ANN ARBOR—Black communities in the United States have been disproportionately affected by the number of coronavirus cases and deaths. At the same time, white nationalist activities have increased in the last months.
Riana Anderson, assistant professor at the University of Michigan’s School of Public Health, discusses how these trends are affecting the mental health of African Americans. She studies racial discrimination and how socialization in black families helps reduce racial stress and trauma and improve psychological well-being and family functioning.
What are the main stressors that African American communities are experiencing as they confront the coronavirus pandemic compared to other ethnic populations?
Black communities are being faced with stressors that impact them on a structural (limited resources), interpersonal (disruption of shared resources) and individual (compromised coping) level. Wealth disparities between black communities and others are stark, such that less disposable income and generational wealth diminish the amount of resources that can be effective at combating COVID. For example, one’s ability to stay home requires a certain job or a specified amount of liquid income to stay out of harm’s way, yet many black citizens have jobs that require them to interact with others in various industries, putting them at increased risk of exposure.
Additionally, the primary strengths that black communities have, such as communalism, role sharing and familialism, are hampered by efforts to distance and keep the most vulnerable safe. All of these stressors interplay with the chronosystem, meaning that they can be short- or long-term issues, but certainly the longer we need to remain isolated, the more each of these problems will compound.
White nationalism is on the rise. A young black man was recently gunned down in Georgia while running through a neighborhood. How does this affect African Americans?
There are a number of stressors that impact black Americans on a daily basis, one of the most deleterious being that of racism. Racism, both for black adults and youth, impacts virtually every element of mental and physical health. Various acts of racial discrimination, whether separate or part of a larger systemic pattern, have been linked to feelings of being unsafe within their own or other communities. The idea that I may not be here tomorrow is a pervasive fear for Black residents, whether it be at the hands of police officers, the COVID-19 outbreak, shorter life expectancies, or environmental racial and social impacts (e.g., lead poisoning, air pollution).
The intentional stalking and murder of Ahmaud Arbery is nothing new—yet it reified the notion that safety is not guaranteed for black people in the home or community. In conjunction with the news of Breonna Taylor in the same week, black people have been hit on all sides with the threat of loss of life. It is exhausting. Depleting. Depressing. And absolutely an additional stressor.
What situations or events are black Americans facing related to COVID-19 that may impact their mental health?
Without a doubt, medical racism—or the dismissal, denial and degradation of black people seeking health care—exacerbates transmission, treatment and mortality rates, and directly and negatively impacts their physical health. This racism continues to chip away at the psychological wellness and wherewithal of black people, just as other forms of racism do. The cumulative effect of one’s personal health, worries about one’s and others’ health, and the greater proportion of loss and grief within the community certainly exaggerate the distress experienced by black folks.
And, with disparities and heightened outbreaks focused on black residents of major cities (e.g., Detroit, Chicago, New Orleans, New York), the fear, guilt and hopelessness associated with those identities are surely exacerbated. All of these factors are related to heightened depression and anxiety, an especially troubling finding for black youth who have been experiencing heightened suicidality in the past several years.
In some cases, people may have a dual role as a worker and caregiver for a family member. What impact does this additional stressor cause?
There are two primary stressors caused by this responsibility: 1) The sheer physical safety of these individuals and their loved ones is compromised with every coming and going. Given that there have not been enough funds allocated to ensure that low-income residents do not need to leave their houses to work, we are essentially sacrificing a certain class of people to meet the needs of others, and those people are likely to have multiple generations within a home or within their realm of responsibility.
2) Workers with multiple roles do not get an opportunity to focus on their own wellness, and may be less effective at both their jobs and care as a result. Without adequate time or resources to express their frustration or challenges, they may need to internalize such emotion, actually availing themselves to more compromised immune systems and again, becoming at-risk for contracting and/or transmitting disease to their loved ones or colleagues/clients.
How is COVID-19 affecting children from a mental health perspective?
Black children are among the most brilliant, beautiful and bright people among us, yet this global pandemic may bring about exacerbated challenges for them. Black youth often have large networks of providers, from teachers to mentors to family members. Their deprivation of in-person contact may reduce the amount of support they are receiving from their extended network. Given that the utilization of, access to and provision of quality mental health care services is lower in black communities, this extended network is critical for black children’s emotional wellness. Additionally, the repeated and blame-worthy stories of urban black citizens engaging in risk-laden health behaviors places undue stress and burden on youth who are seeking to understand facts about the disease.
Families who are already talking to their children about other race-related issues now have to understand how to couch the disparate outcomes of this virus into stressful race-related conversations, adding yet another layer of stress to what children must consider in their everyday lives. Finally, limited resources (internet accessibility, devices, physical space) may preclude black youth from staying as connected to their responsibilities (school), physical routines and loved ones as for others, bringing more strain and distress along an already challenging journey.
Are there any stigmas related to mental health that may provide a challenge to getting people access to resources or help?
Certainly. Black community members not only have less access and quality care for mental health provision, but, given reasonable distrust of health providers from medical abuse, may utilize services less. Culturally, black people may also feel like they must both maintain strength and should not “air their dirty laundry” for others to see, so may feel more protective over engaging in discussion with a therapist. Finally, while ethnic/racial matching does not have a great impact over the outcome of therapeutic care, black clients report more satisfaction with ethnically similar therapists. Given the dearth of clinicians of color, in addition to the aforementioned challenges, black therapy use is not as robust nor plentiful as it is in other communities.
What resources are available to help relieve the stressors that may impact mental health in the black community?
Telehealth, or the utilization of health services from either the phone or computer, has skyrocketed since quarantine. If you have insurance, please call to access the often free or low-cost services being offered now. In addition, several organizations and groups are providing free services—Google is your best bet at this time to find them, but NAMI also has some resources for finding a practitioner. Spirituality and religiosity have been long-standing traditions and practices within our community, so relying on the council of those within your faith community can still be a great outlet for your healing. Finally, various organizations on social media outlets, including Our Mental Health Minute, Eustress, Therapy For Black Girls, Black Mental Wellness, Black Emotional and Mental Health and Talk Naija have tips, events and resources at the ready, so be sure to follow them for more information as well.