By Sarah Dickie
At the beginning of May, a few of us at The NAN Project had the privilege of attending the 18th annual Massachusetts Suicide Prevention Conference at the Sheraton in Framingham. The goal of the conference is to increase awareness of suicide as a public health issue by hosting discussions about advancements in the field through various workshops and exhibition tables. In addition to providing an opportunity for us to raise awareness about The NAN Project’s mission, the conference allowed us to expand our own knowledge about how to best carry out our work. I attended a workshop lead by the Mass Coalition for Suicide Prevention’s Alliance for Equity. It focused on the intersection of social justice and mental health: how racism and other systems of oppression impact not only suicide risk, but treatment of the survivor.
Our instructors began by proposing three “shared agreements” for the discussion: make space, share the air, and embrace discomfort. These meant to encourage participants to prioritize the most marginalized voices, and for those with social privilege to hold back, but remain present. I would argue that these are excellent agreements for the wider discussion of suicide prevention, too. Speaking as a white person myself, it’s easy to feel guilty and dismiss the danger when confronted with the realities of racism. Likewise, it’s easy for straight and cisgender folks to do the same when discussing LGBT discrimination. As dedicated leaders of suicide prevention, it’s a duty of ours to consider the social privileges we have, and how oppression contributes to the issue of mental health — even when, and especially when, it’s uncomfortable.
When the presenters opened the floor to participants, they had a lot to say about how people of color are treated in mental health care, and likewise how mental health is treated in their communities. One East Asian woman on the floor explained the pressure from her parents to earn good grades and make money, markers of success that are valued by her family’s culture. Her experiences with anxiety, which hindered her ability to do these things, were brushed under the rug. The culture dictated that she “be good” and “stay quiet” instead of opening up. One presenter, a bisexual East Asian woman, agreed that when she spoke out about her struggle in her youth, she felt “othered” in her community. If there were people like her, they weren’t talking about it.
Professionals in mental healthcare added that they see racial disparities in their work environments every day. For one, youth who access care for mental health concerns in the greater Boston area are mostly white, despite a more diverse general population. This is likely a result of the toxic intersection of stigma and discriminatory care.
“It depends what your color is, what treatment you’re going to get,” one older Black woman said. She went on to explain that Black folks who are mistreated in mental health care facilities are faced with the choice of whether or not to pursue justice, as within other arenas of their lives. She said that the stereotype of the “Angry Black Woman” has dissuaded her peers from doing so. Not only does racism inform the treatment experience for a person of color, but it also informs how and how often that person will talk about it.
Inequity in mental health treatment is a dangerous reality, a symptom of the discrimination that persists in healthcare as it does in the wider world. We know that mental illness is often a result of trauma — we might not know that oppression is trauma. Day after day, marginalized people face the hostility of a racist world. The stress of this builds up, and can result in complications like heart disease and psychological disorder. This is why the Alliance for Equity dubs non-whiteness as a “forever risk factor”: something only social change can combat. Social determinants — like discrimination, education, wealth inequality, and risk of violence — makeup 80% of an individual’s overall health, according to the MCSP. In our efforts for suicide prevention, the Alliance for Equity advises that we “keep the conversation going”: talk about mental health; work to incorporate diverse perspectives; and consider how societal forces impact risk.