Mourning Madness: Untreated, undiagnosed mental illness in the Black community

By Robert Lilly

I gazed at the face. I did not know this young person, although his name seemed familiar to me. It turns out he was the child of a person I knew. I was stunned – another case of a youth arrested for untreated mental illness.

On this particular morning, I woke to a message with my name tagged in it. That meant someone wanted me to look at one specific message.

I sensed something unusual was happening, so I opened my phone to check an app. There he was — a young man easily identifiable by his mugshot, labeled as someone who had been “busted,” according to the caption. The app was dedicated to showcasing people’s arrests, featuring recent mugshots that almost felt like public humiliation, especially for someone’s child. This image revolted me; it emphasized how failures are magnified by sensationalist news coverage.

Barriers to Treatment

Shanoor Seervai, in the 2022 podcast The Dose, discussed systemic issues that hinder Black youth from receiving the care they need. She said, “Because of historical racial biases, Black teens are treated differently from white teens, not just by the criminal justice system, but also by teachers and health providers. The result? Their mental health needs go unaddressed.” — excerpted from “Closing the Mental Health Care Gap for Black Teens,” March 25, 2022.

That’s when the emotions started to rise within me. I, too, had lost a brother to the ravages of chronic mental illness, and have another one who has been imprisoned for the past 20 years, and despite his mental illness, he is being punished to the fullest extent of the law.

I saw in this young person, my two brothers – I saw myself.

Silence is Neglect

We don’t talk about mental illness enough in the lower socio-economic strata of the Black community. At least not in a manner that would lead to understanding and better responses. We seem to shy away from this topic.

I am calling foul on this neglect.

We all know someone who has exhibited symptoms of mental illness. Waiting until there are cuffs, or worse yet,  a casket, before we speak out, or speak up about this enemy that has come to “kill, steal and destroy,” is a sign of our lack of insight.

An Intractable Problem

Mental illness is a reality that is with us and will continue to be with us.

Denial, dismissal, and self-deception do not serve us or our loved ones well.

I understand what it’s like to live with a diagnosis. I have Major Depression, which I was diagnosed with at Betty Hardwick, the (LMHA) Local Mental Health Authority in Abilene, Texas.
I began showing signs of depression long before I even knew what it was. Because no one ever talked to me about my mental health, I couldn’t embrace my own truth and went deep into denial.
This denial resulted in multiple years of incarceration in both Texas and federal prisons, as well as being bound by my addiction.

For years, I self-medicated with alcohol and drugs, which only further complicated my already troubled existence. The same was the case with one of my brothers; the drugs seemed to mask both his and our maladaptive behaviors, so that we ignored what was right there for us to see. He was sick, and so were we. We needed help, not judgment, and definitely not punishment.

The Shame of Being Sick

Why is there shame associated with mental illness? People openly discuss conditions like cancer and receive sympathy; yet, when it comes to mental health, there’s often an expectation to “toughen up” or pray. We must eliminate the stigma surrounding mental illness to find effective solutions to these complex issues.

Mary Brown, a therapist at Wellpoint Care Network, said, “Mental health looks different for different people … I think we have to start having conversations to open the idea of what mental health looks like.”

Mental health, as a reality, must be normalized.

Not to make excuses, but some of this attitude can be understood when we know that psychiatry has its roots in both the twin American evils of slavery and colonialism.

Samuel A. Cartwright, a Louisiana physician who was a strong advocate for slavery, coined the term Drapetomania, which was meant to describe a mental illness exclusive to slaves that caused them to flee bondage. This “disease” was, he claimed, curable by strict enforcement of slavery and even physical punishment. This is a classic case of science being weaponized to oppress the weak.
And so, like our historical oppressors of the past, systems so-named to help us actually perpetuate even more harm. Data shows that Black youth are especially prone to developing mental health issues but less likely to seek out or receive the specialized services and care they need.

We scold them for not having enough faith, or we question their perspective when they say they just might need to see a specialist or therapist. Medications for any illness are lauded as miracles and cures, but the mere suggestion that someone may need medicine to balance their brain chemistry causes them and others to go into a panic. Something is grossly wrong with this narrative.

Looking back, I realize that I have matured greatly in relation to these issues. I was an ignorant denier in my early years, until the raw facts of my brother’s decompensation, right before my eyes in a prison cell that we shared, made denial an unacceptable option.

Initially, my curiosity grew, and I started reading, believing I could solve both his and my problems independently. However, I soon realized that my efforts were only making our situation worse. Circumstances compelled me to trust someone other than myself to guide me toward answers that I couldn’t find on my own.

Crisis in Black and White

We are facing a crisis today. If you observe the youth and even some adults, you will notice the pain and hurt that many are experiencing. Many of us may avoid looking closely because we know that once we see it, we will feel compelled to take action. So we ignore it, thinking that it will go away. “That’s not my problem,” we say.

I contend that you are mistaken; this is a problem that affects every one of us.

In the three years between 2015 and 2018,  major depressive episodes in Black teens increased by 14 percent,  and suicide attempts by Black youth increased by 73 percent between 1991 and 2017. In fact, for all age groups, over the past decade, in Black America, reports of serious mental illness have been on the rise. (Tutt, P., Edutopia. Breaking the Cycle of Silence Around Mental Health.)
More than 14 million students in rural and low-income areas attend schools that have no counselor, nurse, psychologist, or social worker, says Tutt.

The Solution in Living Color

Experts on this topic are urging schools and adjacent organizations to support Black youth by providing services that recognize the unique social and cultural barriers these students face, both inside and outside of the school environment.

Social status influences a person’s access to resources, either providing opportunities or creating obstacles. Some of our kids are going without care, because few places offer care at an affordable rate. Schools are often our frontline of defense.

“(I)n Niagara Falls City School District in New York (Teacher and noninstructional staff) [must] complete a three-part series of mental health first aid, trauma-informed care, and diversity and implicit bias training so they can support the mental health of their Black students with a trauma-informed, restorative lens.” (Breaking the Cycle of Silence Around Mental Health)

What is happening in the home next door could affect your household. Events occurring in the neighborhood down the block might make the news tomorrow. Situations in a community across town may impact your children at school or even your child after they are married. None of us is exempt from this reality. We all share some responsibility, and we are all accountable for finding answers.

Be Ye Transformed by the Renewing of Your Mind

My church in Austin implemented a solution to address the wellness needs of our congregation. At Mt. Zion Missionary Baptist Church, First Lady Shalonda Horton launched The Village program, where members learned to engage one another by asking, “How are you doing?”

We completed a four-week training with a mental health professional from a faith background, learning how to inquire about the mental well-being of our fellow parishioners.
We learned intentional ways to probe that encourage deeper and more honest conversations about how they are truly doing.

This is a solution that anyone, anywhere can follow. You don’t have to be a professional to know how to ask those around you, “How are you doing?”  and to listen actively, with purposefulness.

We Keep Us Safe

If “one in every three Black children in the United States has been exposed to two of the eight adverse childhood experiences, which can have serious long-term effects on a person’s health,” (Williams and Mohommed, 2013), then it is likely that one in three individuals in our congregation may respond that they are not doing well if they were encouraged to be honest with someone. This acknowledgment could be the first step toward changing their outlook on how they want to live their lives.

The normalization of trauma should be replaced with a focus on wellness. Mental health is an integral part of overall health.