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Illinois data highlights need for diversity, 'difficult conversations' in mental health

The State Journal-Register - 6/4/2021

Jun. 4—Editor's note: This story is the third of three this week exploring mental health and highlighting some of the local efforts taking place to improve the community's overall mental wellness.

There was a point in college where Dion McNeal's mom was regularly calling to check on him.

When he did not respond, her next call was often to the local police in Charleston, where McNeal, 28, was attending school at Eastern Illinois University.

On top of struggling to accept his sexuality, McNeal — who says he is now a "proud gay Black man" — found out he was HIV positive. At the time, he was in his early 20s and his new reality sent him down a spiral that included depression, self-harm, drug and alcohol abuse and thoughts of suicide.

"There were just a lot of emotions," said McNeal, who was a speaker at a mental health rally outside the state Capitol last month. "I felt like I couldn't go to anyone who could connect with me. I was in a town where there was a support group, but the support group was with older white men. They hit on me in the second meeting.

"That made me very suicidal. It put me in a very dark place."

Even though socioeconomic challenges often place people of color at higher risk for mental health struggles, there is also a longstanding reluctance to recognize the need for mental health treatment within Black and brown communities, studies have shown. According to a report from the American Psychiatric Association, one in three Black people who need mental health care receive it.

Statewide data also shows why keeping conversations about mental health wellness is vitally important in communities of color.

An Illinois Department of Public Health report from January through September 2019 — and for the same period in 2020 — shows suicide rates across the state decreased by 7.68%. However, among the state's Black population suicide rates increased by 28.39%.

In feeling like he had to process his HIV status on his own, McNeal began abusing Xanax and mixing it with alcohol, which led to him regularly blacking out. Eventually, he got tired of feeling numb. That is when he turned to cutting.

It has been five years since McNeal last harmed himself. He admits he still struggles at times. But the Eastern Illinois communications graduate is now passionate about sharing his journey in hopes that his vulnerability will help others.

Locally, mental health professionals are working to ensure there are spaces where Black and brown people can feel comfortable receiving treatment.

"I'm pretty lucky to be here," McNeal said. "So I try to use that power of learning who I was, and who I am up until this point, to try to help other people — so they don't feel alone, and they know they don't have to do this by themselves."

A senior resident at SIU School of Medicine asked a patient a question about how he was doing. The man responded. But the resident did not understand his answer, so she asked the question a second time. The patient said the same thing in response.

Barra Madden, who began her fourth year as a SIU medical student this week and didn't reveal the term used, was also in the room for the interaction between the patient and her senior resident.

"I understood deeply what he meant, in terms of what he was going through," said Madden, who is an aspiring psychiatrist. "I was like, 'I'll fill her in.'

"It was just a connection that we were able to build over our culture and our background."

Madden, 27, said an encounter like that — where a patient uses slang terms a doctor does not understand — is a common occurrence she has seen throughout her time in medical school.

"I have many stories where just being in the room changes the dynamics," she said. "I don't even have to be the one doing the interview. I can just be observing and it changes the atmosphere of how minority patients feel at that time."

From her month-long psychiatry rotation to her time spent learning other specialties, Madden said minority patients often pull her aside and thank her for being in the room and making the environment more comfortable for them.

"I always say representation is key," she explained. "I notice that all the time, but especially in psych. Because in psych we're dealing with traumas, we're dealing with difficult conversations — things that people have never told their families. It's just secrets that they're living with. When we ask questions, if you feel comfortable, you bring it up.

"When minority patients see a Black face, it kind of gives them another view or perspective of what they can share, and if that person is going to understand them."

With last month marking the one-year anniversary of George Floyd's murder at the hands of then-Minneapolis police officer Derek Chauvin, local therapist Oluwatamilore "Tami" Odimayo said many of his Black clients have been unaware of some of the trauma they have experienced over the last year.

"Trauma does not have to be direct," explained Odimayo, who works as a clinical professional counselor and certified drug and alcohol counselor at Killian and Associates. "Trauma can be observed. So, in the past year with what has been happening in our country, and what we see on the news, a lot of Black people are being traumatized on a daily basis and don't know."

As one of a handful of Black licensed therapists in Springfield, Odimayo said some of his clients have expressed to him that they previously did not attend therapy because they did not feel comfortable speaking with a therapist who wasn't Black. Many of those clients said they instead relied on the church for counseling because they wanted to speak with someone who could relate to some of their trauma.

With Madden's father incarcerated for much of her childhood, she was raised by a single mother in a poverty-stricken area in Rochester, New York. Even though she witnessed the impact drugs and addiction can have on a family and community, like many Black families, hers did not have conversations about how their surroundings and circumstances impacted their mental health.

"We really didn't talk about our mental health conditions or how we felt or what we were going through," Madden said. "We knew my grandma had diabetes; we were at every hospital visit. But we didn't know if my grandma was dealing with depression, we didn't know if she was dealing with PTSD from anything, because those were just things we did not discuss."

Odimayo said it is important for people of color to be aware of racial trauma — or, as Mental Health America explains, the mental and emotional injury caused as a result of encounters with racial bias, ethnic discrimination, racism and hate crimes — and how it can manifest.

"If I'm driving on the road and there is a cop is behind me. Even if I'm doing everything well, my heart rate is going up," Odimayo explained. "That's a traumatic response to what I have seen on TV.

"A lot of people in the Black community have been traumatized and triggered. Some people don't know where that anxiety is coming from; where those panic attacks are coming from."

Even though spaces such as church can provide relief to those who are struggling, Odimayo said sometimes counseling and other forms of mental health treatment are necessary. He explained treatment can help a person avoid unhealthy coping skills — much like the ones McNeal developed during his darkest moments when he began abusing drugs and alcohol.

About half of people who experience a mental illness during their lives will also experience a substance use disorder and vice versa, according to the National Institute on Drug Abuse.

From October 2019 to October 2020, Illinois saw a 32.78% increase in opioid-overdose deaths, according to data from the Centers for Disease Control and Prevention. While overdose deaths among Illinois' white residents increased by 16.96% from 2019 to 2020, they increased by 49.64% for Illinois' Black population, according to data from the IDPH.

"We have to have these difficult conversations," said Madden, who plans to specialize in child and adolescent psychiatry and addiction medicine. "If we don't, it's going to continue and we're going to be in this minority tax of mental health — we don't deal with it, we don't talk about it and then our family is still suffering with it."

Contact Natalie Pierre at npierre@gannett.com or on Twitter @NataliePierre_.

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