by Ryan Flynn
Mental health is universal to all, but mental health treatment is not. American marganalized groups are just as likely, if not more so, to experience depression or anxiety as their privileged peers -- but when they formally receive a mental health diagnosis, it’s not always as easy as just “getting help.” For example, the Health and Human Services’ Office of Minority Health reported that
certain groups are 20% more likely to endure mental health challenges, but only a fraction the them pursue treatment due to an history of abuse, misdiagnosis, and cultural insensitivity prevalent in the mental health field.
In response, during the summer of 2008, the US House of Representatives established the National Minority Mental Health Awareness Month. Non-profits across the country encourage underrepresented communities, whether by race, gender identity, and/or sexual orientation, to express their feelings and experiences with mental illness through art of all kinds. People write essays and poems, create paintings and pictures – and then their art gets spread around online to open a forum on what it’s like to live with a mental illness as a POC and/or LGBTQIA+ individual. Facilitating a discussion of minority mental health through art provides the public with a comfortable and socially acceptable means of discussing an uncomfortable and stigmatized topic. While the mission has had its detractors, I’ve witnessed firsthand, professionally speaking, the need for the representation of marginalized groups when speaking about mental health.
When I started working in mental health, I wanted to save the world. I wanted my clients to feel seen, to feel heard, to feel like their pain mattered. I took for granted that everyone else in my line of work felt the same way. I had that notion shattered quickly when I first started working with a client named “Rachel,” who was a transgender woman in her thirties. Initially I found myself excited at the prospect of supporting another member of the queer community, and incorporating Rachel into a treatment team where people would recognize and respect her identity. We found ourselves discussing and dissecting the transphobia she had faced in her lifetime, and how it impacted her own self-esteem and mental health.
Her body was mocked and prodded, her history of sexual trauma was questioned, and her clear demand of preferred name and pronouns were ignored and angrily rejected. Each story I envisioned the culprits being bigoted strangers or ignorant coworkers, but one day she clarified: much of her abuse had been at the hands of her own mental health clinicians. Social workers, therapists, psychiatrists – all of them educated, experienced healthcare professionals, who were brought in to heal Rachel’s pain, only to add more fuel to the fire. She found herself in a men’s prison, where between the other inmates and her own clinicians, Rachel didn’t have a single transgender woman to relate to about the transphobic trauma she experienced – and she didn’t have an ally to respect the nuances of her situation.
Rachel needed a voice, a support system for what she was going through. An initiative like Minority Mental Health Month allows for that dialogue and support system to manifest. It gives someone like Rachel the opportunity to say ‘I’m depressed, here’s what that looks like, and here’s how that’s colored differently by me being a transgender woman’. I’m now working for a hospital’s psychiatry and behavioral health department, where all mental health clinicians are required to complete a certain amount of LGBTQ+ sensitivity trainings per year. Their own professional performances are evaluated by their level of cultural sensitivity and knowledge. This is the direct effect that an initiative like Minority Mental Health Month can have on the field of mental health, and I hope that it continues to have a ripple effect for years to come. Despite marginal progress, I still occasionally witness resistance or dismissal from clinicians on the importance of participating in cultural sensitivity training, and I would like for an initiative like Minority Mental Health Month to re-enforce the urgency and relevance of respecting minority patients’ nuances and differences.
Beyond those working in the mental health field, the general public should also understand the importance of engaging in dialogue -- whether it be through art or any type of forum. When people speak out – through poems, through essays, through artwork – it makes a difference. Their voices are heard, and the mental health field is forced to evolve.
Ryan Flynn is a Philadelphia based Psychiatry Program Coordinator and Mental Health advocate.