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Virus, racism pose more mental health risks for black Americans

The twin challenges pose a problem as mental health providers are in shortage

Kendrick Sampson attended a peaceful protest in Pan Pacific Park in Los Angeles two weeks ago, which left him scarred in more ways than one.

During that protest against police brutality, he was shot by officers seven times with rubber bullets and beaten with batons, leaving him with lingering mental and physical wounds.

“We have never prioritized mental health in this country,” said Sampson, an actor and activist, speaking Monday at a Los Angeles City Council meeting where he and other Black Lives Matter Los Angeles representatives advocated for changes to the city’s budget. “Black and indigenous and brown folk in this country need healing, deserve healing, but instead are met by more trauma by these systems.”

[Virus forebodes a mental health crisis]

The impact of police brutality on mental health comes as the nation struggles with the COVID-19 pandemic, which has struck a greater proportion of African Americans than white people. Many experts worry that the mental health toll stemming from the dual crises will disproportionately affect African Americans.

Some providers have already reported upticks in anxiety related to the economic, health and social consequences of COVID-19, and advocates warn that substance use and other behavioral disorders could increase. 

“We’re running two pandemics, of course, in parallel: COVID-19 and police brutality. They are having a tremendous toll on America, period, but definitely on black and brown communities to the degree that we’re going to see several levels of emotional stress,” said Patricia A. Newton, CEO and medical director of Black Psychiatrists of America.

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Psychiatrist Sarah Vinson, who works with children, teens and adults, said coping with COVID-19 was already difficult, and that is being compounded by signs of racism and health disparities.

“There is a structural trauma component of that, even if you are physically safe from a health perspective, [from] watching black people die and people not seeming to care,” she said. “It’s traumatic to see someone who looks like you being murdered by someone with a state-sanctioned uniform who is in a position of authority.”

Growing needs

Some experts have already seen changes in the needs of African Americans and an overall lack of providers.

A mental health provider shortage has been documented nationwide. Health Resources and Services Administration data released in March found that only about 27 percent of geographic areas have enough mental health practitioners.

GiShawn Mance, a Howard University assistant professor of psychology who also works in private practice, has seen an overall increase in patients seeking her services.

“From a mental health perspective, there are definitely implications for the short term and the long term, specifically now for black people who are taking in all that is happening at this moment,” she said. “Seeing the videos of police brutality and the peaceful protesting along with the rioting and along with the looting — and I think it is important to separate those three — I definitely see there’s just varying responses when it comes to mental health.”

Mance, who emphasized she works with patients of all backgrounds, said she has primarily seen an increase at this time from potential clients who are black. Many African American patients have expressed frustration about racist events happening over and over again. 

“Racial trauma is essentially what I’m hearing and seeing people seeking services or support around,” she said, adding that many individuals want “to have a safe space to process all of those emotions in the midst of a pandemic that has all these different layers.”

Vinson told CQ Roll Call it is also important to distinguish responses to trauma from mental illnesses.

“The emotions I’m observing most are fear and sadness. These are not mental illnesses. They are responses to a traumatic situation,” she said. “There is a difference between anxiety and fear. With anxiety, there is excessive worry and an overestimation or misperception of threat. Fear is based on living in a world where you actually are not safe.”

Newton also worries that the added stress could affect COVID-19 infection rates.

“We also know that in terms of healing and recovery, immune competency is critical. If you are anxious and depressed, that lowers your immunity,” she said. “We have a tremendous problem on our hands in the U.S. from a social standpoint as well as from a health care standpoint. It makes it extremely complicated in terms of how we address it from a public health perspective. The mental health piece is part of that whole public health perspective.”

Longer-term effects

Providers worry that more symptoms may manifest in the coming months.

Newton said in three to six months or even a year from now, more people will be compensating for the added stressors from the current period.

“I suspect, when this second wave comes in the fall, that we’re going to see an exacerbation of symptoms that may have been consciously suppressed and then became repressed but now they’re going to be triggered,” she said, adding the pattern could continue for up to two years.  

She also worries about an uptick in drug and alcohol use.

“People will begin to attempt to self-medicate. We are going to see an increase in substance use disorders and alcoholism and that kind of thing because people will do that as a coping mechanism because it’s easy and more socially acceptable to admit than ‘I’m having a meltdown here,’” said Newton.

Mance of Howard University has similar concerns. 

“For some people, you are seeing the impact on mental health immediately in the short term. But for some people, they’re in survival mode. When you’re in survival mode, you’re not necessarily processing, essentially in the moment, how you’re feeling and the impact that it has,” she said.

She also predicts that the effects may show up anywhere from six months to as long as three years from now through flashbacks, nightmares or post-traumatic stress disorder.

Medical groups also emphasize the need to examine this issue.

“This is a trying time for the entire country and especially in the black community,” Malika Fair, senior director of health equity partnerships and programs at the American Association of Medical Colleges (AAMC), said during a June 12 call with reporters. “It gives us an opportunity not only to address racism as a country and address racism within our institutions but also to provide the support we need for all communities and the black community to address the issues … particularly the mental health issue.”

Impact on youth

There’s also an additional worry about the effects of racism on the mental well-being of youth, especially when social media outlets provide easy access to photos and videos of the effects of racism.

“Nobody is debriefing with our young people,” said Samirah Franklin, a youth advocate in Baltimore, during a panel discussion about black mental health last week. “Within minutes and within hours, these videos go viral. Young black children all around the world are witnessing people like them being murdered.”

AAMC experts also worry about the effects on young health care workers, who may be at risk of burning out or facing a traumatic stress disorder.

“We also have to remember that even our future workforce is now starting to feel this fallout that is coming not only from the COVID pandemic but also from the racism and racial injustice they are seeing around them as well,” said David Acosta, AAMC’s chief diversity and inclusion officer.

Newton emphasized that the increased demand for mental health services also may not be able to be met.

“I don’t know that the health care system is prepared to address the mental health increases any more than they were prepared to address the infectious outbreak,” she said.

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