Does Representation Really Matter?

In short, hell yea representation matters!  The End.

Professionally speaking however, I would say that having providers that are representative of your own cultural identity provides an added layer of both comfort and qualified care.

The helping professions span from your dentist to your gynecologist, primary care doctor, ER physician, teacher, school counselor, chiropractor, mental health therapist, pain specialist, massage therapist, entomologist, etc.  And considering that each of these professions began during a time that people of color were valued even less than they are today, we must consider what role racism and bias played in their development.

Now while I would love to explore and am actually really interested in the history of each of these disciplines, I don’t have the time to do the research… soooo, I will task you do that for both of us lol!

But regarding my field, mental health and wellness spaces, let’s get into it!!  So Boom (insert hand clap) …

The next section is a lot of text, but it is soooooo worth the read.  So please bear with me!  Below are a few bullet points taken directly from an article entitled “The historical roots of racial disparities in the mental health system” By Tahmi Perzichilli and published as an online exclusive in Counseling Today:

• In the United States, scientific racism was used to justify slavery to appease the moral opposition to the Atlantic slave trade. Black men were described as having “primitive psychological organization,” making them “uniquely fitted for bondage.”
• Benjamin Rush, often referred to as the “father of American psychiatry” and a signer of the Declaration of Independence, described “Negroes as suffering from an affliction calledNegritude.” This “disorder” was thought to be a mild form of leprosy in which the only cure was to become white. Ironically Rush was a leading mental health reformer and co-founder of the first anti-slavery society in America. Rush did observe, however, that “the Africans become insane, we are told, in some instances, soon after they enter upon the toils of perpetual slavery in the West Indies.”
• In 1851, prominent American physician Samuel Cartwright defined “drapetomania” as a treatable mental illness that caused black slaves to flee captivity. He stated that the disorder was a consequence of slave masters who “made themselves too familiar with the slaves, treating them as equals.” Cartwright used the Bible as support for his position, stating that slaves needed to be kept in a submissive state and treated like children to both prevent and cure them from running away. Treatment included “whipping the devil out of them” as a preventative measure if the warning sign of “sulky and dissatisfied without cause” was present. Remedy included the removal of big toes to make running a physical impossibility.
• Cartwright also described “dysaethesia aethiopica,” an alleged mental illness that was the proposed cause of laziness, “rascality” and “disrespect for the master’s property” among slaves. Cartwright claimed that the disorder was characterized by symptoms of lesions or insensitivity of the skin and “so great a hebetude [mental dullness or lethargy] of the intellectual faculties, as to be like a person half asleep.” Undoubtedly, whipping was prescribed as treatment. Furthermore, according to Cartwright dysaethesia aethiopica was more prevalent among “free negroes.”
• Even at the turn of the 20th century, leading academic psychiatrists claimed that “negroes” were “psychologically unfit” for freedom. And as late as 1914, drapetomania was listed in thePractical Medical Dictionary.
• Researchers further conflated the symptoms of black individuals with perceived schizophrenia of civil rights protests. In a 1968 article in the esteemedArchives of General Psychiatry, schizophrenia was described as a “protest psychosis” in which black men developed “hostile and aggressive feelings” and “delusional anti-whiteness” after listening to or aligning with activist groups such as Black Power, the Black Panthers or the Nation of Islam. The authors wrote that psychiatric treatment was required because symptoms threatened black men’s own sanity as well as the social order of white America.
• The black psyche was increasingly portrayed as unwell, immoral and inherently criminal. This helped justify the need for police brutality in the civil rights movement, Jim Crow laws, and mass incarceration in prisons and psychiatric hospitals, which at times was an exceedingly thin line. In general, attempts to rehabilitate took a back seat to structural attempts to control. Some state hospitals, presided over by white male superintendents, employed unlicensed doctors to administer massive amounts of electroshock and chemical “therapies,” and put patients to work in the fields. Deplorable conditions went unchallenged as late as 1969 in some states.

Now that we have a little snapshot view into of the roots of racism within mental health, let us fast forward to the mistrust that exists between communities of color and those within the “helping professions”.  The history of the justified vilifying of people of color in America, Black people in particular, has created a dynamic in which many Black folk’s cries go unheard, misheard, mis-assessed, misdiagnosed, and mistreated.  Folks start to rely on a little prayer for healing and cognac for pain because history and experience has left a sour taste in our mouths when it comes to “healthcare”.  And while I am all for God’s healing and His will, I also want God’s most qualified care when it comes to my health!

What does all of this mean?  Well, it means that perhaps part of the solution to ensuring culturally informed healthcare is providing opportunities for individuals of color to have access to education and training within the healthcare fields.  And this starts way before medical school…I am talking elementary school, Doc McStuffins level!  Black and Brown children need to be in STEM programs, have science equipment in their labs, be taught about and shown doctors and therapists of color so that they can see from a young age that the opportunities are endless!  Spark the interest and desires early and cultivate generations of Black and Brown children who grow to level out and eventually fix this broken system.

So…representation more than matters.  It can be the difference between life and death.  The difference between a script for pain meds and an order for an MRI.  The difference between a diagnosis of intermittent explosive disorder and an extended conversation to explore racism in the workplace.  The difference between a hysterectomy and specialized fibroid treatment.  Representation allows for a level of understanding that cannot be taught.  It allows for a feeling that, for some, cannot be understood.  And for those reasons alone I will continue to hashtag #representationmatters!

Find the full article referenced above here: https://ct.counseling.org/2020/05/the-historical-roots-of-racial-disparities-in-the-mental-health-system/