Mental health initiative targets black students’ well-being

On 15 February the newly elected United States Senator John Fetterman checked himself into Walter Reed Army Medical Center near Washington DC for depression. Mental health professionals across the United States praised the senator from Pennsylvania both for seeking help and for being public about his mental health struggles.

Vivek H Murthy, the US surgeon general, tweeted that he hoped Fetterman’s “courage will serve as an example to others”. Doctors noted that Fetterman’s depression may be an after-effect of the stroke he suffered last May just before the primary election, which he won, defeating the celebrity doctor Mehmet Oz for the senate seat.

Coincidentally, two days before Fetterman entered the hospital, the United Negro College Fund (UNCF), the Thurgood Marshall College Fund (TMCF) and the Steve Fund announced an unprecedented national programme, ‘Unapologetically Free’ (UF), to address the mental health crisis on the campuses of America’s 102 historically black colleges and universities (HBCUs) and the nation’s 64 predominately black institutions (PBIs), an announcement that was all but ignored by the American news media.

Backed by the Steve Fund, a Providence, Rhode Island-based organisation dedicated to supporting the mental health and emotional well-being of young people of colour, which will be donating its services for two years, UF will allow, through a series of virtual workshops, HBCUs and PBIs to train faculty and staff on mental health issues, develop culturally specific mental health resources and work towards reducing the stigma among HBCU students against seeking mental health support.

In April UF will mount a virtual student conference. The initiative includes a first-of-its-kind mental health research survey of students enrolled in HBCUs and PBIs. At the same time that the UF initiative is rolling out, some HBCUs will be hiring new psychological counsellors.

Dr Annelle Primm, senior medical director at the Steve Fund, said: “The Steve Fund is working to position UNCF students to achieve optimal mental health by equipping them with the skills, tools and knowledge they need to thrive as young adults, scholars and leaders.

“Through our collaboration with the UNCF, the Steve Fund expands its important partnership with higher education to foster the emotional well-being of students of colour through productive dialogue, effective policies and the successful promotion of access to potent, culturally salient resources. It is imperative that the Steve Fund supports HBCUs in their critical mission.”

A national crisis

In large measure, students at HBCUs and PBIs are dealing with the same mental health issues as students on campuses across the United States (and, indeed, much of the world): COVID-19 caused anxiety, depression and loneliness.

Last October, the college and university search portal BestColleges reported that 95% of students who responded to an online survey reported that COVID-19 had negatively affected their mental health: 46% reported feelings of social isolation, 45% increased anxiety, 36% increased depression, 35% increased severity of stress and 32% loss of hope or a sense of helplessness.

A survey conducted by the UNCF in 2021, which found that 37% of students at HBCUs believed their mental health had declined during the COVID-19 pandemic, broadly tracked the general trend in the US. By contrast, a similar survey conducted by the UNCF and the Steve Fund last year revealed an alarming statistic: 60% of HBCU students met the criteria for one or more mental health problems.

“COVID presented a very different, very new dynamic in university life. Many students began to see an exacerbation of negative mental health symptoms, illnesses and depression, anxiety and feelings of loneliness,” said Leonardo Glover, who is director of counselling and student wellness at the University of Arkansas at Pine Bluff (50 miles south of the state capital of Little Rock) and a practising psychologist.

Speaking broadly, he said: “In my professional opinion, this generation of college-aged students is not emotionally and mentally equipped to deal with social let-downs. Because of social media, they have much higher expectations, that everybody wants to be their friend and things of that nature.

“You do that in the world of social media, but you live in this one and when your life doesn’t measure up to the social media narrative, they tend to feel bad about themselves. They lose confidence and struggle with their self-esteem. This leads to a host of other issues, including depression, anxiety and worries,” said Glover.

Since September, approximately 130 students, or 6.5% of the school’s student body of 2,000, have sought mental health support. Glover suspects that this is just the tip of the iceberg.

“Those are the ones who have the courage to come forward or have been referred by administrators or teachers or friends and have overcome the stigma to seek professional help,” he told University World News.

The 2022 UNCF-Steve Fund survey bears out Glover’s point. While 72% of respondents know of the psychological counselling options on the campus, only 52% said they felt comfortable availing themselves of professional help.

Distrust of the medical establishment

The African American students at HBCUs and PBIs differ in a number of ways from their white peers, who make up more than half of America’s college and university undergraduates.

First, there is a stigma in the African American community related to seeking mental health services that is linked to the community’s general distrust of the medical establishment.

This distrust stems from the American medical establishment’s history of racism. In the decades before the American Civil War, Dr J Marion Sims, the founder of gynaecology, operated on enslaved women without their consent and without anaesthesia. Until the 1970s, African American women were sterilised without their consent at rates many times that of white women (almost all of whom were poor).

In the infamous Tuskegee Syphilis Study, which ran between 1932 and 1972, almost 400 African American men were infected with syphilis without their knowledge: 128 died from syphilis, 40 of the men’s wives became infected with syphilis and 19 of their children were born with congenital syphilis.

Additionally, over the decades, instead of working to strengthen African American families in crisis, Children’s Aid Societies in both the South and the North were (and remain) quick to remove children from their homes and often placed them in substandard group homes or dangerous foster homes.

Referring to these and other similar events, Julian Thompson, director of the UNCF’s Institute for Capacity Building, said that it’s unsurprising that African Americans are reticent about seeking professional help for psychological problems: “The medical field in this country has betrayed the confidence of black people over the course of its existence.”

The students at HBCUs like the University of Arkansas at Pine Bluff (UAPB), which is in the Deep South, have another reason to hesitate before seeking professional psychological care: their evangelical protestant religious beliefs.

“We’re in the Bible Belt, where you always take your problems to God through prayer. But, you know, even though I’m a firm believer and follow religious practices, people need real-world strategies, techniques and skills that they can implement outside of just their spiritual or religious practices,” Glover told University World News.

The influence of both the African American community’s distrust of the medical system and evangelical religion combine to produce a social expectation that psychological issues will be kept within the ambit of the family or very close friends.

A study Glover had recently seen reported that 70% of African American students in psychological distress would call their mothers first. The UNCF-Steve Fund survey found that more than 65% of HBCU students said that in a mental health crisis they are most likely to turn to friends or family members. Yet 45% said they would not speak to anyone if they were in psychological distress.

Glover sketched out the family dynamic this way: “What goes on in our home or with our family members is staying right here. We don’t need to let anybody know what is going on with Aunt Kate or Uncle Johnny. We can just keep all that inside.”

Since he already knew my doctoral thesis was on Charles W Chesnutt, America’s first major African American short story writer and novelist, he did not have to sketch out the history of how mental health authorities across the United States were quick to declare African American men and women non compos mentis and institutionalise them.

The stress of being black

The students at Glover’s university in rural Arkansas and at the other HBCUs around the country have to cope with stresses that whites at other colleges and universities don’t (but, of course, African Americans at predominately white institutions do also).

First among these stresses is being African American. For a number of reasons, including being disproportionately members of the poorest demographic, but also because of the racism that is prevalent in much of America, African Americans suffer stress-related diseases – hypertension, heart disease, diabetes, insomnia – at rates far higher than white Americans.

As well, African Americans struggle with the intergenerational trauma not just of slavery but with the century of Jim Crow laws that followed. Jim Crow was, essentially, state-defined second-class citizenship, which can be thought of as American apartheid, that was not officially ended until the mid-1960s.

Thompson described how, to borrow a phrase from Karl Marx, this historical nightmare “weighs on the brains of the living”.

“At least from my vantage point, when you are a student that has come from a community that experiences oppression – and students who are descendants of enslaved Africans can consider themselves among that group – you experience two phenomena simultaneously. First, you experience all the disparities that the world has presented because of your oppression, whether that’s economic, physical, social – or the ability to access certain spaces and networks, as well as media imagery.”

When I asked Glover a similar question, I included reference to the spate of telephone bomb threats suffered by HBCUs between November 2021 and March 2022 and the incipient threat of violence African Americans live with daily.

UAPB, he told me, is in a city that has been majority African American since the early 1900s and is in a majority African American county. Accordingly, he said, UAPB’s students did not feel threatened on their campus.

And yet, a moment later, in a tone, somewhere between sorrow and concern, that I’ve heard African Americans I’ve interviewed use many times, he said: “The students understand that they live in America.”

The psychological impact of living in an America in which the promise of full citizenship has gone unfulfilled and, in some ways, has receded with the rise of Donald Trump’s MAGA (Make America Great Again) is different for different groups of students.

“You have a contingent of individuals who actually use that as a motivation to strive harder and to work hard and do more because they understand that, basically, it is not a fair race. In order to get caught up in that race, you have to work hard.

“Then, there’s a second contingent that basically looks around and is pissed off; who asks, ‘Why is this still going on? Why did they do all those civil rights marches and things of that nature 60 years ago and we still have to deal with this now?’ And then there’s a third group, and this is probably the smallest, who look at this stuff and they kind of give up because they feel a sense of inferiority.”

The limits of resilience

Each of the persons I interviewed stressed that the African American community and the students who attend both HBCUs and PBIs were resilient. “We come from a community of people that are deeply resilient, that have been resilient in the face of adversity that can be hard to describe to the modern mind,” Thompson told University World News.

Victoria Smith, strategy analyst with UNCF’s Institute for Capacity Building, agreed with Thompson, citing what she saw of how undergraduates came together and supported each other at the famed HBCU, Howard University in Washington DC, when, like almost all colleges and universities in the United States, it turned to online teaching in the early months of the COVID-19 pandemic.

However, Smith, who is now a lawyer, who grew up in the predominately white, small city of Acworth, Georgia (35 miles or 56 kilometres northwest of Atlanta) said: “When I got to Howard, it felt like a safe space. It felt safe to be myself. But it is tough to be resilient all the time and to put on a brave face [in the context of racism] all the time.”

A few minutes later, we returned to the topic and after saying that the COVID pandemic gave people a sense of what it means to have to be resilient, Smith said: “It becomes exhausting. Having to do that for your entire life is even tougher.

“Sometimes I can’t be angry in the way I would like to be angry. I see other people being angry, but if I’m in a room, I have to make sure my voice sounds a certain way to make people comfortable. That’s because when I say my life, I mean my livelihood as well.

“If I react in a certain way, the punishment for me or consequence for me might be different than for somebody else. I want to be able to express the full range of emotions, without being concerned that I could lose my job because of the stigma that comes along with who I am, what my identity is, as a black woman.”

Brandi Pretlow, vice-president for programmes and services at the Steve Fund, agreed.

“Where we are in the US in this day and age, there’s a sense of, we don’t know what’s coming next. Resilience is a huge part of managing one’s day-to-day life, but we’re connecting it to ‘Unapologetically Free’ in the sense that today, I can’t or don’t want to be resilient. I’m free to make that choice. And I think that that conversation isn’t always had.”

Cultural competence

Eliminating the stigmas that prevent many African American students from accessing professional psychological help requires, Glover and the others interviewed for this article said, changing the narrative about mental illness and psychological care.

In the immediate term, said Pretlow, the UF initiative will see the development of culturally responsive resources and training of mental health experts and professionals who know and understand the communities they will be working in. In the longer term, the Steve Fund is looking to diversify the psychiatric field by supporting African American students in university.

When Glover told me that UAPB has recently hired a new counsellor and plans to hire another in the fall, our discussion turned to why it was important for each to be African American. While non-African American counsellors can provide good psychological care, the history of American racism would make creating a therapeutic environment more difficult.

Non-African American counsellors would largely lack what’s called “cultural competence”, such as short-hand expressions unique to different demographics and the expected, sometimes stereotypical, family dynamics.

“In order to create an environment that is conducive to sharing information, people have to be comfortable. If I’m not comfortable with you, I’m not going to share that. If I come in and see an African American counsellor, [I know] they understand my culture, they understand certain things, and I don’t have to explain everything.”

Finally, Glover focused on the internal thought processes of the reticent UAPB student seeking professional psychological care.

“As human beings we’re still visual. I see you before I ever speak to you. We make judgments. We have perceptions about things when we first see a person. Now, hopefully, we all have the patience and willingness to at least have a conversation with a person before making any long-term judgments about the person. But initially, everything goes on sight.

“So, the simple fact that I’m picking a counsellor who is African American is going to put me at ease. It’s going to, at first, at least, put me at ease. And it’s going to allow me to open up more readily than with persons of another race or culture,” said Glover.