Category: Mental healthcare disparities

Yes, you can be “successful” and feel like shit

Yes, you can be “successful” and feel like shit

Restauranteur Chef David Chang has it all. At least on the surface. He’s the founder of a gazillion restaurants, is star of the TV show Ugly Delicious, and has won too many awards to count (really). He. Has. It. Made.

Except he doesn’t. In recent interviews publicizing his new memoir, he’s naming what’s been beneath the surface even as he’s been accumulating accolades: depression and bipolar disorder. I was really moved to hear this interview with him, and in particular his naming that professional success is not a protective factor when it comes to mental health. In other words – it’s great if you’re rolling in money, and have an awesome job, and people adore you. But checking off those boxes and looking good on paper, on the surface, doesn’t guarantee ANYTHING about your mental health.

I’m so glad David Chang is speaking up. So many of my clients believe they “shouldn’t” be feeling like shit because their life looks good on paper. (And there are some specific barriers that get in the way of Asian Americans speaking up about mental health challenges.)

I’m grateful for all those famous folks like David Chang who are speaking up about their experiences with depression (including Trevor Noah, Michelle Obama and Lady Gaga, to name a few). Each person who speaks up helps reduce the stigma of mental health challenges. And when we reduce stigma, we bring light to darkness – and it’s THEN that we can get and receive help.

David Chang at one of his massively successful restaurants.

White clients, it’s time to talk about whiteness

I have been thinking lots about what psychologist and writer Natasha Stovall wrote almost a year ago, before the police killing of George Floyd, before the COVID pandemic exposed (yet again) racial disparities in our country. Stovall wrote this:

The couch in my therapy office is occupied mostly by white people. Anxious white people and depressed white people. Obsessive white people and compulsive white people. White people who hurt people and white people who hurt themselves. White people who eat too much, drink too much, work too much, shop too much. White people who are bored, envious, guilty, numb. Racist white people and antiracist white people. White people who look across the room and see a white therapist listening. We talk about everything. Except being white.

Stovall goes on to make the point (and this is a gross simplification; the article is worth reading in full) that white therapists need to support white clients to explore racial identity, including the negative ways white culture impacts all of us—even those of us who also benefit from it due to our whiteness.

I’ve been exploring my own white identity for the last few years, primarily through the workbook Me and White Supremacy, through regular meetings with other white therapists wanting to dismantle our own roles in systemic racism, and through expanding my reading list so it does less to center whiteness. I keep coming back to this checklist about white supremacy culture only to cringe as a recognize myself and many of my attitudes and behaviors on this list.

I am committed to doing my best to support all clients. That means continuing to work to become as anti-racist as possible, and, when clients are ready, helping them unpack the ways their challenges may reflect and result from our problematic culture. This is our work right now. This is my work right now.

Trevor Noah, Depression, and The Ongoing Gaps in Mental Health Care

I just love Trevor Noah. And he’s just given me one more reason. He’s using The Daily Show to raise the issue of why black people and other people of color have a hard time seeking out therapy and finding useful therapists.

Trevor Noah has been public about his own experience of depression in the past, using his leverage as a celebrity to speak bravely and truthfully about what so often goes unsaid and unspoken. Is it a surprise that this extraordinarily funny and smart man also struggles with depression? It shouldn’t be. Noah reminds us that we can never know from looking at someone what their internal experience is. Never.

I’ve written about mental health access for people of color and crappy differences in therapists’ response before here. But it’s still hard to see these disparities continue. “Disparities continue” makes it sound clinical, impersonal—but what that means is that unless you’re white and middle class, it’s still extremely hard to find a therapist who is likely to get you and understand where you’re coming from. That’s the worst. It’s deeply painful to acknowledge you need help and seek it out just to come up empty or invalidated.

It’s time for therapists, and especially white therapists, to do better. As we prepare to enter 2020, us white therapists need to consider our own limited understanding of the varied experiences of People of Color and do our own work to see how race – including whiteness – affects how we care for our clients.

Blog Hodgepodge: ACE Scores, Bias, Lived Experiences, and A Radio Interview

Blog Hodgepodge: ACE Scores, Bias, Lived Experiences, and A Radio Interview

I got to talk on the radio recently about depression, suicide, and teenagers. I’m glad to continue to spread the message about adolescent mental health concerns, even though it’s always sobering to consider how mental and physical health issues can be created or exacerbated by so many preventable factors.

I’m a big fan of the Adverse Childhood Experiences (ACE) Scale as a quick way to look at what sorts of factors may have been present – or absent – in my clients’ lives that may impact them to this day. None of us exist in a bubble. There’s good research on how trauma, neglect, race, class, immigration status, gender and gender identity, and so much else plays into how others treat us, brain function, and how we end up feeling about ourselves. (Here’s a recent reminder of racial bias affecting views toward young black girls.)

In my work as a therapist, I continue to be committed to seeing my clients as individuals whose own stories and experiences are a part of a larger social and cultural framework.

Some helpful stats about the importance of ACEs.

 

“Not Rich, Not White, and Seeking Therapy”

“Not Rich, Not White, and Seeking Therapy”

I was concerned but not incredibly surprised to read the findings of the article “Not Rich, Not White, and Seeking Therapy” in The Atlantic. It’s a quick read, but gets into how hard it can be to access counseling if you don’t sound rich and white when you call therapists to make an appointment. In other words, it shows how much the odds are stacked against people of color and people who sound working class — even with therapy. Here’s a quick quote:

“If [the researcher’s] experiment were to play out in the real world, an identifiably black, working-class man would have to call 80 therapists before he was offered a weekday evening appointment. A middle-class white woman would only have to call five.”

As a white woman who’s anti-racist, I’m appalled. The field of therapy has to do better. We have to do better. Everyone deserves access to high-quality healthcare for physical and emotional concerns.