Advocating for Our Own Ways of Healing
In recognition of July as National Minority Mental Health Awareness Month, Anise Health has partnered with key opinion leaders at the forefront of research and advocacy for culturally-responsive mental health care. This interview represents the last of our three-part series intended to raise awareness about mental health across communities of color and share resources that support BIPOC mental health needs (see other blog posts in our series: Decolonizing Mental Health in the Black Community with The Fight Inside Society and Sanarai: Reinventing Mental Health for the Latinx Community). Watch the full interview with Dr. Malone here and read below for highlights!
“I was born and raised in NYC, and I identify as a Black cis-gender female. My parents are originally from the British Virgin Islands and are first-generation Americans.”
This is how Dr. Celeste Malone introduces herself and, in doing so, draws out her different identities and influences that contribute to the way she views and shapes the world. All of which are an integral part of who she is, and all of which are integral parts to many of our identities. Dr. Malone is an associate professor at Howard University, a school psychologist, and the current president of the National Association of School Psychologists (NASP) in addition to being one of the leading experts in multicultural competence.
How did you get involved in culturally-responsive mental health care?
“Growing up in Harlem, NY, a predominantly Black neighborhood, I went to a predominantly White high school; that was when it became more clear to me about what other people think. The assumptions that are made and the attempts to approach education, mental health, and pretty much everything from this culturally neutral lens, which ends up being a predominantly White focus lens.”
Education has always been a part of Dr. Malone’s life. She went from undergraduate to graduate studies; she taught for a while and then pursued a doctorate degree. “Issues of culture have always been a part of what I do because it’s what I’ve seen in my experience in education and mental health fields. I recognize that culture is an integral part of the human experience, and we can’t organize it nor can we use a one-size-fits-all approach. It’s especially problematic when we think about the experience of oppression, discrimination, and power that is assocaited with identity; when we don’t take culture into account, not only are we dismissing a part of someone’s lived experience, we are marginalizing them even further.”
Important questions that direct her research and advocacy for culturally responsive mental health care are: “How do we train school psychologists and clinicians to practice in a culturally responsive lens? How do we bring more diversity within our workforce? As psychology and other mental health fields are predominately White, how do we get more racial and ethnic diversity so that we have more providers that look like the populations that we serve?”
What is culturally-responsive mental health care?
“People come to us when they are vulnerable. We seek mental health treatment when we recognize that something is going on with our lives in terms of thoughts and behaviors that are not helpful for us and are making a negative impact on our lives. That help needs to be well aligned in recognizing them in their totality. If you are seeking help and the person that you are going to just totally dismisses a part of who you are that you think is key to you, how effectively can they actually help you?” When you seek mental health services and your clinician is able to recognize and acknowledge all of your identities and influences, that is when you’ve received culturally responsive mental health care.
What does culturally responsive care look like?
The first session of counseling can be quite telling of the mental health care you will receive. While it should be focused on rapport building, it is also indicative of whether a client will drop out of mental health services, especially for racially and ethnically minoritized groups. “If you go through that intake, but not once does the idea of ‘how does your background influence you, or who are you as a person, tell me about your cultural background’ come up, or there is no recognition of what is happening in the world; if a clinician does not recognize any of this, that’s a powerful message of ‘how can this person relate or help me’. We have to ask ourselves: “Are we really getting to the root causes if there is a part of yourself that you feel that you can’t disclose to your clinician?”
Culturally responsive mental health care includes being attentive to our language. “Language does matter. A part of my work in training culturally responsive and socially just school psychologists and mental health providers is that language is important. How we talk about an issue primes us to think about ‘well what is the source of the problem?’ When we use terms like “at-risk” students, we use this as an adjective. What is it that makes this person “at-risk?” No one is born at-risk; they are placed at risk because of something external that is happening to them. Even in report writing, how we describe issues determines how we conceptualize what is the actual problem: ‘Is the problem the student or the circumstances the student is experiencing?’.
“We see the same patterns occurring over and over again, but we don’t see people improving. While they’ve learned skills to help them manage, the circumstances are still the same.” This is when systems-centered language is crucial. Using this language “places the problem on the environment as opposed to the individual. When we frame problems, whether education or mental health related, as an environmental problem instead of an individual problem, that shapes our interventions. The focus is now on how to change the environment and systems as opposed to solely thinking we need to fix this person.”
What have been the greatest challenges and overcomings in terms of culturally responsive mental health for children, especially since COVID-19?
“The pandemic really laid bare the gross disparities that exist in the U.S. along racial ethnic lines. Thinking with an intersectional approach, we have to look at linguistic and class differences, gender, and so forth, and recognize how our system is essentially broken. Schools were scrambling to figure out what we do with students. Part of the decision to close was recognizing that the school system provides a broader service to the children, such as school meals, breakfast and lunch programs. For some students, that is their two meals a day. It really made us take a stark look at how we have failed some communities.”
“When you overlay that with racial reckoning that the country experienced in response to George flyod and Breonna Taylor, this Black Lives Matter Movement was the largest protest in the U.S., only possible because of intersectional coalition building. We were already primed to recognize these disparities at the start and throughout the pandemic. We were forced to really think about how racially, ethnically minoritized communities were disproportionately impacted including death and illness rates in Black and Latinx populations, and the increase of stigma and racism about the origins of the virus towards Asian populations.”
“Adults were suffering and saw firsthand how kids were experiencing challenges as well. Kids were able to recognize and use their own voices, and started vocalizing what it is that they needed. With all of these circumstances, it was important to address what's going on with our kids. Long before the pandemic, there was already a mental health crisis. One out of five children met diagnostic criteria but the vast majority were not able to get treatment. For those who are able to get treatment, it was through school.”
For school-aged children, the pandemic wasn’t just a virus taking away everyone’s health; it took away food, and for some, the only access to mental health services. “It is encouraging to see more school-based mental health” and that financial investment is finally being provided, although it is in its infancy. “There needs to be greater recognition and conversation still. Part of creating better mental health is addressing these societal issues, of how they disproportionately impact people of color and making sure there is consistent access. Schools being the most practical way to get access for the youth.”
What resources related to culturally-responsive mental health care do you recommend for your community?
A barrier to getting culturally responsive mental health care is the lack of knowledge of these services, how to use them, and understanding how these services work. “Clinicians have an ethical code to have respect for diversity and recognize diversity of human experiences and bring that into our treatment. People aren’t always trained to do that, especially when little attention is given to mental health care for minioritized communities. When seeking treatment, ask about that. If it’s important to you, it is important to ask outright. That is okay as well, there is nothing wrong with trying to seek mental health care that works for you.”
“It’s important to note that for individuals from racially ethnically minoritized backgrounds, we have ways of being, healing, and existing that have carried us through. Our communities have survived discrimination before, so it’s important to tap into those cultural strengths. There are still things we can do in terms of being in a community together, leveraging our strengths and cultural values. Thinking of our own acts of resistance; so for some, being involved in social movements and engaging in advocacy can be healing. It provides a sense of ownership and control over your own life. There has been a lot of youth advocacy and activism; kids are coming together to create the schools and the world that they want to live in. These are productive ways of using these strong emotions evoked by experiences of discrimination and oppression. Instead of taking things inward and wondering if something is wrong personally and being critical, recognizing that there are external influences and you have the power to change them especially when doing it collectively.”
What is the next goal or hope for your community?
“I hope we continue to normalize discussions around mental health. It is encouraging to see people have this conversation more and it is largely due to the impact of the pandemic. People were forced to slow down and stop; attend to things they have been trying to ignore.”
“I would love for that movement to also translate for people to be inspired to enter mental health professions. We have ways of being, healing, and existing that have helped our collective survival. This is the type of thoughts and thinking that we need to bring to mental health as well. When we think about diversity, and when we think of how everyone is the same in this field, you’re not getting any type of new thought. So when we think about why we need to increase racial ethnic diversity in mental health, it’s to generate new treatments. Bringing in cultural values and traditions, testing them, and refining them. Learning and developing interventions; we can bring that into our work in a multitude of ways, certainly when we work with individuals and as we heal as individuals ourselves, we’re better able to make those changes to help other people, it’s really this domino effect. I really want to see more people who look like us in the field of mental health.”
Here are some resources recommended by Dr. Malone:
The AAKOMA Project - https://aakomaproject.org/
Therapy for Black Girls - https://therapyforblackgirls.com/
Therapy in Color - https://www.therapyincolor.org/
To learn more about Dr. Celeste Malone, her research, and advocacy efforts, visit the following:
