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Community awareness needed to encourage blacks to embrace mental health services

This article first appeared in the St. Louis Beacon, Oct. 16, 2013 - La’Shay Williams, a graphic artist, likes nothing better than spending time creating fancy brochures, colorful outfits or even a striking mural that attests to the peace she feels since shaking off the taunting voices of demons in her head. Those imaginary voices used to fill her with rage as they drew her into expletive-filled shouting matches that made her “forget what peace was like.”

Her smile these days betrays those depressing times when she says she felt as if she were plunging into a “long black endless pit” with no way out except suicide. “I figured I wouldn’t hear anything anymore if I wasn’t there.”

The one thing she never did during those hopeless days was confide in anyone that she was coping with deep depression, triggered, she says, by two bad relationships during which she says she was “let down, hurt, lied to, rejected” and ultimately felt she had no reason to live.

Her refusal to seek help from a mental-health professional is common among African Americans, according to Darrell L. Hudson, an assistant professor at the Brown School at Washington University. He’s the author of a report on the importance of effective use of mental-health services in St. Louis. His brief is one of several being published by scholars from Washington University and Saint Louis University who are examining health-related issues affecting African Americans in St. Louis and St. Louis County. The scholars will wrap up their work next year with a report and conference, marking the 60th anniversary of the Supreme Court’s Brown vs. Board of Education ruling. The overall project, titled "For the Sake of All," is funded by a grant from the Missouri Foundation for Health.

Hudson says Williams’ plight underscores the stigma that many African Americans still associate with mental health issues. He is neither surprised by her attitude toward such illnesses nor by the method she finally turned to in order to cope.

“Jesus was my treatment,” she says. “I know it sounds crazy, superficial. And I understand if people need to see a psychiatrist, seek medical treatment from people who will not judge you or make fun of you. But this worked for me.”

Turning to scriptures, she says, helped her learn forgiveness, love and helped her heal. This marked the end to the days when she’d “sit in my apartment by myself,” think about situations, “replay what had happened, get angry again, and say everything I felt like I should have said when the real situation happened.”

During such scenarios, she said, “I would see the people who hurt me and I would hear them saying things back to me.” Finally, she said, faith and prayer restored her sanity.

Researchers like Hudson and counselors like Jermine Alberty of the Missouri Institute of Mental Health don’t doubt her, but they say many others need a lot more than faith to address mental illness. Alberty, the institute’s mental health first aid training director, was especially interested in her spiritual approach because he also has a master’s in divinity and has been a minister for more than two decades.

“Faith is an important component of recovery,” he says. “But it’s not the only component. It may have been the dominant thing that helped her recover. But you can’t overlook things like therapy, medication and support groups.”

Hudson says research shows that the stigma causes mental illnesses to go underreported and under-diagnosed among blacks. The alternative for many St. Louis area blacks is to turn not to the church but to hospitals and emergency rooms. Overlooked is the fact that outpatient care in mental-health facilities can be an effective way to address and control such illnesses.

Blacks in St. Louis and St. Louis County, Hudson reports, are more likely than whites to turn to costly emergency room care for alcohol and substance disorders, anxiety and mood disorders, such as depression and schizophrenia.

He argues that it’s in the region’s economic interest to put more emphasis on preventing acute mental-health conditions. Doing so, he says, would save hundreds of millions of dollars a year in hospital care alone.

“Improving the mental health of African Americans in St. Louis and St. Louis County is one important way to improve the health, safety and economy of the entire reason,” he says. He urges the region to:

• Improve mental-health awareness and the availability of screening programs. Doing so, he says, would make it easier for consumers to find services and screenings. Better screening in turn would make it easier for providers to identify people needing treatment.

• Invest more dollars in community mental-health centers. Cuts in such funding have meant uninsured patients have had to wait a long time for treatment or turn to the ER for care, Hudson reports.

• Improve the quality and availability of mental-health data. He says this is crucial, offering a way to pinpoint disparities and improve the health of minority populations.

His brief also reminds the public that St. Louis has some good models of mental-health care. These include People’s Amanda Murphy Hopewell center on the south side. It provides comprehensive services, integrating mental health with residential and transportation services, as well as other client needs, according to Hudson.

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