By Edward Henderson
Psychological disorders can create a battlefield in an individual’s mind. Uncontrollable emotions ebb and flow like violent waves crashing on coral infested beaches. One moment, feelings of euphoria and determination can empower people who live with mental disorders with a confidence they’ve never had. The next, dark depressions can isolate them from friends, family members and the activities they love.
For many African Americans in San Diego, the worst part of this battlefield is trying to find allies and professional help within mental health field. In some cases, these disparities are created institutionally. In others, they’re self-inflicted by cultural norms that discourage them from seeking care. Community organizations and county officials are working together to help minorities navigate the winding road towards treatment and recovery.
Understanding the roots of stigma
Stigma towards seeking mental health treatment has cast a looming shadow over the African American community. While therapy can be a beacon of light out of that darkness, there aren’t many African American mental health providers to aid in understanding the sensitive roots of stigma.
Dr. Rochelle T Bastien is one of the few African American psychologists who practices in San Diego. Bastien has practiced marriage and family therapy for 20 years.
“The reason there’s a stigma towards mental health is what African Americans have to deal with … the history of slavery and rumors of inferiority that resulted from it,” Bastien said. “I believe that all of us walk around with a tendency toward humiliation.”
Adding on to the stigma that exists culturally, Bastien believes the lack of African American therapists in San Diego presents another hurdle for those seeking care.
“You can count the number of African Americans who’ve made a living in clinical psychology in San Diego County on one hand,” Bastien said. “If you’re going into therapy and anticipate that the therapist is going to be white is a extra level of caution we generally feel along with trying to understand what’s wrong with me mentally.”
The disparity in minority counseling extends to the school system as well. Kenneth Palmer, a teacher at Monte Vista High School for 14 years, has seen many African American students fall behind due to lack of support at home and the failure of the school’s counseling system to intervene.
“In our school system, these counselors are not culturally equipped to go into the homes of minority children and connect with their families,” Palmer said. “Because they’re not used to dealing with cultural issues, they’re quick to label someone as ADD or some other trauma when the student is just different.”
Identifying the Disparities
Alfredo Aguierre, the San Diego county’s Behavioral Health director, notes while African Americans are disproportionately over-served in terms of individuals that have contact with the county’s mental health system, the quality of care they receive is insufficient.
“You have higher numbers of African Americans that will only receive their health services in a jail setting,” Aguierre said. “The problem is they’re not getting the appropriate level of care in the community or when they leave (jail).”
The 2010 US Census reported African Americans made up 4.6 percent of the county of San Diego’s total population. Of that population, 20 percent received treatment from San Diego County’s Mental Health System, according to the county’s 2010-2011 fiscal year report.
While these numbers look promising, a large majority of African Americans receiving treatment from the county are either incarcerated or in juvenile hall.
“That presents a number of challenges,” Aguierre said. “How do you improve access to care in the community so that individuals can get the necessary services they need to improve their quality of life in the community without having to go to jail or juvenile hall?”
Finding a solution in San Diego County
To address the lack of African American mental health professionals, the county has commissioned independent contractors dedicated to raising awareness about mental health in minority communities.
Harmonious Solutions, a local non-profit in southeast San Diego has been an important ally of the county in the fight to eliminate stigma. The organization provides trainings and certifications for mental health interns and aspiring professionals.
While the solution to mental health disparities in the African American community will take time to manifest, Aguierre believes there is a silver lining for individuals dealing with mental health issues and looking for help.
“Having a mental illness doesn’t mean a lack of character but this is something that is a condition,” Aguierre said. “It is treatable and can achieve recovery. Meaning they can achieve their goals, recapture their dreams.”