teaching them how to pick a therapist — shows they have power and the ability to pick who they want to see and be treated by.”

Outreach is needed to reach people in difficult economic circumstances and let them know where to access such services, Jacobs said, so that “safe spaces” can be developed, where Black folks can find qualified clinicians and talk to culturally competent therapists they can relate to and who understand the Black experience.

“The way to get people comfortable, men in particular, is getting them around other individuals and having that safe space where they can sit down and talk,” Jacobs said. He added that statistics show pervasive conditions such as mental health and substance abuse are best treated in group therapy.

Talking About Suicide 

“Black youth are increasingly participating in suicidal behavior or ideation. They’re thinking, attempting, and some have completed it,” Flournoy said. “The trends are disturbing. Black youth are two times more likely to attempt suicide than their White counterparts. Those disparities are alarming, especially when White men, in particular, have always been considered the highest risk and most likely to attempt.”

Today’s kids are bombarded by media and the internet, which Ms. Flournoy said includes ideas and images that glorify self-harm.

“They have many stressors that influence them — family problems being the biggest one,” Flournoy said.

She said children are under many stressors, “family problems being the biggest one.” These stressors, known as adverse childhood experiences, can predict whether a child will experience mental health problems such as suicidal behavior or ideation.

“It’s really important for us to stay aware of what’s going on with our youth,” Flournoy said. “We have to start talking to kids about what and how they are feeling as early as possible to give them the ability to express themselves in whatever way they can.

“The biggest thing these youth need is mentorship and guidance. We need to rebuild our community into believing that we have the willingness and ability to hang in there and support each other.”

Finding A Safe Space

Sacramento has Black safe spaces. They’re county operated through the Mental Health Services Act (MHSA) and Mental Health Services Fund (MHSF), which funds and supports more than $2 billion in programs and services for California counties, including support for Black safe spaces. People can go talk specifically about their feelings, emotions, the effects of COVID-19 and how it’s affecting their children, and so much more.

In 2018, Flournoy was able to start a program in Sacramento called The Living Room, which helps bring awareness to African American suicide prevention by helping people find hope and rise above their circumstances and situations.

They studied what suicide looked like in the Black community and found the results startling. They showed suicide to be less an impulsive act, as often perceived. Instead, it happens over a drawn-out period. People fighting depression might not so much look it, but “edgy” behaviours such as substance abuse betray their struggles.

“That’s what suicide looks like in our community — the behaviors that people engage in when they are trying to escape something in their reality,” Ms. Flournoy said. “Substance abuse has been used as a way for people to slowly but surely erode their lives. People have given up early and have then crafted a lifestyle that closes doors rather than opening them.”

Keeping Our Loved Ones Safe 

Youth can incorporate practices to adjust their mindset about mental health, such as what they focus on and what they expose themselves to, Flournoy said.

“If you are thinking negatively then you will create negativity,” she said. “If you think positively then you will create positivity. And they need to practice that. If they can feel it then they can walk in it, but the moment they forget about it, they lose it.”

It starts, she said, with parents changing their own behavior, followed by emotional development of the child. Kids look up to and mirror the actions of those around them, so if a parent acts out instead of articulating their feelings, the child will notice and mimic.

“Parents must try to understand the stressors their kids are experiencing,” Flournoy said. They need to listen to them and create an atmosphere where children can talk to them.

“You can talk to your children till you’re blue in the face. But if they are not talking back to you, then there is no progress being made. Being vulnerable and open with your child can take the power out of being a parent, but it goes a long way in developing the relationship you have with them.”

A focus on emotional development allows kids the opportunity to talk about feelings and gain awareness of how to express them, Flournoy said. She gave as an example the common lament of parents of teens, who so often greet questioning with “I don’t know.”

“Given the opportunity to speak without consequences, teens will talk a lot,” she said. “We don’t want to see them incarcerated because nobody ever allowed them to talk about their feelings and the only way they could work it out was to be physical and harm others or themselves. We need to open these possibilities and look at these kids, and allow them the room to express themselves and grow.”

Brother Be Well focuses on four core components: connection, wellness, positive thinking, and life meaning to create an environment that is healthy and inhabitable for the person and their mind.

“Connection is important to the healing process because it allows people to share similar experiences in a safe space, hopefully resonating with them,” Smith said. “Then they can rely on those relationships, week after week or month after month, to build their own confidence and resilience and take charge of their mental health because they’re the most important part of their own care system.”

“Everyone has a right to be and feel well — to wake up and experience the positives of life,” Smith said.

Jacobs said wellness is a complex component that the individual must control, but also manage and tailor to their specific needs, including nutrition and its effects on how the brain operates.

“Positive thinking is the essence of mental health,” Jacobs said. “Every modality that a therapist teaches, like Cognitive Behavioral Therapy (CBT), is based on changing the person’s maladaptive thoughts, meaning to change their path of thinking from negative to positive.”

Smith agrees, citing the importance of having and maintaining adherence to a personal care plan, which can include positive morning affirmations, prayer or meditation, or exercise.

Meaningful lives, Jacobs said, is what we all ultimately seek. We find meaning when our lives’ components are in sync, and through that discovery, he said, we gain clarity on how to contribute productively to society, purging the pervasive negativity about the past that has confined us.

“All these things come together to create a whole life meaning of saying, ‘Even though I have a mental health condition, I can be a contributor to society, I can overcome, and I can live a good life,’” Jacobs said.

The post Having The Hard Talk appeared first on The Sacramento Observer.

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