Montefiore in the News
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Montefiore in the News

February 23, 2022

Mental health providers and startups acknowledge that Black Americans have experienced mental health stresses in individual, nuanced ways, therefore care approaches cannot be monolithic. To provide mental health care in the overall Black community, a specialized touch is necessary, experts and industry players say.

"Over the last two years, we've been faced with a dual pandemic of COVID as well as heightened awareness around racism and anti-Blackness," said Dr. Christin Drake, clinical associate professor and vice chair for diversity and equity in the Department of Psychiatry at NYU Langone Health. "However, the mental health stresses are felt differently by the Black community across socioeconomic strata, and our approach to care must reflect that nuance."

Crafting solutions for mental health challenges has to account for not just socioeconomic status but also immigration status and even geography, said Naiylah Warren, therapist and clinical content manager at Real, a digital platform addressing mental health and wellness.

"When tailoring our clinical content for clients, we have to think of as many access points as possible," she said. "Do they live in a food desert? Do they work in a corporate environment? Are they in a coastal city? These all matter."

Mental health services have to focus on inclusion or cultural competency or they will actively exclude many people from getting support, said Marah Lidey, cofounder and CEO of Shine, a company that helps employers implement mental health and wellness programs.

For example, Shine's platform offers meditations focused specifically on the Black experience that speak to topics like representation burnout and intergenerational trauma. Key to offering such tailored experiences is a diverse team, and Shine has 85% of employees identifying as people of color, Lidey said.

Individualized care has to start with providers, said Dr. Karinn Glover, a psychiatrist at Montefiore Medical Center and an assistant professor at Albert Einstein College of Medicine. Physicians have increasingly received training to look at mental health patients beyond their symptoms and consider their social determinants of health when assessing a plan, she said. Glover and Drake shared that physicians at their respective institutions receive regular trainings on delivering culturally competent care and on conversations surrounding medicine and race.

"A common example would be to recommend exercise for depression," Glover said. "If I want to ask whether a patient can take a walk around the park, I'd have to learn if there are safe parks around, especially if the patient is Black or a woman. And if there aren't safe places, I'd have to consider other viable alternatives."

As much as institutions try to provide racial concordance—where a patient shares a racial identity with the provider—there remain bottlenecks. Of the estimated 41,000 psychiatrists in the country, only 2% are Black, Glover said.

"We're not going to be able to match every Black patient with a Black provider," she noted.

That's why it's important to equip physicians of all races with the right protocols and instill empathy to ask the right questions, Drake said.

But it is not the patient's responsibility to teach the provider about their background, Warren said. It behooves clinicians to proactively think about ways to connect with the patient to learn more.

There remain pressing structural barriers to mental healthcare that need to be addressed, Warren said. Affordability and access are big issues, where a lot of mental healthcare must be paid for out-of-pocket or, even if insurance is accepted, involves a long wait, she said.

But there are causes for optimism, Glover said. Many new digital tools can help members of the Black community find the tailored help they need, such as Hued, a New York–based startup that provides healthcare solutions for Black and Latino communities.

"An analogy I'd liken it to is when my ancestors were driving around in the South back then, they'd have to consult the 'green book' to know which towns were safe for them," Glover said, referring to the travel guide Black travelers used during the Jim Crow era. "We now have digital tools that are instructing Black patients where to find providers for that deeply humanizing experience where they will be listened to."