By Dr. CHRISTOPHER J. MORGAN
I have two close relations with people living with a mental illness. Both are males, and in both cases the symptoms first appeared in young adulthood (18-23). One was dealing with depression, the other was diagnosed with bipolar disorder. The conditions are very different but the impact it has had on their lives is significant.
In one, the family had a rude awakening. The experience was very stressful, even traumatic, on siblings and the parents. Contributing to all of this was an apparent shortfall, a gap in adequate mental health services for young adults in our health care system. In the other, the illness led to a disruption in his university education, altering his career aspirations, affecting his recreational pursuits and ultimately having a life-changing impact on his future outlook in all areas of his life.
Unfortunately, too often our awareness of mental illness comes at the cost of someone we know becoming affected. As such we may find ourselves not knowing how to support and assist; in fact we may be at risk of making things worse rather than better. Over the recent years more attention has been given to mental health. Over the next several months the Black Health Alliance (BHA), with the support of its members and partners, will help shine a spotlight on mental health in the Black community.
First, on Monday, September 28 at the Barbara Frum Library at its Annual General Meeting, BHA will be honouring Akwatu Khenti, Director of Transformative Health, Centre for Addiction and Mental Health and Assistant Professor, Dalla Lana School of Public Health, University of Toronto with the Black Health Alliance Legacy Award for his excellent, long-standing efforts in the mental health field. In addition, that same evening we will launch a discussion on “Mental Wellbeing and African Canadians: Crisis, Resilience and Opportunities for Change”, being presented by Nene Kwasi Kafele, founder and CEO of the Akomo Learning Centre, former director for health equity at the Centre for Addiction and Mental Health and former senior policy analyst with the Ministry of Intergovernmental Affairs.
I recently had an opportunity to connect with Nene Kafele and asked him the following questions:
What is your definition of mental health or mental wellbeing?
Mental wellbeing for African Canadians in my view is the balanced and healthy outlook, attitude, behaviour and life practices that are consistently filled with joy, satisfaction, autonomy, a sense of purpose, a positive orientation, confidence, resilience, self-worth and a strongly affirmed racial, cultural and social identity.
The theme for your presentation at the BHA AGM on the 28th is “Mental Wellbeing and African Canadians: Crisis, Resilience and Opportunities for Change”. Can you briefly describe the crisis component?
We are gripped by an unfolding mental health crisis, a deep crisis of identity, the direct and vicarious trauma that comes with being witnesses to the unrelenting persistent state violence (most vividly police violence/brutality/killings but including our relationship the entire prison industrial complex); community violence and interpersonal violence. We are seriously impacted by the racial micro-aggressions of everyday racism (media, employment, school, interpersonal relationships, etc). We have a crisis of poor community leadership in this regard and very minimal African-centred, anti-racist mental health prevention, community dialogue, planning or programming. Stress, chronic stress, stress-related trauma, depressive symptoms, depression and mental illness usually go unaddressed for the vast majority of our folk and often spiral into a whole range of things, including early death. In combination with the range of social determinant of health-especially income inequality/poverty and persistent exposure to violence we should not be surprised that we are in a mental health crisis.
Is the expression and impact of mental illness in the Black community different than in other communities?
The facts are clear. Next to the Aboriginal community we are the most vulnerable population in all of Canada. When we consider our representation across the spectrum of the prison industrial complex (jail, prison, probation, parole, etc.), the high level of school failures and dropout rates, the level of those in forensic institutions (not criminally responsible), the high levels of community violence and so forth – the dimensions are more stark. It is no surprise that the documented (though under-reported) levels of depression for African-American women are so stunning in the U.S. Similar the levels of depression, psychoses and neuroses for Black inmates and those involuntarily detained in mental health facilities (especially those diagnosed with schizophrenia) have skyrocketed. An easy axiom is that the greater the economic and social vulnerability, the higher the likelihood of a mental health problem.
How can we, as community members better support someone who is living with a mental illness?
Remember that mental “illness” is at one end of the spectrum of mental ill health. Spectrum includes issues like anxiety, chronic stress, depression, clinical depression, mental illness (psychosis, neurosis) etc. All of us are somewhere on the spectrum. If you mean those who have mental illness then we definitely need more public awareness to reduce stigma and encourage open dialogue, better coordination of services, Afrocentric and anti-racist clinical programming, lots of protective and preventative activities – especially with our young people – many of whom are becoming more severely depressed at an earlier and earlier age.
You have worked on local, provincial and national strategies pertaining to mental health and you have travelled to other parts of the world. Are there models of care you have seen elsewhere that you think would work in Canada and specifically within the African Canadian community?
Our approach in my view has to focus on a strong grounding on African/African Diasporic culture, intense work on resilience – both at the personal, family and community level to reduce our vulnerabilities, a balance between talking therapy and medication (with a bias away from medication), a holistic approach (mind/body/spirit) continuum that recognizes our unique and powerful legacy and possibilities.
We need partnership and intense collaboration to create and advance strong messages about our powerful possibilities and step by step things that folks can do to reduce vulnerability to mental ill health.
We are nearing the end of the longest federal election campaign in Canadian history, yet I have heard very little, almost no discussion, on health care. In your opinion what message or questions should we be asking of the MP hopefuls regarding their party’s position on improving how Canada’s health care system addresses mental illness?
More resources that acknowledge the diversity and health equity dimensions of mental health care – with the requisite resources. This could be tied into things like improved economic productivity and social engagement, reduction in crime and incarceration, etc.
Stronger focus on attacking social determinants of ill health. Community Health Centres can start by developing a position paper on mental health and African Canadians and promote it to our constituencies and politicians.
We need to talk about the relationship, in particular, between poverty/racism and mental health problems for Black people and make a strong and relentless case. The public discourse in the election has not even acknowledged racism (except for the brief NDP piece on the missing and slain Aboriginal women).
What are you most hopeful for in terms of the improvement in the mental wellbeing of African Canadians?
We have lots of health-related organizations doing amazing work. However, I think we need to be more coordinated, more coherent and more innovative in addressing this urgent priority. Forget the turf stuff and ego and nonsense. We cannot afford that.
We come from a long line of resilient and resourceful people so we have lots to build on. Our youth are keen and eager for adult support and we can creatively utilize social media as a dynamic tool for creative prevention, promotion and conversation initiatives in this regard.
Thank you Nene for your work and your thoughts.
I would like to invite the community to seek out opportunities to participate in open and meaningful discussions about mental health. Join us on Monday, September 28 at the Barbara Frum Library from 6 pm – 8 pm. In addition, The Walnut Foundation will host a Conference on Men and Mental Health Issues on Saturday, October 24, and BHA will host A Sound Mind: Mental Health in the Black Community on Saturday, November 14, 2015.
Dr. Christopher J. Morgan is the director of Morgan Chiropractic & Wellness, an interdisciplinary health centre in Toronto; and the founder and former president of the Black Health Alliance, a network of community organizations, health professionals and community members working in partnership to advance the health and wellbeing of the Black community. He can be reached at 416-447-7600 or firstname.lastname@example.org.
Link to: Mental health in the Black community – a discussion, part 2