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African Americans and
Caribbean blacks experience mental health episodes with
greater severity and persistence than whites or others. Yet
we are losing the battle to stress, anxiety, depression and
other mental health issues while hiding behind cultural
masks such as “not airing our dirty laundry” or refusing to
“put our stuff in the streets.”
The truth is, that major
depression and mental illness, according to former Surgeon
General David Satcher, MD, Ph.D., “are not an attitude
problem nor a character weakness or spiritual weakness.”
Although they may reflect in the attitude or character,
mental illness is related to chemical changes in the brain
and is not something “that you can just snap out of it.”
What we should also
understand is that mental illness is an issue in which
touches all of our families or someone we know. Last year
the Lucas County Mental Health and Recovery Services Board (MHRSB)
served 32,000 people in 2017 in order to save lives, lead
individuals to recovery, and help clients and their families
overcome the shame of pain by sharing the emotional burden
of mental health disease. Thirty three percent of those
served were African Americans and another six percent were
Latino. Ten thousand of the 32,000 were youth.
The MHRSB, now in its 50th
year, is currently running Issue 11, a renewal levy to
continue promoting health and saving lives. I spoke with
MHRSB executive director Scott Sylak, to discuss the levy
and issues of mental health.
Perryman:
It’s good to speak to you today. Can you begin by telling us
about the Issue 11?
Sylak:
Well, Issue 11 is a 1-mill levy. It is not a new tax. It
will generate 7.1 million dollars for local operating
expenses. The $7.1 million is actually about 28 percent of
our entire operating budget. It is helpful to know that 93
cents of every dollar that the Mental Health Recovery
Services Board brings in is returned to the community
agencies to provide services that include mental health,
addiction and gambling prevention, treatment and support
services.
Perryman:
Who are some of the agencies that the MHRSB funds?
Sylak:
Many of the agencies that we fund are very familiar to the
people in our community, while they might not connect us
with them. These are organizations such as Unison, Harbor
and Zepf, New Concepts, Rescue, St. Paul’s Emergency
Shelter, and many others. The services that we provide, the
contracts that we let, actually fund about 400 units of
housing support for the mentally ill, another 200 units of
recovery housing, detox services in our community. We have
employment programs for individuals who have mental health
disorders. We also fund criminal justice services. We feel
that many with behavioral health disorders are better
treated in the community than locked up and that there are
many ways to hold people accountable for their behaviors.
Encouraging treatment over incarceration is certainly one of
those ways when it’s appropriate because we know that the
cycle of arrests and incarceration will not be broken unless
we can move people to recovery so that they can become
valued members of the community and contribute back to their
community so that they can maintain connections to their
community, their families, their friends, their children.
They learn to be better parents, learn to be better brothers
and sisters, family, sons and daughters. All that is part
of making communities viable and by the way safe.
Perryman:
What is mental health?
Sylak:
It’s a disease of the brain, it can be treated with
medication and therapy and many people who have a mental
health disorder can live very productive lives working their
plan of recovery.
The research will say that
people with mental illness die on average 25 years earlier
than people without mental illness. They don’t die,
necessarily, because of their mental illness; they die
because of their untreated physical health ailments as it
relates to their mental illness. So the more we can bring
people into recovery the more likely it is that they will
address those health issues, they’ll be around to support
their family, their parents, their communities, their loved
ones, their neighbors and become a fabric within their
communities.
Perryman:
Many people associate mental illness only with schizophrenia
or really severe psychiatric disorders. However, that’s not
totally accurate.
Sylak:
Mental illness takes many different forms and it doesn’t
manifest itself in one way consistently across all
populations. It can be a severe and persistent mental
illness that you defined as schizophrenia, bipolar disorder,
or major depression or it could manifest itself in minor
depression or other fears related to trauma that individuals
may not have treated appropriately and thus could
exponentially increase into some more severe disorders.
What we know is that the
brain responds to trauma differently in everybody and what
we also know is that if you experience trauma such as
domestic violence, for instance, or child abuse, and even
witnessing events that are tragic, that these experiences
can change the mental state of somebody and if not treated
correctly or at all then it can really develop into more
problematic behaviors.
Perryman:
So that can be anything from like the loss of a job, the
loss of a parent, child or a spouse…
Sylak:
Or removal of a loved one from the home due to
incarceration. Trauma takes many different forms, it just
doesn’t have to be about physical abuse or mental abuse,
trauma is experienced differently and many of our systems
are not trauma-informed in the way they are able to identify
trauma and treat trauma. The Mental Health Recovery Services
Board along with its community partners such as Children’s
Services Board, are working to improve the diagnosis and the
treatment of trauma, so that as we identify it we have
systems in place to address those issues.
Perryman:
While mental health can affect any particular race,
ethnicity, socioeconomic status, African Americans living in
America disproportionately face stress, anxiety and trauma
daily. This can be the result of merely being caught in the
pressure between being perceived either as too black or not
black enough. It can also be a result of the pressure from
what Harvard legal mind Charles Ogletree has said concerning
African American leaders, in particular, who “face
tremendous obstacles rising to the top and even greater
challenges staying there” and of blacks who “are always
expected to show strength, determination and confidence, but
the burden of depression will do everything it can to pull
us back down.”
Can you talk about the
disproportionate representation of black men in the mental
health system, the obstacles created by inequality and your
system’s ability to deal with this situation?
Sylak:
Absolutely A part of it concerns stigma and shame as it
relates to individuals seeking services. The history of the
way we treated individuals with behavioral health is
prevalent not only in our community, but across the nation.
We think of them as less than or bringing it upon themselves
instead of understanding that this is a disease that can be
treated. Culturally, there are many ethnic backgrounds that
have not experienced positive relations with behavioral
health systems or many systems in that respect and therefore
have been conditioned to not seek help because of the
previous experiences that have molded their behaviors.
We, as a system, have
taken it upon our responsibility to close that treatment gap
for people who may otherwise go without seeking treatment
services, reaching out and becoming more responsive to not
only the African American population, but the Latino
population and the Muslim population, the Arabic population
and the Middle Eastern population. We need to do a better
job as a system of engaging those populations in their terms
of our clinicians that are providing those services. We need
to reflect the people that we are trying to connect with.
Our marketing materials need to reflect those people as
well. Our color schemes, our posters, our lobby, and
waiting areas all need to be culturally responsive and
reflective. It all goes to if people can see themselves in
those materials and in the people that are providing quality
treatment services, then they are more likely to engage,
they are more likely to remain engaged and they are more
likely to encourage others to engage, and that also goes to
improving language access as well.
Perryman:
So what have you done as a system to really address the
issue that you just mentioned?
Sylak:
So as a system, we have been for the last 3 years organizing
our system to implement national standards for improving
engagement and retention of individuals who are otherwise
disenfranchised. The realm of those changes both internally
as a board and externally as a system of care include
reviewing and adapting our policies and operations to
reflect the desired outcome of engaging minority populations
more thoroughly. That includes ensuring that language
access, ensuring that we have individuals providing the
services that reflect the population that we are trying to
engage, it ensures bilingual access to counselors when
appropriate, and ensuring that we are intentional about our
engagement strategies and treatment strategies for that
population. We are also identifying strategies on how we
engage with peer systems like Children’s Services, like
juvenile court and adult court, like Developmental
Disabilities, that share our mission for achieving health
equity amongst minority populations and the disabled
populations.
(to be continued)
Contact Rev. Donald Perryman, D.Min, at
drdlperryman@centerofhopebaptist.org
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