Part Two: "It hurts my soul to really have to explain to somebody that I deserve to live."
How the stress and trauma of racism and racially motivated violence against Black bodies and minds contribute to and exacerbate vulnerability to epidemics and chronic health issues in Black communities.
Gabriella Chiarenza is managing editor for Invested and Regional & Community Outreach and Steve Osemwenkhae is senior photography and video specialist for Invested and Corporate Communications, both at the Federal Reserve Bank of Boston.
On May 25th, as the pandemic spread across the U.S. and millions of Americans remained locked down at home, a white Minneapolis police officer killed George Floyd, a Black man, by kneeling on his neck for over eight minutes. The next day, the protests began. After more than two months of staying at home and avoiding contact with other people due to COVID-19, some found it jarring to see so many people suddenly out in the street, marching together and calling for justice. People began to ask, why protest now? It is a horrific reality in the United States that hundreds of Black people have lost their lives to armed police officers just over the past few years.1 This horror is not new. But was it worth it for people to risk their lives exposing themselves to other people in a pandemic, particularly one that was hitting Black Americans hardest? For tens of thousands of Black Americans, their non-Black allies, and many public health experts,2 the answer was yes—one risk to Black lives seemed just as menacing, if not more so, as the other.
“I see both police brutality and the disproportionate number of infections and deaths related to COVID-19 among people of color as different threads of systemic racism,” Dr. Cassandra Pierre of Boston Medical Center told me. She said she was not at all surprised to see Black Americans protesting, even with the COVID-19 risk. “We know that the same systems that have led to marginalization—redlining, lack of housing access, lack of health care, lack of education—so many of these things are at the root of the disproportionate brutality against Black bodies and the ravaging of Black bodies by infection.”
Dr. Charmain Jackman, a Boston-based psychologist, also felt the one-two punch COVID-19’s destructive path through Black communities followed by the news of yet another Black American killed by police. Jackman told me that the constant replaying and reposting of bystander video of George Floyd’s death was causing for many Black Americans what psychologists refer to as vicarious trauma. People viewing the recording end up visualizing themselves or their loved ones in the same experience, leading to tremendous anxiety, disturbance of sleep, mood swings, and a sense of hopelessness. “It’s something that once you see it, you can’t unsee it,” Jackman said. “To spend over eight minutes watching someone’s life be stripped from them is absolutely traumatic, and people can have their own trauma reaction to that.”
For sisters Rochelle Levy-Christopher and Ahjah Gage, the moment led to some soul searching about how to best serve their Black community. Earlier this year in Boston, Levy-Christopher and Gage were in the process of building and launching their nonprofit organization, the Black Literacy and Arts Collaborative (BLAC) Project, which creates and supports programs that combine arts, entrepreneurship, and mental health and wellbeing for underserved BIPOC communities. But as 2020 brought one painful hit after another against the very communities they hoped to empower, Levy-Christopher and Gage felt they had to pivot more toward the mental health and justice sides of their work to reflect the anxiety, rage, and exhaustion they were hearing all around them and experiencing themselves.
“Having our trauma played out over and over again on media outlets, on social media, having to relive things over and over again, having that fear instilled in you over and over again every day, every time you pick up your phone—I want to say that it’s almost to make us feel hopeless,” Levy-Christopher said. “If you stand up for what’s right, you’re going to get killed. If you stand up for what’s right, you’re going to have your home taken away from you. If you stand up for what’s right, you’re going to get fired from your job. So, it makes people fearful and hopeless.” The community needed more outlets for their grief. Levy-Christopher and Gage, along with their colleague Khori Anderson, built out virtual spaces where Black creators and speakers could share their work, express their emotions and their solidarity, and help educate the broader online community around racial trauma and how to be a better ally.
“Initially, when we started the BLAC Project, it was not an intersection of arts and activism, because that wasn’t what was needed,” Levy-Christopher said. “And then 2020 happened, and it was needed. So, we are trying to think about, how do you ignite your activism through your art? How do you showcase your feelings, your anger, your Black joy? We try to give you a safe space to feel your feelings, all of your feelings, whatever they may be.”
Gage, who is currently completing her training to become a licensed mental health counselor, realized that this would be an ideal time to push for greater acceptance of and discussion around mental health in Black communities using BLAC Project’s virtual platforms, especially as so much trauma was circling. “My family is from the Caribbean so there’s already a whole stigma surrounding mental health,” Gage told me. “We don’t go to doctors. We don’t tell strangers our business. But we desperately need to be well in our spirit and in our mental health. I felt like BLAC Project would be a perfect way to get those services into underprivileged communities, and to see Black people in those professions, and to build a certain level of trust and help to destigmatize the whole issue of mental health in Black communities.”
Jackman agrees. She has been in practice as a psychologist for almost 20 years, and recently launched a parallel business, InnoPsych, to address racial inequities in mental health care. In her own market research, she told me, she found that “90 percent of people of color will stop after the first session if there is a cultural or racial mismatch between the client and the therapist. Often, people will say, ‘I don’t want to go in and have to explain my culture.’” Jackman and her colleagues have launched a national online directory of therapists of color, and have led workshops and discussions within the Black therapist community and with businesses and institutions around cultural competency and racial trauma. She told me that she had long observed, and had experienced herself, how difficult it can be for Black people to find Black therapists. With so few therapists of color (who may or may not be geographically or financially accessible to those who need them); cultural stigmas around mental health within the Black community; and the combined strain of COVID-19, racially motivated violence, and economic woes, Jackman sees Black mental health as a detrimentally ignored issue. She said that she and her colleagues believe “the next pandemic is going to be the mental health pandemic.”
This crisis around Black mental health has been brewing for a long time, and is heavily fed by systemic racism in medicine, law enforcement, and education. Jackman has worked in schools and in the juvenile court system over the course of her career, and saw evidence of how these biases impact children early on. “Black and brown girls and boys are trapped in certain ways,” she said. “Their behaviors are labeled as more aggressive, more defiant, compared to their white counterparts, where there are more allowances, there’s more forgiveness for behaviors. When I was starting out, I would see lots of Black and brown boys being diagnosed with oppositional defiance disorder, but white kids would get diagnosed with ADHD.”3 She has seen similar dynamics throughout systems as young Black people grow older: Black youth more likely to come through the juvenile court system and be punished more harshly, while white youth were treated with more lenience;4 Black people struggling with substance abuse more likely to end up in the prison system for addiction than white people, who were often tracked into rehabilitation programs.5 “You just have to open your eyes and it’s very clear how these systems are disproportionately impacting communities of color,” Jackman told me.
Rev. Dr. Gloria White-Hammond of Bethel A.M.E. Church also pointed out how early in their lives Black children are exposed to the biases deeply embedded in our culture, and how quietly detrimental they can be to Black people’s mental health over time. She referenced Drs. Kenneth and Mamie Clark’s infamous “doll test,”6 conducted with children as young as three: “When we’ve done the doll studies, asking Black kids what their preferences are in terms of Black and white, which is the prettiest doll, that even from a young age, not just Black kids but even white kids will pick out the stereotypical white doll as the prettiest doll. Kids pick that up very early on—what we see, what we hear. So, these things are so prevalent that they’re invisible.”
Michael Curry of the Massachusetts League of Community Health Centers told me that recent numbers show an increase in suicide rates among Black youth as well,7 and that mental health in the Black community is increasingly a topic of discussion and concern for the NAACP. He said, “there’s a phrase we have in the Black community that you may have heard about before: ‘Black don’t crack.’ Figuratively it means that we survived slavery, segregation, Jim Crow, institutional racism, and we’re still here standing, picking up the pieces after all this time. And the reality is, I tell people: Black don’t crack, but the cracking’s on the inside.”
These multiplying mental stress fractures can lead to physical damage over time. “If you hold onto your burdens and you don’t have a place to release those, they can compound as chronic stress,” Jackman said. “It’s like your body running on adrenaline all the time. Our bodies weren’t meant to do that. It has a long-term impact on our sleep and our eating patterns, but also on our cardiac systems.”8
For Levy-Christopher and Gage, the strain of coping with threats to their community while also trying to help educate the public is starting to take a toll, as it is for many leaders in the cause. “It’s not my job as a Black person to teach white people, or Black people, about their history, about themselves, about systemic racism, about white privilege,” Levy-Christopher said. “However, as an educator and as the founder of the BLAC Project, it is my job. So, trying to find the balance has been very difficult for me.” It is painful for them, they told me, that “Black Lives Matter” is seen as a politicized slogan, rather than a straightforward plea for others to recognize the very worth of their existence as Black people. “Just the fact that we’re declaring that my life matters, that that’s where the negotiations start? It’s crazy,” Gage told me, shaking her head. “It’s mindboggling to me. And we die every day, just declaring that ‘I mean something.’ It hurts my soul to really have to explain to somebody that I deserve to live.”
- Joseph Wertz, “A Typology of Civilians Shot and Killed by US Police,” Journal of Urban Health 97, March 24, 2020, https://link.springer.com/article/10.1007/s11524-020-00430-0. Ian Thomsen, “The Research Is Clear: White People Are Not More Likely Than Black People to Be Killed by Police,” News@Northeastern, July 16, 2020, https://news.northeastern.edu/2020/07/16/the-research-is-clear-white-people-are-not-more-likely-than-black-people-to-be-killed-by-police/.
- Brian Resnick, “What public health experts want critics to know about why they support the protests,” Vox, June 26, 2020, https://www.vox.com/science-and-health/2020/6/6/21279592/protest-pandemic-covid-19-risk-second-wave-systemic-racism.
- Matthew C. Fadus, Kenneth R. Ginsburg, Kunmi Sobowale, Colleen A. Halliday-Boykins, Brittany E. Bryant, Kevin M. Gray, and Lindsay M. Squeglia, “Unconscious Bias and the Diagnosis of Disruptive Behavior Disorders and ADHD in African American and Hispanic Youth,” Academic Psychiatry 44, 95-102, November 11, 2019, https://link.springer.com/article/10.1007/s40596-019-01127-6.
- Joshua Rovner, “Racial Disparities in Youth Commitments and Arrests,” The Sentencing Project, April 1, 2016, https://www.sentencingproject.org/publications/racial-disparities-in-youth-commitments-and-arrests/.
- Equal Justice Initiative, “Racial Double Standard in Drug Laws Persists Today,” EJI, December 9, 2019, https://eji.org/news/racial-double-standard-in-drug-laws-persists-today/.
- Leila McNeill, “How a Psychologist’s Work on Race Identity Helped Overturn School Segregation in 1950s America,” Smithsonian Magazine, October 26, 2017, https://www.smithsonianmag.com/science-nature/psychologist-work-racial-identity-helped-overturn-school-segregation-180966934/.
- Congressional Black Caucus, “Ring the Alarm: The Crisis of Black Youth Suicide in America,” December 2019, https://watsoncoleman.house.gov/uploadedfiles/full_taskforce_report.pdf.
- LaPrincess C. Brewer and Lisa A. Cooper, “Race, Discrimination, and Cardiovascular Disease,” AMA Journal of Ethics, June 2014, https://journalofethics.ama-assn.org/article/race-discrimination-and-cardiovascular-disease/2014-06.
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