Table of Contents
- What is Co-Occurring Disorder?
- Afro-American Icons Who Battled Co-Occurring Issues
- Co-Occurring Variance and Suicides between Afro-Americans and Caucasians
- The Stigma Factor in Afro-American Culture
- The Afro-American Church and Mental Health
- Solutions to Co-Occurring Disorders in the Afro-American Community
Whether weaving athletically between defenders on a NBA basketball court, weaving multiple scriptures into an explosive sermon, or rapping about the vicissitudes of urban poverty and violence, the Afro-American race and it’s unique gifting is not spared from mental health challenges. Resolve, perseverance, and faith are perpetual watchwords among Afro-Americans, yet the mere mention of mental health issues, especially in tandem with substance abuse is still considered taboo with many. Why is this? What fosters most of a race to be so silent, reserved, and shamed based concerning such a common malady as co-occurring disorder? This is the premise of our project and discussion.
What is Co-Occurring Disorder?
Co-Occurring disorder is a term for when someone experiences a mental illness and a substance use disorder simultaneously. Either disorder—substance use or mental illness—can develop first. People experiencing a mental health condition may turn to alcohol or other drugs as a form of self-medication to improve the mental health symptoms they experience. However, research shows that alcohol and other drugs worsen the symptoms of mental illnesses. Based on modern statistics, approximately 9.2 million people suffer from co-occurring disorders globally. (Chatters, Taylor, Jackson, & Lincoln, 2008) As with any disease there are certain symptoms which will eventually present themselves such as: High risk behavior, tolerance and withdrawal, denial, powerlessness, unmanageability, legal, family issues, isolation, and more.
Afro-American Icons Who Battled Co-Occurring Issues
Earl Simmons, known globally as rapping sensation DMX has openly shared about his battles, tests, and failures with substance abuse and bi-polar disorder. DMX traces his problems to early childhood trauma, abuse, and neglect. It led to over 40 arrests, multiple prison stints, and fifteen children he’s fathered! DMX admits to loathing his medication and therapy sessions. He often speaks of being called to preach and being an ambassador for God. Despite numerous attempts at treatment, he yet struggles with co-occurring disorder, and on Oct 13, 2019 he checked himself into a rehab to address both issues. (Kreps, 2019)
Renowned English actor David Harewood has hosted documentaries and given multiple interviews chronicling his fight with psychosis and substance abuse. By his own confession as a teenager, he was admitted into RADA which is one of the UK's most prestigious drama schools, yet in little or no time he found himself immersed in the drug culture, perpetually angry and oblivious that he was also mentally ill. Harewood had many psychotic episodes/mental breakdowns, reckoned he was the second coming of Dr. Martin Luther King, heard divers’ voices, and thought he had three brains. Through therapy, speaking out, and intense mental health treatments Harewood has gain great victory and is leading a happy life. (Sexton, 2019)
Co-Occurring Variance and Suicides between Afro-Americans and Caucasians
The Afro-American community suffers from a disproportionately higher incidence of co-occurring disorders than that of the Caucasian race. There several key factors which contribute to the Afro-American plight:
- The ever-present reality of belonging to a marginalized culture who have to protest and fight for basic human rights.
- A higher than average number of Afro-Americans in their communities who either sell or abuse drugs.
- Afro-American role models who use drugs or display mental health illness with relative impunity and disparage white oppression.
Members of the white community often owe their dual diagnosis to, the stress resulting from pressure to excel, the desire to escape a painful life, and the fun their friends claim that drugs bring them. By the same token blacks who become ensnared via co-occurring disorders share a different genesis. Here are their shared responses: the need to sell drugs to assist with family/systemic poverty, overwhelming debt, and single parenthood dilemma’s. Witnessing the drug trade openly and the relative ease in obtaining drugs. To combat drug Kingpins who often dominate entire neighborhoods by debt, threats, and violence.
While there are radical variances between Afro-Americans and Caucasians concerning addiction and mental health issues. The fallout which results in suicide and attempted suicides has increased dramatically for Afro-American teens. According to a study done by The University of Toledo’s Dr. James Price, the rate of suicide deaths among young black males increased by 60 percent from 2001 through 2017. There was a 182 percent increase in the rate of suicide deaths of young black females during that same time period. Georgia had the highest rate in the nation, at 5.8 per 100,000 people, between 2015 and 2017. 'There are far more African American adolescents attempting suicide than has been recognized in the past, and their attempts are starting to be much more lethal,' Price said. (1998 Jama)
The Stigma Factor in Afro-American Culture
One of the greatest and longstanding taboo’s and strongholds within the community of color is the stigma surrounding co-occurring disorders and mental health. The age old comparison with overcoming the tyranny of slavery leads many to erroneously conclude that they should also easily overcome addiction, depression, and a host of other mental health nemeses. The promulgation of this false belief system is amazingly resilient, many pursue into the gates of insanity and death. To give in to or admit to anything less is equated to weakness, lack of faith, or attributed to things black folks just don’t do!
What inevitably manifest from this mindset is the inability to recognize or differentiate between normal feelings of despair, melancholy or actual clinical depression or panic anxiety. According to the National Alliance on Mental Illness, “approximately 1 in 5 adults in the United States experience mental illness each year. This is irrespective of race, creed, or color. In addition, according to the U.S. Department of Health and Human Services Office of Minority Health, adult Black/African Americans are 20 percent more likely to report serious psychological distress than adult Whites”. Yet, the alarming fact revolves around how blacks remain resistant to seeking mental health treatment and or abort treatment early.
The Afro-American Church and Mental Health
From the treacherous days and endless nights of bondage associated with being held in captivity to slave owners until modern day mega churches, the Afro-American church has long been a hub of faith, hope, and solutions. The vibrant singing, enthusiastic praise, resounding waves of worship, joyful fellowship, and dynamic sermons it has long been a source of mental/phycological well-being in the Afro-American community. Yet, in some circles it has also lent itself to being one dimensional, dogmatic, and judgmental regarding mental illness maladies. Many faith-based leaders often shamed, bashed, and browbeat congregants who complained or barely mentioned mental illness as them lacking faith, lacking a prayer life, or being full of demons!
The vast majority of these leaders did this without malice nor because they were mean spirited, they mostly lacked formal education in this domain-others were merely acting out faulty ministry models that were passed down to them. The Bible plainly states in Genesis 1:11, “each fruit produces seed after its own kind”(KJV 1993). Meaning that the parent fruit or vessel will always give birth to a similar replica of itself. In many ways that is good, in other cases that can be tragic, even terminal. Rather than delving into all of the gory mishaps and problematic areas regarding the Afro-American church lets examine at length how this formidable institution can be a beacon of hope, inspiration, and a potential conduit into the arena of mental health wellness!
Many studies reveal that African Americans utilize their faith as a coping mechanism for dealing with mental health problems more so than visiting a mental health therapist. One study shows that 90.4% of African Americans reported use of religious coping in dealing with mental health issues. (Chatters, Taylor, Jackson, & Lincoln, 2008) There are a plethora of methods by which we can bridge the chasm between faith and the clinical. Herein lies a mere handful:
- Conduct faith and clinical thinktanks, public forums, question and answer meetings.
- Reach out to, develop, and cultivate transparent and symbiotic relationships with faith-based leaders. In order to establish an inroad through local churches we must do something deliberate and intentional.
- Understand what our strengths, assets, and purpose is and leave the spiritual and faith declarations up to them. Their expertise is their flock, faith, and declaration of the spiritual—ours is the clinical, empirical research, theories, therapy, treatment, practical life applications, and being the conduit for mental health problem solving. In other words: Stay in Our Lane!
- Share with faith leaders the positive attributes, benefits, and potential fruit of having a trained Social Worker/Mental Health Therapist on staff.
Solutions to Co-Occurring Disorders in the Afro-American Community
Honest communication, rapport, and dialogue beginning with the individual, family, faith-based, and community levels without fear of reprisal. Many individuals when interviewed, partaking of Psychosocial Assessments, individual or group therapy share a one sordid cord in the tapestry of their co-occurring illness. Which is a culture of fearful silence, a mask of shame, and a family heritage that fosters little outside therapeutic intervention. A family that suffers in shame, silence, and fear usually perish by the same measures they unknowingly inflict upon themselves. We must bring an awareness of such problems in order that we can address the besetting issues.
Issues, problems, and enemies operate best under the cloak of darkness, obscurity, and shame. Darkness only aids and abets darkness, only light can dispel darkness. Whether it be depression, anxiety, maladies that span the entire the entire DSM-5, or addictions, they cannot remain ambiguous--we must put a name to such problems. Unnamed problems have the propensity to remain unsolved problems! The old clique says, “Name your demon and he must flee!” When an area of distress is properly identified only then can we begin the clinical task of reducing or eliminating said problem.
We must overcome the shame-based mentality which spews forth error full reasoning and faulty logic. This perspective leaves the wounded, violated, and hurting locked within a veneer of no escape. It causes those who need help to be afraid or ashamed to ask for help, instead they wear masks that glow, shine, and smile, while inside they cry, wither, and continue to hemorrhage. Social Workers and Mental Health Therapist operating in their respective metrons are qualified and able to share the plight of broken humanity—how we all have feet of clay and need help from time to time. Some more than others, others much more than some.
Originally coined with little or slight revelation of its potential, the term known as, “The Talented Tenth” was brought into prominence and renown by Dr. W. E. B. Du Bois. Du Bois was an educator, philanthropist, author, poet, civil rights activist, and intellectual extraordinaire. Du Bois built his premise on empirical research spanning many documented years on the Afro-American race and culture. In his words, here is the crux of Du Bois’s foundational theory, “The Negro race, like all races, is going to be saved by its exceptional men. The problem of education, then, among Negroes must first of all deal with the Talented Tenth; it is the problem of developing the Best of this race that they may guide the Mass away from the contamination and death of the Worst”. (OpenLibrary.org, 1970)
Upon initial inspection, it seems somewhat lofty, aloof, and rather grandiose, yet housed within this seed theory was the reality of greatness, brilliance and exceptionalism. Perhaps the thought occurs, “what has DuBois to do with co-occurring with the black community?” While DuBois proposed this possibility towards 10 percent of the Afro-American generationally, I see where, “The Talented Tenth of Afro-American Social Workers/Mental Health Therapist” also is relevant, needed, and obtainable! The question beckons, “Will our current generation contribute to the Clinical Talented Tenth? Will the Talented Tenth of class rise to the occasion and answer the clarion call to arms to love the unlovable, reach the unreachable, advocate for the voiceless, and be the solution for generational problems?
If we find our proper place of exceptionalism within the ranks of Macro, Mezzo, and Micro Social Work, we too can be likened unto a modern day version of a W. E. B. Du Bois of Bessemer, Pratt City, Five Points, Ensley, Hoover, Gate City, Fairfield and the Greater Birmingham populace. The cost association is beyond arduous---it is stupendous, yet the fruit of our labor exceeds the human vernacular…it borders upon the divine. It is with the ever-descending hand of providence and the willingness of our arms, legs, backs, and minds of willingness can we address, advocate, and transform those caught within the fowler's snare of co-occurring disorders. We then will have a legacy of our own rivaling that of DuBois, and be known and remembered as this 21st Century’s “Talented Tenth!”