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Blacks urged to begin uncommon conversation about mental illness

This article first appeared in the St. Louis Beacon, May 5, 2011 - When he was a kid, Bryan Evans used to feel shame because his father was schizophrenic.

"I wasn't comfortable with it. I internalized the shame because everybody in the neighborhood knew who my father was," said Evans, who now directs suicide education for Mental Health America of Eastern Missouri.

He talked about his experiences of confronting mental illness as a family member and as a social worker when he spoke Wednesday night during a rare public forum on mental illness among African Americans. The event at the Missouri History Museum drew about 150 people. Evans and other speakers acknowledged that the stigma associated with mental illness cuts across racial and cultural lines. But they also said the stigma was especially pronounced among blacks, who were urged to do more to end the silence and encourage victims and families to seek help.

As he grew older, Evans said he began to appreciate the challenges facing his father. He was finally able to talk frankly about the issue with family and others. The experience, he said, is one reason he became a social worker. He urged minorities to leave the forum and continue the discussion "at the dinner table, the lunch table" and even at family reunions.

"This isn't just something I do professionally, but something that we experience and practice in our own home. We're learning from one another, learning from each other's stories."

Part of his work, Evans said, involves educating church leaders. He said that showing ministers and others how to deal with issues surrounding suicide "has been a hard row to hoe, as my grandmother would say. It's been a challenge. The same stigma we hear in this room is also shared by the faith community."

People can help victims through simple gestures.

"Tell the person that you can make the journey with them to seek help. They're more likely to continue their treatment because they were not alone, because someone offered them support."

Other speakers joined Evans in appealing to black St. Louisans to take the issue out of the closet and do more to help victims and families become whole again.

The forum's moderator, Bethany Johnson-Javois, CEO of the St. Louis Integrated Health Network, said people need to understand the history of mental illness in their families and communities. "It's not just an illness of 2010," she said. "If we go back to the experiences of our mothers, grandmothers and great grandmothers, we've actually heard stories in our families that we don't associate with mental illnesses, but they've been there."

Another panelist, Dr. Collins Lewis, a psychiatrist at Washington University Medical School, said minorities were less likely than whites to seek treatment. He says the reasons include mistrust of medical institutions as well as the stigma associated with mental illness. The mistrust extends to minorities other than African Americans, he said.

One study showed that 15 percent of Latinos felt that doctors and other health providers judged them unfairly, and they felt disrespected, Lewis said. He added that "12 percent of African Americans also felt disrespected, as opposed to 1 percent of whites."

People who are mentally ill "become embarrassed or feel shame or try to hide their symptoms. Some don't want to go to treatment, or turn to primary care (doctors) or emergency rooms (for help) as opposed to specialized mental health treatment. This stigma lowers self-esteem and causes people to isolate themselves more, which causes hopelessness."

One overlooked challenge involves children living in household where a parent may suffer from mental illness, said Ponchita Argieard, a school social worker in the University City School District.

"What happens in the broader community also affects children," says Argieard, who was in the forum's audience. Children "feel the impact of families facing unemployment, disease, mental illnesses and incarceration. All that is brought into the schools because the children can't separate themselves from these problems. It affects their academic performance, their social and emotional health."

One of the persons responsible for setting up Wednesday night's public discussion was Justin Idleburg, who was also one of the panelists. Idleburg, who is bipolar, is an advocate at the Independence Center in the Central West End. He's also one of the few African Americans in St. Louis to speak openly about his mental illness.

"We need meetings like this to help people learn to accept what may be new to us. It's important to have these kinds of discussions because we don't support each other enough."

Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.