Consider This from NPR - For Black Men, Barriers To Mental Health Care Can Be Complex

Episode Date: January 14, 2023

The start of a new year can push us to think about how we take care of ourselves – our bodies or our minds. And for some people that can mean seeking help for mental health issues like depression and anxiety. In some ways, being open about pursuing treatment for mental health concerns is becoming more commonplace. But for men who are socialized not to express vulnerability and keep emotions in check, seeking therapy may feel taboo. Black men must also contend with the long history of neglect and abuse that has influenced how generations of African-Americans feel about health services, a lack of Black mental health professionals, and the understanding that shielding emotions are a way to face the pressures and dangers of racism. Host Michel Martins talks with writer Damon Young, author of What Doesn't Kill You Makes You Blacker: A Memoir in Essays, and psychologist Earl Turner of Pepperdine University, on making therapy more accessible for Black men.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

This message comes from Indiana University. Indiana University is committed to moving the world forward, working to tackle some of society's biggest challenges. Nine campuses, one purpose. Creating tomorrow, today. More at iu.edu. The start of a new year often pushes us to think about how we take care of ourselves, whether it's our closets, our finances, our bodies, or our minds. And for some people, that means getting professional help. Therapy can be an important element. And in recent years, being open about mental health concerns and seeking therapy to address them has become a lot more common. A new beginning. Hi. Good morning. Their next chapter. Made possible with a little help from their Talkspace therapist. Talkspace, get personally matched today with a therapist who can give you a little help too.

And the idea of improving your life with the help of therapy has shown up in places you might not expect, like the music of Kendrick Lamar. I wanna get me a therapist, I can debate all my theories and share in it, whoa. Consolidate all my comparisons. Humble enough because time was imperative, whoa. And the surrealist imaginings of Donald Glover's Atlanta. Earn, I know it can be hard to disconnect, but we can't have productive sessions

with your cell phone on, Earn. It's important. I can't pay for this if I don't do this. And Rathaniel, the stand-up special from Gerard Carmichael, the host of this year's Golden Globes. At some points, the critically acclaimed special played more like a therapy session than a comedy routine. I've been trying to be very honest because my whole life was shrouded in secrets. And I figured the only route I haven't tried was the truth.

Therapy in popular culture isn't new. From TV shows like The Bob Newhart Show to Frasier to In Treatment to movies like Ordinary People and Good Will Hunting, therapy has been a vehicle for laughs and drama. But portrayals of Black men in therapy have been rare. One of my favorite lines in the album is where it says, you really need to go to therapy. We learned to hold all our shit in. That scarcity of representation on screen reflects the reality, as research findings from the CDC show.

The research indicates that black men experience similar rates of anxiety and depression as white men, but are only about half as likely to seek mental health services. The distrust stems from the fact that the health care system is flawed, deeply flawed, and treats African Americans differently. Harriet Washington is author of the book Medical Apartheid, the dark history of medical experimentation on Black Americans from colonial times to the present. She told NPR that the long history of neglect and abuse has influenced how generations of African Americans feel about health services.

African Americans have an understandable wariness, which is cheating us of years of life and health. There's also a lack of representation in the mental health professions. Altha Stewart was president of the American Psychiatric Association from 2018 to 2019 and was the first Black person to serve in that role. And she says an inability to find a Black provider can cause a lack of faith in the system. I get calls from people right now asking, can't you refer me to a Black psychiatrist? And because there are so few of us, I'm limited in how many of those people's referrals I can make to their satisfaction. Consider this.

Depression and anxiety are on the rise among many groups, but encouraging Black men who would benefit from mental health services to seek them is a particular concern for African Americans in the field. But how to change that when the barriers to getting help come from within and without? That's coming up. From NPR, I'm Michelle Martin. It's Saturday, January 14th. You know, it's a complex question to understand why men are less likely to seek help.

Erlanger Turner, who goes by Dr. Earl, is a licensed psychologist and associate professor of psychology at Pepperdine University in Los Angeles. He says that from a very young age, boys, not just Black boys, are taught which feelings and behaviors are okay. And so this idea about how we're socialized from a gendered perspective, to be more self-reliant and control our emotions, makes it really difficult sometimes as we grow up to now be comfortable sharing those sort of vulnerable parts of ourselves.

And Turner says that by the time boys become men, many feel the range of emotions permitted to them is very narrow. I think anger is a very normalized emotion for males. Like, we can be angry, we can be upset, we can verbalize that. But if we're anxious, if we're worried, if we're sad or depressed, those are things that we can't openly share sometimes in our friendships or with our family. Turner says Black men may also contend with a restrictive definition of what constitutes manhood within their own families, where shielding emotions is seen as a way to face the pressures to some of that. And so I do understand why some parents do still encourage their male sons to like, you know, not show this fear because you could be, you know, targeted by others for a lot of different reasons. Turner points to Black male celebrities like Kendrick Lamar and Jay-Z and professional athletes who've come out in support of therapy.

And he says he hopes that that kind of visibility helps to shift the perception of therapy for Black men. There's been NBA players that talk about their experiences in going to therapy as well. And I think all of those examples are really pivotal to, like, reduce some of the stigma. And Turner agrees with Altha Stewart that having a therapist who looks like you can be crucial. If they have a white therapist, is a therapist comfortable talking about race and discrimination? And if their client has issues that come up around that, well, they probably are not going to want to bring it up to that clinician. And so that's, I think, another reason why

they may prefer to work with a Black therapist because they can understand like, okay, this person understands my experiences. Coming up. For me, in person understands my experiences. Coming up. For me, in terms of my own pursuit of therapy, it's just, I guess it's just me making an effort to take care of my entire body. That's when we return. I'm fortunate, I'm privileged to be in a position where I can afford it. Because if you had asked me this question, you know, maybe 10 years ago,

then, you know, I'm still dealing with the same anxiety, still dealing with the same neuroses and whatever, but I wasn't in a position where I could afford to seek therapy. Damon Young is a writer and columnist and author of What Doesn't Kill You Makes You Blacker, a memoir and essays. He's written and spoken about his own struggles with mental health. He says in his experience, though, the decision to access mental health care isn't just about affordability. Growing up in a mostly black neighborhood in Pittsburgh, he says he thinks about when his dad went grocery shopping. There's a Whole Foods that exists in Pittsburgh. And my dad would go to Giant Eagle, which was the, I guess, the quote

unquote regular supermarket, and never thought to go to Whole Foods. And I feel like there were just some invisible barriers that exist that communicate to people that, you know what, this thing, even though I might be able to access it, is not for me. As we said, Young has been in therapy. And I asked him what brought him to that decision and what he thinks can get in the way of other men seeking therapy. For me, there wasn't necessarily like an epiphany or an impetus that I could just point to as like, okay, this is the thing that happened or this is the reason why I decided I need to do it. It was just the thing that, you know what, I need to start being more mindful of taking care of myself. And this is just another aspect of that. So there wasn't necessarily like a stigma I had to overcome.

It was more of just, I need to do this in order to be a responsible adult. Do you remember, though, how you thought about or heard about it? One of the reasons I ask is that the culture is all around us, just like the pop culture of therapy, for the most part, until very recently, has been very much of a specific demographic. Like there's like Woody Allen therapy plays a big part in his comedy and his movies. And then there was the character of Tony Soprano. And then there was like the Bob Newhart show. That's a very specific demographic. And if you get your cues about what you're supposed to do from the culture,

you would not necessarily have seen that until very, very, very recently. So I was just wondering if you recall how you first, the thought first occurred to you. I mean, I think that to your point, it was the sort of thing that I associated, not necessarily with race, but with class, with a certain upper middle class sort of person who could afford and who also had the space in their life to be able to pursue, to be able to just sit on somebody's couch for a couple hours a week and talk to this person about what's going on in their life. I think that what kind of led me or kind of what maybe pushed me, and again, this isn't really like this great impetus or great epiphany, but it was this, you know what, I have this anxiety,

which I've dealt with my entire life. I'm in a space now where I'm in front of a lot of people. I have a lot of responsibilities, not just with my work, but with my family. And so I need some help. I wanted to ask about Gerard Carmichael, the comedian. He hosted the Golden Globes. Last year, he premiered the stand-up special. You know, it was extraordinary because it was almost like a therapy session. It was almost like you saw him kind of going through his emotions in real time.

And during the special, he makes a decision to come out. I was just wondering what you thought about that. I kind of felt like it did something. It felt kind of like a watershed. I don't know. What about you? Yeah. His special was one of the, I guess, the best stand-up specials that I've probably ever seen.

And I don't even know if I would call it a stand-up special is one of the, I guess, the best stand-up specials that I've probably ever seen. And I don't even know if I would call it a stand-up special. Because there's something different that he was doing with the audience that I haven't really seen in a stand-up. Now, I have seen it before. I know his performance art might be a better way. Yeah. I think the first time I saw a stand-up comic do a thing like that was with Hannah Gaspi and her special Nanette a few years ago and so Gerard Carmichael's stand-up special kind of had those same sort of elements where he's not necessarily telling jokes you know even though there were some parts in it that were meant to make you laugh but it was it was one it was you know him coming out in a way. And also, there was a vulnerability there that was just so rare and so visceral.

And so, beyond, it's intimidating. Because I attempt to be vulnerable in my work. But when I saw him do that, I felt like my vulnerability still had places to go. On the other hand, though, I'm thinking about the recent death of Stephen Twitch Boss. He was a dancer. He was a big part of the Ellen DeGeneres show. He died by suicide. And there have been a number of black young men and men of a certain age who have died by suicide. And it's just, that has, it just seems, statistically, it just seems sort of that there's something going on. And I just wonder if you have any sense of what you think that might be. I mean, I can't speak to any of those particular circumstances because I don't know what was going on in their lives. But, you know, I go back to a point that you had made earlier about how therapy was associated with people like Woody Allen. And I've always thought that even though that sort of humor is associated

with a certain class, if anyone's going to be neurotic, if anyone is going to have anxiety, it's going to be someone who is from the hood. If any environment is going to make someone need therapy, then it's the environment that so many of us come from. And, you know, plus America, plus racism, plus all of the things that are associated with being Black in America. You know, when you think about the causes, and you think about, you know, the environmental factors that cause anxiety and that could cause neuroses, if anyone is going to need therapy,

it's probably going to be us. What I think I hear you saying is this is a both-and problem. On the one hand, there are real external barriers to people getting the kind of care they need, whether that's mental health care or physical health care. On the other hand, there are some internal barriers that keep people who particularly may need it from physical health care. On the other hand, there are some internal barriers that keep people who particularly may need it from accessing that care. Yeah, I think, and again, I don't necessarily think that this is a specifically Black male thing. I think that that might be a male thing where, you know, we've been socialized to, you know, to be silent and to not express any pain or not emote. And I feel like if you are a man at this point, you need to get past that because there's enough out there to show that,

hey, there is space for you to show emotion and to feel and to grieve. In fact, people around you need that from you so that the only emotion you express isn't anger all the time. Do you mind if I ask, since you've been kind enough to get kind of personal with us, is that when you have pursued therapy, did you feel it helped? I did. I did. Yeah, it definitely did help. What does it do? For me, it just made me feel lighter. And obviously that's in a like more of like an existential sense, right? I just felt like I was able to take some of the things that I was carrying around with me and finally have a place to put them. That was Damon Young. He is a writer and author of the book,

What Doesn't Kill You Makes You Blacker, a memoir and essays. And if you or someone you know may be considering hurting yourself or even taking your own life, please call or text 988. You'll reach the Suicide and Crisis Lifeline. It's Consider This from NPR. I'm Michelle Martin. This message comes from Indiana University. Indiana University is committed to moving the world forward, working to tackle some of society's biggest challenges. IU makes bold investments in the future of bioscience and cybersecurity, cultivates visionary work in the arts and humanities,

and prepares students to become global citizens by teaching more languages than any other university in the country. Indiana University, nine campuses, one purpose. Creating tomorrow, today. More at iu.edu.