By many accounts, the negative societal stigma associated with mental health problems — seeking counseling in particular — is as low as it’s ever been. Experts point to the pandemic’s effect on the rise in telehealth and how that has helped ease many people skittish about receiving help into therapy or how social media has helped raise awareness of mental health problems and provided a space for people to interact with others who are struggling with the same issues.
But reduced stigma and increased awareness haven’t been the case for every demographic, and a local mental health professional is doing something about it.
Valarie Cunningham opened the in 2003, a nonprofit mental health services clinic that gives particular attention to issues facing the Black community, to help fill in what she saw as gaps in services. The center is located at 625 Harrison St., strategically placed there to be close to both the Northside and Eastside neighborhoods of Kalamazoo, where large concentrations of Black city residents live. It is funded mostly by donations and grants from area foundations.
Barriers to seeking care
In U.S. Black culture, there is a deeply rooted narrative that one needs to take care of one’s own problems, Cunningham says. Seeking help, not being able to “handle your own stuff,” carries the risk of looking weak in the eyes of family or peers, she adds. One 2014 study showed that 63 percent of Black people saw a mental health condition as a sign of personal weakness.
There is also a religious component in Black culture that suggests that if a person struggling with a problem “gives it up to God,” it will be taken care of, that talking to God eliminates the need for talk therapy, Cunningham says.
“Talking about mental health and how it impacts Black people shifts the narrative from (it being) taboo to normalization, from shame to acceptance, from lack of understanding to a greater awareness,” Cunningham says. “Educating the Black community on the stigmas and their impacts, along with providing them resources they were not aware of or didn’t know how to find, changes the narrative.
“It says it’s OK, that nothing is so wrong that I can’t work through it. It says, I can have faith in my God, and it’s OK to have a counselor too. It reverses the stigma to say, instead of feeling weak, I acknowledge my strength by getting the help I need. There is power in perspective. When I change my perspective, I can change my narrative.”
To be effective, therapy requires that trust be built between a patient and a counselor. A person seeking help needs to know that it’s safe to be vulnerable so they can enter into a healing space where deep-rooted issues can be brought to the surface and dealt with. But if the therapist sitting across from that person doesn’t understand their unique cultural experiences, the likelihood that they will enter into that space can diminish, Cunningham says.
In 2019, the American Psychological Association noted that 17 percent of the psychologist workforce identified as racial/ethnic minorities. And although studies show that having a counselor who comes from a background similar to yours does not guarantee a beneficial experience, they also show that divulging your struggles to someone who is competent in your culture does help.
In addition to issues of stigma and cultural experience, seeking counseling also involves economic challenges. Counseling is not cheap, running upwards of $100 or more per session. And although mental health services are increasingly covered by insurance providers, people in the Black community — more underinsured than whites — often see the cost of counseling as prohibitive. In 2019, 12 percent of African-Americans were uninsured, according to the U.S. Department of Health and Human Services.
About 60 percent of Synergy’s revenue comes from billable services, Cunningham says. This is a challenge because the population the agency serves is often uninsured or underinsured, with insurance sometimes not covering the cost of service, she adds.
The rest of Synergy’s revenue comes from grants, fundraisers and donations, with support coming from a myriad of groups, including the Stryker Johnston Foundation, the Irving S. Gilmore Foundation, United Way and KYDNet.
“If I didn’t write a lot of grants and work at building partnerships, then it would not be sustainable to provide services to the underprivileged even when they have insurance,” Cunningham says. “It’s (often) still not enough. I was once told my model was not sustainable, and my response was ‘Of course, it’s not’ because of the population we are serving. That’s why funding support is always needed.”
Adult and youth programs
In an effort to break the stigma and increase mental health in Black and other minority communities, Synergy offers a slate of in-depth programming that is rooted in cultural awareness as well as outcome-based research.
One of the most popular programs offered by Synergy is a series of monthly gatherings called Let’s Talk: Black Mental Health, aimed at creating a space where Blacks can gather and be open about what they are struggling with while being supported by one another. Almost 250 people came to the first gathering in 2019. And though Cunningham had to push pause on the events during the pandemic, she says she is ramping up the get-togethers this year.
The gatherings have focused on such topics as the psychological evolution of the Black male, racial disparities in Black mental health, and suicide prevention. The events are meant to provide a space to continue dialogue about stigmas surrounding Black mental health and how to heal and get past them.
Cunningham also knows that overcoming stigmas about mental health should start earlier rather than later in people’s lives and that Black youth are experiencing mental health problems at increasingly higher rates. A 2018 study found that Black children between the ages of 5 and 12 are almost twice as likely to die by suicide as white children in the same age range. Another study notes that suicide rates among Black children and adolescents have been worsening: Between 2003 and 2017, suicides rose among Black youth, especially Black girls, whose rate of increase was more than twice as high as that of Black boys. While the Suicide Prevention Resource Center says a combination of approaches is needed to address suicide prevention comprehensively, two important components are helping people build life skills and resilience and promoting social connectedness and support.
Synergy offers many youth-centered programs through its UrbanZone. UrbanZone is a youth-driven center that provides opportunities for youth in the areas of arts, education, mental health, and social and emotional well-being. Located on the third floor of the Synergy Health Center’s building, the UrbanZone space features computers, a commercial kitchen and open spaces for meeting or just hanging out.
One of its programs, the Mind Health Ambassadors Program (MiHAP) is a peer-to-peer mentoring program that focuses on educating Black and Brown students in grades 9–12 in Kalamazoo County about mental health and its impact in school and on their families and communities. Each ambassador engages in their own therapy journey as a part of the program, which helps them work through any issues they may have and, in turn, helps them walk their peers through the process of receiving mental health care.
A study of similar peer-to-peer clubs for high school students conducted by Bring Change to Mind, a national nonprofit working to end stigma and discrimination surrounding mental health, found that the programs resulted in important improvements in students’ knowledge of mental health, their attitudes toward mental illness and their intended actions to combat stigma.
Utilizing yoga, journaling, mindfulness techniques, role playing and other strategies, the UrbanZone’s MiHAP informs teen ambassadors to recognize the signs of someone who may need mental health help, identify when to get an adult involved, and educate on how best to present resources and other ways of helping.
Another UrbanZone program, Be BRAVE (Brilliant, Resilient, Attuned, Virtuous, Empowered), meets weekly for one hour. Initially formed as a trauma group to meet the needs of girls who lived in a group home, it has expanded to include teenage girls within the entire community. At the meetings, girls participate in activities focused on developing self-esteem and self-worth and establishing healthy boundaries.
The UrbanZone is also looking to host an event for teens called Breaking the Stigma: Black and Brown Adolescent Symposium and to continue to host events on Instagram about adolescent mental health.
“Mental health counseling is woven through everything that the Synergy Health Center does,” Cunningham says. “What we don’t often talk about is mindfulness and giving people the tools to help themselves, teaching them to rewrite the narrative of their lives and transform their pain into something powerful.”
Dealing with trauma
The deaths of George Floyd and Breonna Taylor at the hands of white police officers and other acts of violence against the Black community have accentuated for Blacks a shared trauma — both historical and present-day — that both binds them together and also holds some of them back from living a life free of anxiety and worry and realizing their full potential, Cunningham says.
“We say, ‘Therapy works, therapy is dope,’” she says. “If we can normalize it and say it’s OK to seek it out, then we change the narrative. All of a sudden, it’s not a weak thing to do, it’s the right thing to do. If you have high blood pressure or diabetes, you take your pills or your insulin. You need your mental health medication too, and that’s therapy.”
Generational trauma is a large, if unspoken, issue in Black culture, Cunningham says. It is common for many in the culture to chalk up issues they’re dealing with to simply being the struggles of life, when, in fact, these are manifestations of having survived a trauma-filled past.
“From the foundation of America, there was the idea that we (Blacks) were inferior in body and mind, that we are less than,” Cunningham says. “Jim Crow, segregation, slavery — I don’t think the nation has thought about the mental impact of these injustices. It’s not as blatant as 50 years ago, but it’s had a large impact on the mental health of Black lives. There are layers on layers that have to be peeled back.”
Synergy provides a safe place where members of the Black community can find culturally relevant help, the kind that gives voice and credence to their unique experiences while utilizing best-practices approaches such as cognitive behavior therapy that, if done under the supervision of a professional, consistently show results.
“Your problem is my problem, but your healing is also my healing,” Cunningham says. “We need to support each other — Black, white and all other races. The greatest gift God gave us all is our mental health.”
This story is part of the Mental Wellness Project, a solutions-oriented journalism initiative covering mental health issues in Southwest Michigan, created by the Southwest Michigan Journalism Collaborative. SWMJC is a group of 12 regional organizations dedicated to strengthening local journalism. For more information, visit swmichjournalism.com.