Brought to you by the Depression Is Real Coalition, The Down &
Up Show is dedicated to the reality of depression. Each week our
hosts will talk with some of the world's top experts on depression,
as well as people who have been impacted by this illness. The reality
of depression is that it is a debilitating and potentially deadly
medical condition that affects more than 15 million Americans every
year. The other reality of depression is that there is hope.
Down & Up Show #47: Depression in Underserved Populations
TERRIE WILLIAMS:
Welcome to the Down and Up Show on Depression is Real.org. I'm your
host, Teri Williams. Today we're discussing depression among African
American men with Dr. Keisha Braithwaite (ph.), the Associate Director
for Community Voices, Healthcare for the Underserved, and an Assistant
Professor of Clinical Psychiatry at Morehouse School of Medicine.
She earned her Doctorate Degree from Howard University in Counseling
Psychology and completed a National Institute of Mental Health Funded
Post-Doctoral Research Fellowship at Johns Hopkins University in
the School of Medicine and Public Health. She is a bad, bad sister,
young and striking and making a difference.
Dr. Keisha is committed to promoting the health and wellbeing of
culturally diverse families and the development of strategies to
inform mental health parody. Today we'll be discussing the obstacles
preventing certain people, in particular African America men, from
receiving proper treatment for depression.
Welcome Dr. Keisha. We are very happy to have you here today to
discuss such an important issue.
DR. KISHA BRAITHWAITE:
Thank you very much, Teri. I'm pleased to be of assistance and provide
as much information as I can.
TERRIE WILLIAMS:
Yes, and you are a wealth of information. I'm gonna ask you if you
could just be sure to speak up a little louder for us.
DR. KISHA BRAITHWAITE:
Okay. Sure.
TERRIE WILLIAMS:
I'd like to begin by asking you to tell me a little bit about your
work at Community Voices, specifically with African American men
but, you know, in general.
DR. KISHA BRAITHWAITE:
Okay. Well Community Voices, Healthcare for the Underserved, as
you mentioned, is based at Morehouse School of Medicine within the
National Center for Primary Care. And what we are dedicated to is
trying to address a number of issues around access to care, mental
health and health disparities.
And we have eight different learning laboratories, is what we call
them, but there are community base sites across the country, one
in Miami, one in Oakland, Northern Manhattan, Denver, New Mexico,
Baltimore, Ingham in North Carolina, (Inaud.) North Carolina.
And in each of those programs what we're hoping to do is to develop
strategies and programs that are community-based that we're able
to really address ways to assist individuals with access to care,
culturally sensitive care, promoting the integration of primary
care and mental health services in order to address racial and ethnic
health disparities, as well as increase the awareness.
And, really, all of this is to assist with the development of policy
(inaud.). And so that's kind of a broad overview of some of the
work that we do, but my dedicated interest is central to mental
health and substance abuse, particularly for African Americans and
men of color (inaud.).
TERRIE WILLIAMS:
Uh huh. Can you talk a little bit about some of the sources of stress
that you believe contribute to the pain and depression in African
Americans and the men in particular? You know, men, women and youth.
DR. KISHA BRAITHWAITE:
Okay. Well, I think that African Americans in general have a lot
of different sources of stress to deal with. When we look at the
society in which we are living, for many of us dealing with social
political issues and not necessarily feeling comfortable in the
structural setting that we have to deal with contributes largely
to how we feel about ourselves.
And so that impact of the-of the larger societal issues, whether
it be poverty, whether it be financial concerns, whether it be stress
from job and employment or lack thereof, certainly contributes to
our views of how we are in a-in society, how-what our standing may
be.
Additionally, this-some of the other issues may be around individual
perceptions of identity, how we are feeling about ourselves as women
and men and youth. And I think youth in particular have to deal
with unrealistic expectations in trying to live up to an ideal.
For example, some young women, they have (inaud.) perceptions of
what body image should be, what they should fit into in terms of
an ideal or a mold. And for some of our black youth, boys in particular,
they may have to try to fit into what the perceptions of what it
means to be a man, being tough, being cool.
And sometimes those distorted perceptions can affect how we feel
about ourselves and increase the levels of stress which then leads
to increased levels of anxiety and in some ways depression. And
I also know that for black women trying to deal with multiple roles
and balancing the roles of being a mom, being a-a-a worker, if they're
a-an employee, just trying to balance all of these serious roles
can contribute to increased levels of stress.
And additionally for black men I think there's this issue around
internalization of emotions and not feeling comfortable being able
to express maybe thoughts and feelings that they may be dealing
with. And so the internalization of anger, frustration, pain, disillusionment,
misunderstanding that may come from external forces of (inaud.)
society, not necessarily feeling supported, fear of failure in the
hopes of other emotions, that internalization can then cause a great
deal of pain that leads to some of the signs and symptoms of depression.
TERRIE WILLIAMS:
I wonder-I know that you're doing really incredible work at Community
Voices in terms of trying to reverse this stigma around depression
with black men. Can you talk a little bit... I know you spoke about
it at the outset but are there more specifics that perhaps you can
share, the conferences that you're hosting and just the hands-on
work that I know that you're doing.
DR. KISHA BRAITHWAITE:
Well, stigma is a big issue and I think it's not only stigma as
it relates to other people's perceptions of people who may suffer
from depression or mood-other mood and anxiety disorders, but there
is also this (inaud.) stigma and that-again, the internalization
of feeling almost embarrassed or uncomfortable that you do have
some problems around depression or if you think that you do and
not necessarily knowing how to cope or express those feelings or
thoughts or experiences that you may=that that person may be going
through.
And I just wanted to acknowledge that there are many very smart,
successful people who are walking around who are depressed and who
are living in pain and-and-and suffering in silence and may not
know exactly what to do or how to cope with it. Just to say that
there is no typical face of depression, again leading to the whole
issue of stigma, that it's not just those who you think may be depressed.
It's a-it's a whole host of other individuals who are probably not
even able to acknowledge some of their pain or some of (inaud.)
may be dealing with and stigma is certainly a part of that. So in
trying to reduce stigma there are several things that could be done
but, again, we have to look at how ethnic minorities may feel about
their place in society because there's this general issue of a mistrust
of the system, the medical system, and then even more so the mental
health system and not necessarily feeling it.
So there are clinical environments that they can go into for treatment
that are respectful of them or compatible with their cultures. Particularly
when we know that within the African American community is just
so diverse and there's so many subcultures, then-in linguistic issues
as well, that, you know, it may not-our system is not even set up
to really address some of the concerns that we have.
So, again, the feelings of inequity that may exist and the institutional
instructional racism and exposure to racism that many have experienced
certainly influences perceptions of stigma from the community, from
society, but even also from an internal perspective.
And so what we're trying to do is look at ways in which we can address
stigma, which can include trying to, one, encourage more black,
African American, Caribbean Americans or Caribbeans in general to
go into the fieldÑmental health field so that we can have a larger
cadre of therapists, mental health professionals who are able to
provide services or provide treatment to people who are seeking
mental health care who may be of similar cultures.
That could help to increase people to feel a little more comfortable
with the services that they may receive.
TERRIE WILLIAMS:
Yes. We had Depression is Real.org really, really making a concerted
effort to reach as many different communities as possible because
it obviously affects different groups in different ways, although,
you know, it is a universal issue. We're gonna have to be wrapping
up shortly although I've really enjoyed our time together. All right,
are there any last minute thoughts that you would like to share?
DR. KISHA BRAITHWAITE:
Well, just that Community Voices, we're doing a number of programs
and conferences, meetings. We are very much interested in trying
to promote the issues that are specific to black men, poor men,
underserved men, men who are uninsured, those who are overlooked.
That there's a-many programs that are set up for women and children
which I'm very much in support of, but a lot of times men who are
poor, and black men in particular, are less out of that loop.
TERRIE WILLIAMS:
Okay. So I duly noted... I just thought about it. But in any case,
Dr. Keisha Braithwaite, thank you so very much for taking time out
of your schedule to talk with us today. It was really, really wonderful
having you and I know that our listeners will be inspired by your
message. Until next time, I'm Teri Williams. Please make sure to
join us next week for another episode of the Down and Up Show on
Depression is Real.org. Stay strong.
