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Connecticut Mental Health Providers Tackle Barriers To Care In Black Communities

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Mecklenburg County
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Michael Manson isn’t shy about sharing his past of criminal charges, mental illness and problems with alcohol and substance abuse, because lately, he’s been focused on improving relationships with his family, staying sober and managing his mental health.

“I had therapy yesterday. I’m having therapy Friday. Some weeks I have two days — it depends on the week I’m having, because I know every day is a struggle,” he said. “Every day, I’m trying not to re-offend.”

After years of violence and other issues, Manson got connected to behavioral health services and a health insurance plan that supported him. But living in the North End of Hartford, he said he sees people every day in his neighborhood who don’t realize they could get that kind of help, too.

“I deal with my mental health every day. Every day,” he said. “For me not giving up, I’m still putting myself in a better position, so I feel like it’s my obligation to give back to a community that I helped destroy.”

Stress, anxiety, depression and other mental illnesses affect people of all races, but studies show that black Americans and other ethnic minorities are far less likely to seek treatment, leading to racial disparities in mental health outcomes. Wellness experts in Connecticut said that’s because black residents may face unique barriers to services in addition to problems with stigma, access and cost.

But they want that to change.

“It’s a topic that’s not talked about in a number of communities, and certainly it’s not one that’s talked about often in black communities,” said Greg Jones, of Hartford HealthCare. “We got to embrace it and embrace the challenges people have, because we don’t know what those challenges are.”

Hartford HealthCare recently co-hosted an event with Alpha Phi Alpha Fraternity Inc. in Hartford for residents like Manson and health providers to talk about emotional wellness in black communities.

Among people with any mental illness or issue, an average of 46% of white adults got some sort of treatment, while only about 30% of black adults did, according to a report from the U.S. Substance Abuse and Mental Health Services Administration.

Use of mental health services was even lower among Asian and Hispanic adults, data show. As to the reasons for the differences, the American Psychiatric Association stated that a lack of cultural understanding by health care providers may lead to under-diagnosis or misdiagnosis of mental illness among people from diverse communities.   

Dr. Gary Rhule, author and mental health advocate with the National Alliance on Mental Illness of Connecticut, said that relates back to a lack of diversity in the mental health provider field. He said there aren’t as many black psychiatrists, psychologists and other professionals, who would be more likely to understand cultural barriers.

“What happens is, especially if you’re going to talk therapy, if you have to relive or explain some of your cultural or your experience about living in an urban environment or living in the different culture, that’s one barrier you have to overcome,” Rhule said.

Developing cultural competency is an important part of the job, said Kimesha C. Morris, director of social work at the Institute of Living in Hartford. A culturally competent provider is more likely to recognize, for example, when someone has been directly affected by racial trauma, or indirectly affected by seeing or reading about violence happening to people of color elsewhere.

“Racism is so pervasive today in our society, that a lot of times it’s unconscious,” she said. “I like to say it’s in the air that we breathe, it’s in the water we drink — it’s just so unconscious. So a lot of times, a clinician may be really well intentioned, and don’t even know what they’re saying may be a racial micro-aggression.”

Other factors that can affect the use of behavioral health services among people of color include problems with insurance, language barriers, a more pervasive stigma and distrust in the health care system, according to the American Psychiatric Association.

Morris created a monthly support group aimed at people in black communities with a goal to decrease that stigma around treatment and to provide a safe space for black men and women who may otherwise not seek services.

And at the end of the day, Morris said it’s also important for professionals to recognize their own biases, and be willing to learn more about their patients and communities without assuming that every person of color has the same story.

“You may have people who grew up right next to each other and their experiences are completely different,” she said. “You may have a black person who comes into your office and you’re assuming, ‘oh, they live in this neighborhood, this is what they experience.’ But how do you know they weren't adopted into that neighborhood? You just don’t know. So it’s really good to get to know the individual and it’s about building the relationship.”

Nicole Leonard joined Connecticut Public Radio to cover health care after several years of reporting for newspapers. In her native state of New Jersey, she covered medical and behavioral health care, as well as arts and culture, for The Press of Atlantic City. Her work on stories about domestic violence and childhood food insecurity won awards from the New Jersey Press Association.

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