Caring for Mental Health in Communities of Color During COVID-19 (www.rwjf.org)

One of the most troubling aspects of the COVID-19 pandemic is how it is exacerbating long-standing and deeply rooted inequities in communities of color. Health disparities stemming from structural racism have contributed to COVID-19’s devastating toll on blacks and Latinos in America. Often overlooked is how heightened stress from this heavy burden is impacting mental health.

Yolo Akili Robinson, a recipient of the RWJF Award for Health Equity, is swiftly responding to this new reality the pandemic has created. As the executive director and founder of Black Emotional and Mental Health Collective (BEAM), he leads his colleagues in training health care providers and community activists, as well as non-mental health professionals (family members, peers, etc.) to address mental health needs in communities of color. Robinson is witnessing firsthand how lack of access to testing and fear of profiling while wearing face masks, among other issues are increasing toxic stress and straining mental health.

In the following Q&A, Robinson shares insights about the impact and implications of COVID-19 on mental health within communities of color.

What are the unique mental health needs facing the communities of color you work with during this pandemic?

First, we must acknowledge the historic causes of mental health challenges: the legacy of racism, homophobia, transphobia, ableism, economic stressors, and systemic failures that contribute to our mental health struggles. Adding COVID-19 has greatly amplified this distress.

Data is showing that people of color are more likely to die from COVID-19. That’s not surprising. We have already been living in spaces zoned so that black and brown people aren’t healthy—in food deserts, or where the water isn’t safe to drink, for example. And we endure untreated chronic conditions that lead to poorer outcomes from COVID-19, while struggling to access health care. So when COVID-19 began spreading, we were already in distress because of systemic and structural failings.

When people of color actually do manage to receive care, doctors are more likely to minimize their pain and dismiss their symptoms. Serena Williams, a world famous athlete, experienced this. So imagine if you’re not a celebrity, but an elder in rural Alabama! Will you be heard? We have a long way to go in dismantling all of the “isms” within the system.

At BEAM we’re seeing these factors culminate in greater depressive symptoms and increased isolation within our communities. For instance, we are seeing that our folks who are living with diagnosed mental conditions like bipolar or anxiety disorders report higher distress.  

We also rely on our traditions to process grief. After a funeral, we usually return to the home and eat together, a repast. That’s part of our healing process and how we support one another. Mandated bans on traveling and gatherings have interrupted these traditions when we need them the most.

We must acknowledge the historic causes of mental health challenges: the legacy of racism, homophobia, transphobia, ableism, economic stressors, and systemic failures that contribute to our mental health struggles.

Our community partners such as domestic violence shelters are also witnessing a marked increase in calls related to intimate partner violence or hostile home environments. For instance, social distancing is forcing LGBTQ youth to stay at home with families who are hostile or abusive about their sexuality or gender.

Exacerbating all of this is that the words “mental health” are a trigger for communities of color. Someone seeking our services shared that when he hears the words “mental health,” he envisions a social worker taking away his cousin. And not too long ago, the American Psychological Association had to demand that Immigration and Customs Enforcement stop using confidential psychotherapy notes to justify deportations.

Finally, staff at community-based organizations are already overworked and under-resourced. This stress is now amplified as they face increased demands.

How is BEAM adapting its approach to new challenges stemming from COVID-19?

Our work is modeled on the idea that we cannot rely solely on psychiatrists, social workers, therapists, and other professionals to do all of the mental health and healing work within communities, especially now. Our goals have been to educate and equip peers and families with tools, resources and skills so they can support themselves and their friends, families and communities. For instance, we know through our work that young people need the consistent presence of someone who can listen, validate and support them. It’s not always a deep clinical intervention that’s needed, but rather someone who knows how to listen, hold space, be compassionate, witness and process things. And that’s work we need to know how to do wherever we are.

We now have to use our voices, through art, media, and politics, to keep issues of equity at the forefront.

We know our services need to be more accessible during this pandemic so we now have offerings on Instagram Live, Facebook drop-ins, and so on. Previously, much of our work was in person. While we’ve had virtual options in the past, we’re now ramping those up. We also acknowledge that many may not have access to the Internet. Not only does that make it harder for us to reach them, but it intensifies their sense of isolation. To address this, we are providing services by telephone and also training the people who can virtually access our platforms to support those within their own networks who are more isolated.

So this crisis has provided an opportunity to reimagine how we plan for accessible and innovative care delivery, how we run our organizations, and how we prioritize mental health and wellness for our staff.

What advice do you have for community health workers who may be feeling overwhelmed?

Many community workers do not prioritize self-care. They may tell themselves “I’m not doing enough and I should be doing more.” There is always work to be done. We must recognize that every dime we raise, every meal we drop off, every phone call we make, any information we share matters and is valuable.

This is a moment for us to concurrently attend to our own stress and anxiety because if we don’t, it will show up in our work. Seek out virtual support from other organizers. Find a practice that will ground you and center you as much as possible. If we don’t prioritize our own wellness, we will not be able to sustain supporting our communities and ourselves now and especially not beyond COVID-19.

Where do you see hope?  

I think back to the early days of the HIV epidemic and am reminded of all the ways advocates had to push the government to respond, over a period of years. They advocated and protested until finally the government put its weight behind finding effective treatments. That also had a very real impact on the structure of health care and the way programs were designed to help people with HIV.

We, too, have to force a discussion and remind ourselves what started and energized national conversations that led to change. It was Martin Luther King, the Black Panthers, Gloria Steinem, Angela Davis, Fannie Lou Hamer, Black Lives Matter, ACT-UP. They got in our faces, even antagonized, and they got us past the collective amnesia and wishful notion that racism or sexism or homophobia don’t exist. We now have to use our voices, through art, media, and politics, to keep issues of equity in the forefront.

Another hopeful sign is that a lot of community-based organizations are working together, providing aid to the community, training one another, collaborating. Together they’re trying to make sure that everybody gets groceries and medicine, and they’re checking in on the vulnerable and staying in touch to combat isolation. We hope those alliances continue.