Mental Health Awareness Month
May is not only viewed as the month when the season begins to change but, also as the month of mental awareness. Mental illness has become a concern for the nation as more people continue to suffer from some form of the disorder. In an interview with Dr. Britany Alexander, a psychiatrist at Kaiser Permanente Riverside, an Our Weekly reporter learned about the differences between mental illness and how an environment can impact the development of one.
“I don’t think there is “one defining” moment. We cannot discount the impact of sentinel events such as racial incidents, mass shootings, and the TikTok ADHD phenomenon on perception and awareness of mental health.”
Alexander touched on the defining point when Americans began in earnest to be more aware of the problems of mental illness. “It’s [especially] sad to see a person die of suicide or drug addiction. When a beloved celebrity such as Robin Williams or Michael K. Williams dies of a mental health or substance use related issue, it certainly draws attention and re-kindles discussion.”
As the discussion around mental illness starts to deepen, some people may become confused about how illnesses differ from a disorder, diseases, or syndromes. Alexander said the classification [can be] interchangeable. She discussed the variables that can affect mental health quality. Alexander named a slew of different things that can decrease somebody's mental state.
“Both the environment literally (e.g. pollutants, air quality, cleanliness, exposure to pathogens and allergens) and the social environment (e.g. poverty, access to food/healthcare, interpersonal relationships, violence, lack of leisure time/exercise) can directly affect our mental health.”
Many low-income communities–especially Black communities–deal constantly with forms of trauma that can lead to mental instability. Mental health experts have suggested that Black adults are about 20% more likely to experience serious mental health problems, such as major depressive disorder or generalized anxiety disorder. Alexander suggested that poverty can also affect mental well-being. African-Americans are reportedly twice as likely to live below the poverty line as their White counterparts and, therefore, are twice as likely to report serious psychological distress.
Another reason schizophrenia and bipolar are overly diagnosed in the Black community is because of the high levels of stress and substance abuse.
“[These] are likely genetically modulated and sometimes manifest during stressful times or related to substance use/abuse,” Alexander said in detailing how it is not uncommon for individuals under these conditions to show symptoms. “There are cases in which a generic vulnerability is exacerbated by using drugs, alcohol, sleep disturbances, and stress.”
Alexander’s data, taken from 2020, revealed that suicide was the third leading cause of death for Blacks ages 15 to 24 years. Despite the need for treatment, only one in three Black adults who need mental health care actually receive it. According to the American Psychiatric Association’s Mental Health Facts for African-Americans, Black persons are less frequently included in research and are less likely to receive guideline-consistent care. Black people also do not trust medical professionals because of the historical prejudice and discrimination in the health care system in the US.
This distrust can be supported by the fact that Black women frequently state a lack of concern displayed by physicians when they come in reporting physical or mental health problems. Alexander noted that Blacks are less likely to be treated for depression and anxiety disorders and less likely to receive adequate pain medication, especially during childbirth.
“What we have identified is that African-Americans are more likely to be diagnosed with schizophrenia and prescribed an antipsychotic or lithium early on in treatment,” Alexander said. “The differences in antipsychotic treatment by ethnicity include an increased likelihood of receiving an antipsychotic, higher doses, older drugs, and more frequent use of depot formulations.”
PTSD (Post Traumatic Stress Disorder) is also another form of mental illness that comes into question when people witness consistent violence and crime. They tend to become “numb,” Alexander noted, in their personal reaction to tragic or violent occurrences.
“It would be hard to compare the experience of the African-American person in America directly to hand-to-hand combat associated with military service simply because of the number of nuanced variables such as socioeconomic factors that may limit their resources to cope with traumatic stressors,” Alexander said. “This includes exposure to assaultive stressors associated with displacement and immigration cultural differences in emotional expression.”
Alexander suggested that the cumulative effects of racism can exacerbate any genetic predispositions and contribute to PTSD and racial trauma that can go untreated due to institutional racism and lack of access to appropriate care. “Structural racism, experienced disproportionately by Black people confers a social disadvantage through neighborhood factors, discrimination, and collective stress and trauma,” she noted.
Depression and anxiety, while commonly diagnosed for millions of people, can be complicated to understand as they represent two of the many variables that can cause or trigger these mental states.
“I think most people can easily connect their symptoms with external stressors. But insight is variable, and there is less knowledge about how deeply health habits, personal coping skills, interpersonal skills, environmental factors, and genetics can come into play.” Alexander said. “Some people connect mental health symptoms with spiritual warfare or other metaphysical phenomena.”
Social media is playing an increasing role in mental well-being. “I think that social media can be quite harmful. There are many unrealistic standards and a general lack of truth because we have so much opportunity to ‘edit out reality.’ There are also time issues, and the easy access can lead to less presence in one’s real life,” she said.
Alexander warns that while people want to help individuals dealing with mental disorders, they need to be careful with the words they use when addressing or “curing” one's issues.
“I want to be careful about the word ‘cure’ because this implies that we can be ‘done attending to our mental health’ and (military) ‘combat’ could sometimes imply that a person is at fault for being ill. There are many mental health disorders. Some of which can be short-lived, many/most of which will be ongoing and prone to exacerbation,” Alexander explained.
There are ways that families and friends can help comfort and reassure family members and friends who are undergoing a mental health crisis.
“Parents/families can help manage and support their loved ones by listening, being open and nonjudgmental, advocating for the patient, encouraging treatment adherence, having healthy boundaries, and doing their mental health work as well,” she said.
Alexander also wants people to educate themselves on the mental health system, mental health conditions, people triggers, and the appropriate treatment recommendations for each mental condition.
“I am hoping for a brighter future. There is a push to destigmatize mental health, increasing awareness of the mind/body connection, access to mindfulness apps, curiosity about the gut microbiome, and general discussion and awareness of the need to total self-care,” Alexander said.