How Police Killings Lead To Poor Mental Health In The Black Community

Yet another example of the effects of systemic racism on African Americans:

A recent study published in The Lancet Medical journal shows that police killings of unarmed black men leads to poor mental. NPR’s Michel Martin talks with study co-author Dr. Atheendar Venkataramani.

MICHEL MARTIN, HOST:

Now we’re going to talk about a subject that has become one of this country’s flashpoints – police shootings of unarmed black men. It happened again last Tuesday in Pittsburgh, where Antwon Rose Jr. was shot three times as he ran away from police during a traffic stop. A neighbor caught it all on camera. The video was widely shared and inspired three straight days of protests in Pittsburgh.

But the negative effects of that shooting won’t end whenever the demonstrations stop or the reporting ends – this according to a study published in The Lancet medical journal. That study looked specifically at states that had a police killing of an unarmed black man in the three months leading up to the survey. And it found that these violent encounters have a direct effect on the mental health of black Americans living in communities that have experienced police violence. The telephone survey asked respondents how many days their mental health was not good. Black respondents in states with recent police shootings were found to have significantly more of those not good days.

Dr. Atheendar Venkataramani is one of the study’s authors. He’s an assistant professor in medical ethics and health policy at the University of Pennsylvania’s Perelman School of Medicine. He joined me from member station WBUR in Boston, and I started our conversation by asking him why he and his fellow researchers wanted to look into the link between police killings and mental health.

ATHEENDAR VENKATARAMANI: My co-authors and I were very struck by the images of police killings of unarmed black Americans, and we had seen in some small, local studies, as well as through our social networks and on social media, the kinds of things that black Americans who weren’t directly part of the event but had heard about it or read about it or seen it through the videos that were released – the kinds of things they were saying about how they felt – what it made them feel and what their mental state was after viewing or hearing about such an event. And for us, it made us wonder do events like this cross the line from just being upsetting to being something that make us sick? And that’s what really motivated our study.

MARTIN: The facts are that black Americans, as you point out in the study, are nearly three times more likely than white Americans to be killed by police. They are five times more likely than are white Americans to be killed unarmed. I just think that’s important to point out because it’s important to note that white Americans are also killed by the police, but it is far more likely that an African-American male particularly will be unarmed when that occurs.

So part of the reason that I raised that is to ask whether you saw any similar effects of other groups? Like, did, for example, killings of white Americans stimulate a similar effect? Do we have any comparison that we can draw upon?

VENKATARAMANI: Absolutely. So we looked at the police killings of armed black Americans and the police killings of unarmed white Americans, which don’t necessarily have that same kind of salience to people as far as their relationship to structural racism. And when we looked at the impacts of those kinds of events, we didn’t find any impact on mental health nor did we find any impact on mental health of white Americans who were exposed to police killings of unarmed black Americans.

MARTIN: And you know, the survey focused on people and communities where these shootings occurred. But we live in a time when many of these deaths were caught on camera. They’ve been widely shared. Do you feel comfortable extrapolating that this effect may be broader than the people who actually lived in the places where these incidents occurred?

VENKATARAMANI: Yeah, I think we do. And so for example, Eric Garner’s killing was seen by everybody in the country. And for the purposes of our statistical design, we considered people in New York State exposed. So one of the things we think is striking is that we find these large population-level effects even when we know that we are likely to be underestimating the true burden.

MARTIN: The summary says that, you know, the interpretation is that, you know, police killings of unarmed black Americans have adverse effects on mental health among black American adults and the general population. And it suggests that programs should be implemented to decrease the frequency of police killings and to mitigate adverse mental health effects.

What would that look like? I mean, what do you hope people will do as a result of this study which validates what, frankly, has been sort of widely discussed informally among many people for some time?

VENKATARAMANI: We don’t believe we’re telling people in the black American communities something that they don’t know. I think what this study does is provides a public health rationale to further try to understand why police killings occur of unarmed black Americans. And it further motivates policies and programs that would try to reduce those events.

And from the clinical side, as a physician, these events really kind of show you that when something happens in a community that there is a trauma that is a pathology, meaning it’s a true illness, and that health systems – community health centers, public health organizations – can try to rally around people to make sure that people are OK and that we’re treating the burden of disease that’s there.

So I think that’s why it’s useful to put numbers around something that many people have noted anecdotally because it sharpens the case for action, and it also lets us know the scope of the problem and potentially how we would need to address it.

MARTIN: That’s Dr. Atheendar Venkataramani. He’s one of the authors of a study published in The Lancet which looked at the mental health effects of police shootings on black Americans.

Thanks so much for speaking with us.

VENKATARAMANI: Thank you.

MARTIN: I also want to mention that the study was funded by the National Institutes of Health and the Robert Wood Johnson Foundation. The latter is also a supporter of NPR.

Source: How Police Killings Lead To Poor Mental Health In The Black Community

Let’s Talk about culturally sensitive treatments for depression

One of the more interesting articles I have recently read and of particular importance given mental health issues is a diverse population:

Each week Dr. Yusra Ahmad, a psychiatrist and clinical lecturer at University of Toronto, meets six to eight women with a range of mental health disorders at a mosque in the city’s west end. She leads them through a program that combines mindful meditation with concrete skills to manage negative thoughts and regulate emotions.

However, this is not your typical mindfulness therapy. Each session began with prayers from the Qur’an and incorporates teachings from Islamic scholars.

She also uses imagery familiar to the women. For example, when leading a session on mindful eating, instead of using the example of a raisin, as she does with other audiences, she focuses on a date. The reason: Dates have an important role in Muslim traditions, enabling the women to relate to meditation techniques on a more personal level.

Dr. Ahmad is among a growing group of mental health experts who advocate a more culturally sensitive approach to treatment for disorders such as anxiety and depression than the conventional “one-size-fits-all” methods that currently apply.

An approach that recognizes Canada’s diversity, these experts argue, should become an integral part of the conversation on mental health, including during events like Bell Canada’s annual Let’s Talk campaign, which takes place on Jan. 31.

Immigrant mental illness

The argument for more culturally nuanced treatments rests, at least partly, on the idea that many Canadians come from a background where mental disorders are stigmatized and associated with hospital treatment for severe disease such as psychosis.

This stigma not only harms the patient, but often the entire family is ostracized.

Take Saira (not her real name), a 31-year old Muslim African-Canadian human resource manager, who was diagnosed last year with an anxiety disorder. Saira recalls being brushed off by friends and family with words like: “What do you have to be worried about, there’s nothing wrong with you.” Or, “you need to pray more.”

Such advice ended up worsening her feelings of isolation and her anxiety, to the point where she had to take health leave from her job.

Saira found Dr. Ahmad’s Mindfully Muslim program by chance on a Facebook group, after exhausting her options with conventional psychiatric treatment and medications. Dr. Ahmad’s six-week mindfulness program, with elements rooted in Muslim and African culture, gave her renewed hope, she says.

The latest data from Statistics Canada shows that in 2012, 16 per cent of Canadians met the criteria for a mental illness diagnosis.

But the Centre for Research on Inner City Health has found that although immigrants have similar rates of mental illness as people born in Canada, they make far less use of mental health services.

Managing difficult memories

Dr. Ahmad is not alone in her campaign to infuse cultural elements into mental health treatment of specific communities. Leysa Cerswell Kielburger, community program leader at The Centre for Mindfulness Studies in Toronto, has collaborated with Sistering, an organization for “at-risk” women in Toronto, to develop a drop-in mindfulness program for Syrian refugee women.

The program brings about 10 women together every week and facilitates a mindfulness program that centres on the trauma of being a refugee. A mindfulness-based cognitive therapy combines meditation with concrete skills to manage your thoughts, such as learning how to observe your thoughts and not to judge them.

The emphasis during the workshops is on managing difficult memories, taking care of the body and easing the stress of being a newcomer to Canada.

The women benefit from the program, Ms. Kielburger says, because they are in the company of others with the same refugee experience.

What’s more, they are able to talk about their experiences in their mother tongue and can access mental health services where they live, rather than in the more conventional but also more intimidating hospital setting.

Dr. Melinda Fowler, a Métis and Mi’Kmaq primary care physician in Winnipeg, approaches mental health treatment with an emphasis on spirituality — which most Indigenous peoples regard as a core tenet for effective treatment of mental illness.

Thus, Dr. Fowler begins each session with a traditional smudging ceremony aimed at developing a connection with her patients, and at helping them connect to their spirituality.

“There is a legacy of trauma, and mistrust of institutions such as health care in the Indigenous community,” says Dr. Fowler. She takes the view that by incorporating Indigenous customs in the management of mental disorders, patients are able to slowly regain a measure of trust in a system that has eradicated many traditional practices that used to be cornerstones of medical treatment in their communities.

Dr. Fowler is also taking her approach to indigenous mental health into the federal prison system. She has started a pilot program among inmates in the Prairie provinces that incorporates traditional ceremonies as well as Indigenous medicines such as weekay root, or wiikenh, a popular antidote for anxiety.

Spirituality in health

Arji Elmi, a social worker and PhD candidate at the Ontario Institute for Studies in Education, enrolled in Dr. Ahmad’s Mindfully Muslim program as a learning opportunity to improve her skills as a crisis social worker. She says the experience has been transformative in her work.

She often found in the past that religion and spirituality were discouraged in the structured therapy programs offered in crisis centres — due to concerns that patients might feel they were having religion forced on them. Yet for for those Canadians whose spirituality embraces all aspects of their lives it must play an important part in their treatment.

Ignoring the key role of spirituality or religion in a person’s health can deepen the isolation that often leads to mental breakdowns, Elmi says.

Diversity means that therapy must take different forms for different groups, whether it is women discussing their stresses as they farm the land, or of Indigenous ceremonies designed to achieve emotional balance, or Catholic churchgoers filing into the confessional box each week to share their struggles with a priest.

When mental health providers incorporate cultural nuances and engage in community based treatment, they can go a long way towards improving the mental health of the most vulnerable Canadians.

via Let’s Talk about culturally sensitive treatments for depression