By Dr. Peter Sealy
With all of the celebrations of Black History Month just wrapping up last month, it may not be the right time to talk about the stigma associated with mental illness among Black Canadians. But that is exactly how stigma works. With stigma, it is never the right time to talk about mental illness. It pushes us to deny that mental illness exists and to lower our heads in shame. Mental illness and the stigma associated with it are not sexy topics and many of us would prefer not to talk about it. But not talking about it is not going to make it go away.
My interest in the stigma associated with mental illness first occurred when I noticed young Black men who appeared to be acting unwell mentally. I enquired about these young men and would often be met with responses like, “oh he smoked some bad weed” or in the dialect “his head is not right”. I would later get to meet a few Black women who dressed immaculately in public but were hiding a little dark secret. Nobody, not even their general practitioner, knew what was happening to them. But I would later find out from them the price that they were paying for human guise. Then I noticed some young Black children who seemed to be struggling with emotional issues. However, I couldn’t dare raise questions with regards to these children’s behaviour to their parents.
There were the Black seniors who were “shut ins” during the week and released on Sundays for church where the body shaking was consistent with receiving the Holy Ghost. They had stopped eating their cultural foods, forgetting to take their medications, neglecting their personal care, isolated and at times sad. When I raised concerns about their well-being, I was told by family members that they were just old and miserable. I told them that old age doesn’t render a person miserable, but I just received blank stares.
The teenagers had the swagger, but that swagger was a dagger I would later find out. There was swagger because of stigma to cover up a deep, dark and cutting pain. After doing a lot of personal and educational work, I found out that mental illness was the elephant in the room and that stigma was fueling the silence. The elephant in the room means an obvious, yet uncomfortable truth, which nobody wants to address. When I spoke out about mental illness publicly, I was told by some people in the Black community not to “air our dirty laundry in public”. But I couldn’t just sit back and watch a segment of our community struggling with the pain of mental illness in silence because that would not be the right thing to do. Still, the issue of stigma is a broader issue with two-thirds of all Canadians suffering in silence with mental illness and not receiving treatment.
The stigma associated with mental illness that prevents Black Canadians from seeking treatment is ever prevalent. Mary lost her job and became depressed. Monica came to Canada from the Caribbean to help her daughter with the children and found herself a shut in and is now depressed. Vincent started hearing voices during his first year of College. His mother kept him at home for two weeks before he saw a Pastor who prayed for him and then after it was a visit to an “obeah man”. He now self-medicates with alcohol and other drugs. Sandra is dealing with post-partum depression after the birth of her baby but nobody wants to name it. Cindy, at age 18, has just been unceremoniously dumped by her boyfriend and is finding it difficult to cope and feels misunderstood by her parents. Harriet has recently learned that she has diabetes and is now depressed. However, Harriet’s diabetes is treated, but not her depression. In all of the named cases, whereby pseudonyms have been used, mental illness is never named; which means no treatment. So great is the denial and shame. So great is the stigma.
The symptoms of mental illness in Blacks can differ from other cultural groups. Ten years old Devon sleeping in the classroom, may not be tired due to lack of sleep the night before, rather he could be depressed. The Black male and female, acting irritable and snapping at their friends, may not be simply having a bad day but rather dealing with depression. The teenager who doesn’t clean his or her room nor do chores around the house, yet finds time to talk to friends on the phone, party almost every weekend and drink alcohol at clubs, may be dealing with depression.
There are some who would read this and say that we are too quick to diagnose. But stigma in its undiluted form works to oppose. Still, what we are witnessing today, is the sitting back and watching of little Black boys like Devon, graduate from the elementary school system to the justice system. This is due to the stigma of denial and non-intervention associated with mental illness. We can no longer keep silent due to stigma and bury our heads in the sand, when adults and children in our community are suffering and worse even committing suicide.
Black Canadian parents work hard to raise their children, with many working two and three jobs. Despite this, we have to find the time to spot any changes in our young children and seek a professional opinion early. The “not my little Johnny has mental illness” is the stigma of denial. Stigma is preventing Black Canadians from seeking treatment for mental illness.
We cannot simply wait on governments to do things that we can do for ourselves. In this sense, we have to start the conversation now about the stigma associated with mental illness. Mainstream anti-stigma campaigns associated with mental illness do not reach the Black community and this has become the diversity disconnect of mental health promotion. The Black community needs to take action now with regards to stigma and mental illness. On February 27, 2015 and each year after, I would like to see stigma free zones set up in the Black community. These stigma free zones should also include homes where people can talk openly about mental illness and not feel restricted due to stigma.
Dr. Peter Sealy received the Public Service Award for outstanding work in the interest of mental health from CMHA in 2007.