Across the country, people are calling for greater focus on the issue of mental health. Fauquier NAACP president Ellsworth Weaver frequently calls for addressing locally what has become a national mental health crisis.
Last Wednesday, July 13, from 10 a.m. to noon, Warrenton Town Councilman Renard Carlos facilitated a virtual panel discussion on BIPOC (pronounced “bye-pock,” stands for Black people, Indigenous people, and people of color) mental health hosted by the Mental Health Association of Fauquier County. Three local health professionals served as panelists:
Darlene Kelly, who has a background in health both as an RN and an administrator (and serves on the Health Committee of Fauquier NAACP);
Bernice Felder, a counselor at Spiritual Care Support Ministries who facilitates a nurturing parenting program designed to help families function more effectively and volunteers as a grief worker; and
Tenne Wordsworth, licensed clinical social worker (LCSW) and owner of ReEmerge Child Therapy.
While packing a lot of information into two hours, everyone on the panel agreed that mental health is a topic they could have discussed all day, and beyond.
Renard Carlos began the discussion by sharing the following information:
50-70% of youth in the juvenile justice system meet the diagnostic criteria for a mental illness.
The “cultural incompetency” of health care providers likely contributes to the under-diagnosis and/or misdiagnosis of mental illness in our BIPOC population.
Language differences between patient and provider, the stigma of mental illness among the BIPOC community, and cultural presentation of symptoms are some of the many barriers to care that explain these errors in the diagnostic process.
Overt racism and bigotry lead to mental health burdens that are deeper than what others may face.
Panelist Darlene Kelly spoke first, on the topic of health equity: “All human lives have the same value, and every human being has the right to be healthy and reach the full potential of their lives,” she said. "People need to stand together, everyone working together to correct the injustices that some people face." Limited awareness of mental health illness is one of the major obstacles to health equity, Kelly believes. "There are specific challenges unique to the BIPOC community," she said. "But the solutions to those challenges involve us all.”
Kelly shared personal stories about her own experiences and spoke of how, over the years, she has developed tools to deal with the challenges she has had to face in her life. She noted that, as an educated woman and trained professional, she’s had tools available to her that many in the BIPOC community do not. “Mental health is all-encompassing," she said. "It starts with the basics: A safe place to live and adequate food, clothing and health care, both mental and physical.”
Panelist Bernice Felder spoke about grief and the impact of the COVID-19 pandemic on Black people, Indigenous people, and people of color. It is her belief that many diagnoses of mental illness are “really just grief.”
There is a long history in this nation of misdiagnosis of Black people presenting with symptoms of grief. In 1851, southern physician Samuel A. Cartwright published a report on “the diseases and physical peculiarities on the negro race” in which he asserted medical conditions seen only in enslaved Africans. In her remarks, Bernice Felder mentioned "drapetomania," the mental disorder Cartwright offered as the illness which caused Black people to want to escape enslavement. According to Cartwright, it was a scientifically supported fact that slave life was so pleasant, you’d have to be crazy to want to run away.
(As an aside, "dysasthesia aethiopica," another of Cartwright’s invented disorders, was the mental illness which explained why Black people, both free and enslaved, were "lazy.” Cartwright's prescription for both these maladies? The whip, as prescribed by the Bible.
Cartwright also sharply criticized and did not believe in germ theory, the theory--now proven, of course--that pathogens cause disease. His report on diseases among Blacks was a noxious mix of pseudoscience and his personal interpretation of the Bible which, in his time, saw publication in multiple journals and was widely accepted in the medical field.)
Bernice Felder emphasized that today, there are many interventions which mental health professionals can be trusted to do to help people. But first, people must be given time and space to deal with and process their grief. People must be given permission to grieve their losses, she said, whatever those losses may be.
Grief and trauma are interchangeable, Felder stated: Grief brings about trauma, and trauma brings about grief. Both affect all aspects of a person’s being: mental, physical, spiritual, and psychological.
Felder described grief as a feeling of loss and an interrupted, or broken, connection. There was so much personal loss during the pandemic. Loss of loved ones. Loss of traditional gatherings held to remember those loved ones. The social isolation created by the pandemic affected people in all communities and has greatly impacted our children. These conditions, Felder said, have resulted in “disenfranchised or unrecognized grief.” But, she added, “if you don’t deal with grief, grief will deal with you.”
Bernice Felder believes professionals must develop a better understanding of grief and set aside judgment, understanding that different communities present with grief in different ways. Mental health providers need to familiarize themselves with their clients’ cultures and be intentional about how they deal with people in the community, being careful not to have preconceived notions or to make assumptions about anyone, she said.
Panelist Tenne Wordsworth said that people of color, with a history of having been marginalized by people in power, experience mental illness “a little bit differently.” She listed some of the ways racism causes trauma in the BIPOC community: mass incarceration of their peers, school curricula which ignores their contributions to society and their history, and discrimination in housing and banking.
There are a lot of mixed diagnoses of people of color, and symptoms of depression are often overlooked, Wordsworth said, noting that people in BIPOC communities historically have been diagnosed with psychotic disorders more frequently than their white counterparts: Four times more people in the BIPOC community are likely to be diagnosed with schizophrenia than white people.
Wordsworth challenges health professionals with these questions: Racial, social, cultural traits—how do you keep all three in mind when assessing a client? How do mental health professionals make themselves aware of their own cultural biases and assumptions? “Do you see the real person, or are you imposing your own biases upon them when they are in front of you?” she asked. The question then becomes: How can you see the real person, not who you think they are or how you feel about them?
Tenne Wordsworth is a “proponent of compassion.” Merely being compassionate can be very therapeutic, she believes.
At the end of the discussion, Darlene Kelly summarized her comments by saying that the goal is for health equity in its totality. With that in mind, she asked: "Where do we go from here?"
Kelly announced that she, along with Fauquier NAACP Health Committee chair Kathy Marmet, have co-founded the Health Equity Action Team (HEAT), a community-driven health action plan. They have conducted an assessment of health equity in Fauquier County and are looking at it from all aspects. “It’s going to be a real community effort,” Kelly said, and provided an overview of where HEAT hopes to go as it identifies strategies to reduce health inequities in Fauquier County.
Questions from the chat box, with the panelists’ paraphrased answers, included:
What can we do as a community to strengthen awareness of mental health issues in the BIPOC community?
Darlene Kelly: First, HEAT was founded as a community effort to do just that. Second, turn to faith-based organizations. Any faith. All faiths. Ask them what they are doing about mental health. You can’t just pray. You have to create educational resources. There has to be outreach so that leaders of religious organizations can begin to look at mental health in a different way.
In the chat box, someone added: “Faith served as a foundation in the Black community—making comparisons to biblical characters and our own lived experiences is significant.”
Bernice Felder: Tap into the commonality of all of us having struggles. Just be real about who we are. Sometimes you can’t just pray it away, and it’s okay to ask for help.
Tenne Wordsworth: There is a huge stigma surrounding mental health in the BIPOC community. We need to address fears about exposure and overcome the tendency toward secrecy and the desire to not want to bring strangers into our lives. Lack of trust caused by injustices committed by health care professionals in the past can be an issue in the present day BIPOC community.
There’s a good chance some Black people, Indigenous people, and people of color are not aware of the legal requirement for confidentiality; that today, mental health providers, like medical physicians, must abide by privacy laws.
Again, there needs to be an emphasis on education. People in the BIPOC community need to be educated about what mental health therapy is and how it can help them, and peer support is extremely effective in bridging the gap. Having someone to guide a person through the process is helpful. The creation of a local hotline would be helpful, as well as finding out what resources exist in the community which people may not be aware of.
What is the best way to decrease judgmental stigmas on mental health in general and, more specifically, in our community (individually and within groups)?
DK: Have conversations like we’re having today. Educate people about the stigmas associated with mental health. Educate and move together as a community that cares about one another.
BF: Hold mental health workshops that would be inclusive and nonthreatening. Don’t forget about spirituality. Focus on the spiritual aspect of mental health: You are worthy. Talk about mental health in easier, less threatening terms.
TW: All of the above. Education, especially, but also with an emphasis on compassion, that the person is just told it’s okay, we care about you. When we see a person suffering, we can offer to help.
The trauma grandparents in the BIPOC community suffered is different from the experiences of their grandchildren. How do we address trauma across generations?
DK: No segregation. I would like to see us do this collectively, realizing mental health issues vary in communities. If we continue in our boxes and everybody is working on a piece at a time, we’re not going to move the community forward…So let’s continue with conversation and education. Let’s move forward so that everybody is involved. Let’s work collectively to raise awareness, educate, then come to the table to resolve the issues.
BF: Generationally, we have to listen to them, their stories, without any “yes, buts.” I agree that we have to work together. Disparities in mental health are there because historically, people have come to the table with division mindsets.
July is BIPOC Mental Health Month.
For more information about the Health Equity Action Team (HEAT), contact Darlene Kelly at: firstname.lastname@example.org
Mental Health Association of Fauquier County:
Bernice Felder, Spiritual Care Support Ministries:
Tenne Wordsworth, ReEmerge Child Therapy: