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African Americans and Behavioral Health Disorders
• June 2021 •
From Juan Navarro, Executive Director
Los Angeles Centers for Alcohol and Drug Abuse
African Americans and Behavioral Health Disorders
Every year, Juneteenth — June 19th — commemorates the end of slavery in the United States. On that day in 1865 federal troops finally arrived to enforce the law in Galveston, Texas – and they were late. It had been two and a half years since President Lincoln signed the Emancipation Proclamation declaring Black people in confederate states “shall be then, thenceforward, and forever free.” Today, observance of Juneteenth takes place primarily in local celebrations. Traditions include public readings of the Emancipation Proclamation, singing traditional songs, reading works by noted African American writers, and enjoying traditional foods.
And yes, America still has far to go in remediating the wrongs of inequity to Black people. This includes behavioral health disparities. One of the best reports I’ve ever read is We Ain’t Crazy! Just Coping with a Crazy System: Pathways into the Black Population for Eliminating Health Disparities . The study was conducted right here in California by the California Reducing Disparities Project (CRDP). Even though it was published in 2012 – before the inequities of the pandemic and recent civil unrest – it is relevant today. This was the first report written from the perspective of Black people, not from the established system.
We have long known that African Americans are subject to disproportionate rates of arrest/incarceration, discrimination, racism, and related toxic stress. It’s no surprise that the CRDP report provided proof of high rates of psychological distress, depression, suicide attempts, dual diagnoses, and other mental health concerns among Black respondents. Co-occurring medical conditions, including heart disease, cancer, stroke, substance use, and violence, were also noted in large numbers. This data paints the picture of a population in crisis. If our African American community is to free themselves from the slavery of addiction and mental health disorders, we need systems change, specifically:
- Correct diagnosis
- The funding of more Black treatment providers
- Fighting back against stigmatization of Black people with alcohol, drug, and mental health issues
- The expansion of care beyond the church– there are few linkages between the church and the formal mental health system
- The inadequacy of service integration for primary healthcare, mental healthcare, and substance use disorder treatment for African Americans.
Client's Corner
JP
“Ok, my name is JP, and I am an addict. In recovery. I grew up in a family that used drugs. My mom and my auntie, they were in and out of jail all of my life. It’s funny. I always said I don’t want to be like my mom, but here I was killing it. I started smoking pot when I was 11. Like all of us here, I went on to experiment with every drug there is. In one of my many jail sentences, a Black jailer said that drugs is as bad as slavery was. I laughed because I knew in one week I would be out free and that brother was wrong. No slavery for me. But when I finally, finally got into the program, I started to understand what he was trying to tell me. Being addicted is being a slave to the drug and you’re not really free. I would always need it unless I really worked a program. So, I came to understand, even if it was late in life, that recovery is freedom for addicts. Now, I’m two years clean and I’m a sponsor for other people who are like I was.”
SPOTLIGHT – THE EVIDENCE IS IN:
Culturally Responsive Behavioral Health Treatment for Black Participants
The words “culturally-competent” and “culturally-responsive” can’t become mere buzz words. Especially when behavioral healthcare professionals want to be better allies to African American participants. But what does culturally-responsive mean to the Black community? The research gives us some “best practice” core principles:
- Discuss a client’s substance use and mental health disorders in a context that recognizes the totality of life experiences faced by African Americans.
- Provide equality in the counselor–client relationship; be less distant and more disclosing.
- Emphasize the importance of changing one’s environment—not only for the good of clients themselves, but also for the greater good of their communities.
- Focus on substance use activities that underscore spiritual well-being, personal rituals, and the power of cultural language and traditions.
- Frame recovery as a process that involves gaining power in the forms of knowledge, spiritual insight, and community health.
- Help clients view recovery within a broader con-text of how recovery contributes to the overall healing and advancement of the African American community.
Learn more about incorporating cultural responsivity in: Recovery for African American Clients
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