America’s Quiet Health Problem

By: Marc H. Morial
President and CEO
National Urban League

Even in this era of intense concern about health, talking about one's mental health—and, more particularly, admitting to a mental illness, or suggesting to someone that they're suffering from a mental illness—remains a profoundly difficult task.

That's why, mental health experts say, it's so often avoided.

This is especially true among African Americans whose general distrust of the medical establishment grows even sharper when it comes to mental health issues.

While there are poignant historical reasons for that wariness, Black America can no longer allow it to be a barrier to learning what mental disorders may be, how to cope with them, and how to improve African

Americans' access to good mental health care.

Not only do undiagnosed and untreated mental disorders exact an enormous toll on individuals and individual families, they also have a larger social impact. They diminish the "human capital"—healthy, functioning individuals—available to Black America.

That's the reason the National Urban league and Eli Lilly and Company, the pharmaceutical giant, have joined in sponsoring a series of community-based discussions across the country with health-care providers, community leaders, and others to develop ways to educate African Americans about mental health.

That's what drew more than three-score community leaders, mental health professionals, and political officials to the inaugural meeting of the series earlier this month at the spacious headquarters of our affiliate in this central Indiana city, the Indianapolis Urban League.
The other cities in which Urban League affiliates and Eli Lilly will co-sponsor these roundtables are Memphis, Philadelphia, Houston and Seattle.

Certainly, the statistics about the extent of mental illness among all Americans reveal in stark terms that we have a problem that needs to be addressed.

For example, Annelle B. Primm and Marisela B. Gomez, two medical doctors writing in the National Urban League's The State of Black America 2005, cited numerous studies to show that annually as many as one in five American adults endure some kind of mental disorder—which is defined as a significant disturbance in their thinking, mood or behavior, or some combination of all three, induced by some sort of distress or impaired functioning.

Their essay, packed with data, points out that depression, ranging from mild and momentary to severe and long-lasting, is one of the most common types of mental illnesses. So common, in fact, that many people who may realize they are depressed refuse to characterize it as a mental illness—such is the power of the stereotypes about mental illness—and don't seek treatment for it.

Thus, if left untreated, depression itself can wreak havoc on an individual's overall health. This is especially true among African Americans—who, while they suffer the same general rate of mental disorders as other Americans, generally do not have primary-care physicians and have less overall access to quality health care.

Add the significant impoverishment that afflicts many black communities and one can easily understand that African Americans as a whole are more threatened by the general American reluctance to discuss and do something about mental illnesses among them.

Thanks in part to the fact that Indianapolis is Lilly's corporate headquarters, there's a significant awareness of mental health issues among local officialdom here.

The city's Deputy Mayor, Steve Campbell, sat in for part of the session; state representatives Gregory W. Porter and William A. Crawford, chairman of the Ways and means Committee of the Indiana lower House, stayed even longer; and Delois Dilworth-Berry, a top official of the Marion County (Indianapolis) Health and Hospitals Corporation, gave a wide-ranging presentation that included discussion how depression had touched a member of her own family.

But undoubtedly the most electric moment of the day occurred late in the session when our affiliate chief executive, Joe Slash, called upon a woman, who had been sitting quietly throughout the event, who then rose to ask a series of questions.

Her daughter, now an adult, with a young daughter of her own, had been struggling for years with recurrent episodes of bipolar disorder, and she often had to care for her granddaughter much of the time.

Where could she go, she wanted to know, to get help for her daughter?

What should she do when her daughter becomes agitated and wanders away? Where could she, on a fixed income, go to get adequate treatment for her daughter? What legal rights did she, the grandmother, have when it came to making important decisions about her granddaughter's schooling and care?

It was evident, even as the seasoned professionals around the conference table began listing for her the myriad mental health services in the city, that the woman's poignant questions had underscored for them the mental health issues that many African Americans (and other Americans) confront every day.

And they also underscored the need for efforts like the Urban League-Eli Lilly collaborative to pierce the veil of ignorance and uncertainty.

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