1 00:00:00,000 --> 00:00:04,040 The U.S. mental health system requires significant improvement. 2 00:00:04,040 --> 00:00:08,760 The system leaves many people and families facing challenges accessing resources and 3 00:00:08,760 --> 00:00:10,360 receiving treatment. 4 00:00:10,360 --> 00:00:15,920 Meanwhile, the weight of mental health disorder and suicide has significantly increased among 5 00:00:15,920 --> 00:00:22,800 Black and African-American communities, leading to significant racial disparities for Black 6 00:00:22,800 --> 00:00:25,320 families across the country. 7 00:00:25,320 --> 00:00:32,240 In this episode of Badly Governed, our guest speaker, Cole Voyard, discussed with us the 8 00:00:32,240 --> 00:00:38,560 occurrence of suicide among Black youths and what needs to be done. 9 00:00:38,560 --> 00:00:43,400 Cole Voyard is a veteran psychiatric master prepared nurse. 10 00:00:43,400 --> 00:00:49,200 He has been working in mostly all capacities for over 30 years to ensure that patient-centered 11 00:00:49,200 --> 00:00:53,660 care remains at the forefront of all nursing thinking. 12 00:00:53,660 --> 00:00:58,480 Working process while meeting, planning, and caring for all our vulnerable population 13 00:00:58,480 --> 00:01:00,600 struggling with mental illness. 14 00:01:00,600 --> 00:01:01,600 Welcome to the podcast. 15 00:01:01,600 --> 00:01:02,600 Thank you. 16 00:01:02,600 --> 00:01:03,600 Thank you, Andrew. 17 00:01:03,600 --> 00:01:05,040 Well, thank you. 18 00:01:05,040 --> 00:01:11,920 Just in February 2023, the CDC reports a disturbing trend among Black children between the ages 19 00:01:11,920 --> 00:01:14,680 of 10 and 24 years. 20 00:01:14,680 --> 00:01:22,280 The data shows that from 2018 to 2021, the rate of suicide among Black children increased 21 00:01:22,280 --> 00:01:24,480 by 37%. 22 00:01:24,480 --> 00:01:29,880 The same data shows a decrease among White children in the same age group. 23 00:01:29,880 --> 00:01:36,600 However, it is not understood why this phenomenon is occurring to this specific population. 24 00:01:36,600 --> 00:01:43,960 In your opinion, why do you think Black youths are dying at an alarming rate through suicide? 25 00:01:43,960 --> 00:01:57,160 I would say loneliness, hopelessness, lack of support, shame, ignorance, adverse childhood 26 00:01:57,160 --> 00:02:07,520 experiences, racial discrimination, PTSD from the death of Trayvon Martin, Michael Brown, 27 00:02:07,520 --> 00:02:14,440 and other young Black individuals, and the psychological barriers, the stigma related 28 00:02:14,440 --> 00:02:16,440 to mental health treatment. 29 00:02:16,440 --> 00:02:17,440 Right. 30 00:02:17,440 --> 00:02:20,200 So, go ahead, please. 31 00:02:20,200 --> 00:02:30,520 I think with all of that, it's been extremely, in addition to COVID and all this, on top 32 00:02:30,520 --> 00:02:39,160 of that, I think COVID didn't help the situation because the isolation on top of it makes things 33 00:02:39,160 --> 00:02:41,600 a little bit more difficult. 34 00:02:41,600 --> 00:02:47,440 Do you think perhaps during the pandemic, the fact that a lot of Black youths experienced 35 00:02:47,440 --> 00:02:53,880 loss, a sense of loss, not just the isolation, but a lot of them, their parents were actually 36 00:02:53,880 --> 00:03:05,240 front desk workers or taxi drivers or Uber drivers, service delivery type work that they 37 00:03:05,240 --> 00:03:11,600 were doing, and therefore, they sort of had to go out even in the middle of the pandemic 38 00:03:11,600 --> 00:03:18,000 while it was at its highest, and a lot of them sort of endured loss in their family, 39 00:03:18,000 --> 00:03:21,320 whether it was a parent or a grandparent or a brother or a sister. 40 00:03:21,320 --> 00:03:29,320 Do you think this sort of all kind of added to some of the pre-existing conditions that 41 00:03:29,320 --> 00:03:34,960 were causing Black people stress, Black kids stress already? 42 00:03:34,960 --> 00:03:43,040 Like I said, it's been so complex that it's hard to really pinpoint out exactly what happened, 43 00:03:43,040 --> 00:03:52,640 and you also have the phenomenon where a lot of people had those parents always at work 44 00:03:52,640 --> 00:03:57,520 doing a lot of things, so now the parents had to stay home, and they're like, okay, 45 00:03:57,520 --> 00:03:58,520 who are you? 46 00:03:58,520 --> 00:04:09,880 They both had to truly trying to understand each other or learning each other and learning 47 00:04:09,880 --> 00:04:16,080 to know who my son or who my daughter was truly. 48 00:04:16,080 --> 00:04:26,520 That person who had been living in that house for so long with certain identification that 49 00:04:26,520 --> 00:04:35,760 perhaps they never know, certain personality, certain social anxiety, certain behavior, 50 00:04:35,760 --> 00:04:44,680 none of that or all of that had to be exposed because of the COVID situation as the parents 51 00:04:44,680 --> 00:04:49,280 had to stay home, most of them, during the pandemic. 52 00:04:49,280 --> 00:04:50,280 That's a good point. 53 00:04:50,280 --> 00:04:56,160 So what do you think within the same vein, the world, that technology sort of had to 54 00:04:56,160 --> 00:05:03,600 play during the pandemic where children went from a classroom setting and now they're being 55 00:05:03,600 --> 00:05:11,640 taught through this device or technology at home, and the parents sort of had to have 56 00:05:11,640 --> 00:05:15,960 some sort of more involvement, I should really say they've always had involvement in their 57 00:05:15,960 --> 00:05:20,360 school schooling, their kids' schooling, but there's more involvement to set up this 58 00:05:20,360 --> 00:05:25,960 technology and help it being available to help assist them with this technology. 59 00:05:25,960 --> 00:05:33,320 Now do you think having to add that technology to these kids, even though a lot of them are 60 00:05:33,320 --> 00:05:39,240 very savvy, technology savvy, but do you think that added to the level of stress that, for 61 00:05:39,240 --> 00:05:42,520 instance, they were already experiencing with school? 62 00:05:42,520 --> 00:05:54,480 Certainly, yes, because at least they don't have school provide mentor or tutor so much 63 00:05:54,480 --> 00:06:06,960 support that most of even the immigrant parents, the folks who don't have that, a lot of black 64 00:06:06,960 --> 00:06:20,120 kids don't have that, those type of parents with the knowledge, the education that could 65 00:06:20,120 --> 00:06:29,120 help them, I think that create, I'm sure that create a lot of stress and added stresses 66 00:06:29,120 --> 00:06:32,240 to their time during the pandemic. 67 00:06:32,240 --> 00:06:42,760 I think the pandemic overall was never a joy for anyone and of course could contribute 68 00:06:42,760 --> 00:06:50,800 to added stresses and anxieties to most of these children. 69 00:06:50,800 --> 00:06:52,960 That's a very good point. 70 00:06:52,960 --> 00:07:02,440 Also the Lancet published an article last year, last August actually, and they're hinted 71 00:07:02,440 --> 00:07:10,360 that a few clues to us, and they said that the reason for such an increase in suicide 72 00:07:10,360 --> 00:07:22,520 actually were multifactorial, including mental health issues and disruption to the social 73 00:07:22,520 --> 00:07:27,600 relationships that the kids used to have. 74 00:07:27,600 --> 00:07:36,400 The CDC data actually shows a decrease in the white populations in that same age group. 75 00:07:36,400 --> 00:07:40,320 They went through the same experience with COVID. 76 00:07:40,320 --> 00:07:42,480 Can you help explain that? 77 00:07:42,480 --> 00:07:49,760 What would you think attributed to such a discrepancy between two different races in 78 00:07:49,760 --> 00:07:52,320 the same age group? 79 00:07:52,320 --> 00:07:54,320 I would say kudos to the white community. 80 00:07:54,320 --> 00:08:05,360 I think as you can see with the social media, a lot of good things have happened lately 81 00:08:05,360 --> 00:08:17,920 where many shows have exposed the mental health and really present the mental health as something 82 00:08:17,920 --> 00:08:28,000 that normal, something that most of folks with in the white community or people with 83 00:08:28,000 --> 00:08:37,520 some what we would call money would use as something relaxing, as something helpful, 84 00:08:37,520 --> 00:08:39,840 as something productive. 85 00:08:39,840 --> 00:08:47,760 So I think that helps the media in all of that to help the folks in the white community 86 00:08:47,760 --> 00:08:51,440 to accept mental health as something positive. 87 00:08:51,440 --> 00:09:07,000 So we hope that we could at least that would start becoming a trend in the other culture 88 00:09:07,000 --> 00:09:10,680 where we could see it as something positive. 89 00:09:10,680 --> 00:09:17,040 We could use it as something positive because it is something helpful that people need to 90 00:09:17,040 --> 00:09:27,800 use instead of seeing it as something negative as the stigma presented it. 91 00:09:27,800 --> 00:09:32,480 So you think the attitude and the beliefs of white people can help in that sense? 92 00:09:32,480 --> 00:09:33,480 Definitely. 93 00:09:33,480 --> 00:09:34,480 Definitely. 94 00:09:34,480 --> 00:09:35,480 Okay. 95 00:09:35,480 --> 00:09:45,880 So how do you think we as public health advocates can sort of help narrow that gap and improve 96 00:09:45,880 --> 00:09:51,680 the attitude and some of the beliefs that the black community has as it relates to mental 97 00:09:51,680 --> 00:09:56,680 health? 98 00:09:56,680 --> 00:10:00,080 I think first of all we have to look at the stigma behind it. 99 00:10:00,080 --> 00:10:08,040 The stigma can include the reluctance to seek help in our treatment, the lack of understanding 100 00:10:08,040 --> 00:10:17,560 by family, friends and co-workers and others, the fewer opportunities for work, school or 101 00:10:17,560 --> 00:10:28,000 social activities or trouble finding housing, the bullying in the school, physical violence 102 00:10:28,000 --> 00:10:35,800 or harassment, health insurance that doesn't adequately cover your mental health treatment 103 00:10:35,800 --> 00:10:42,760 that needs to really improve greatly, the belief that you'll never succeed at certain 104 00:10:42,760 --> 00:10:49,360 challenges or that you can improve your situation once you have mental health, those got to 105 00:10:49,360 --> 00:10:50,360 go. 106 00:10:50,360 --> 00:11:01,000 So I think to help we really need to take steps to cope with those stigma which is get 107 00:11:01,000 --> 00:11:10,120 treatment, don't let the stigma create the self-doubt and shame that it brought to most 108 00:11:10,120 --> 00:11:17,800 of us, don't isolate yourself, those are the signs and symptoms that family, friends, people 109 00:11:17,800 --> 00:11:27,120 need to start looking at when you have kids at home, don't equate yourself with that illness, 110 00:11:27,120 --> 00:11:35,080 illness like any illness, mental health or diabetes or anything, it's an illness, you'll 111 00:11:35,080 --> 00:11:46,920 treat it as an illness but you cannot say I am, you cannot equate yourself to it because 112 00:11:46,920 --> 00:11:53,440 at the end of the day you will take care of that illness and you will move on so you should 113 00:11:53,440 --> 00:12:00,440 not really equate yourself to the illness, then I would always say to join yourself and 114 00:12:00,440 --> 00:12:05,280 your family, to join support groups so that you can understand better how to treat yourself 115 00:12:05,280 --> 00:12:15,360 and treat the illness and then get help at school, there's always support around but 116 00:12:15,360 --> 00:12:20,480 be vocal, let them understand what you're going through so they can be more supportive 117 00:12:20,480 --> 00:12:28,560 to you, speak out against the stigma, that's the only way you can really be above it versus 118 00:12:28,560 --> 00:12:30,240 suffer from it. 119 00:12:30,240 --> 00:12:35,480 I think that's a very good point but I also think that there needs to be some significant 120 00:12:35,480 --> 00:12:42,760 social changes that occurs at various levels, not just the individual but also community 121 00:12:42,760 --> 00:12:50,960 and system level in order for stigma to stop being addressed and start to disappear. 122 00:12:50,960 --> 00:12:59,920 So just prior to Governor Baker leaving office, he did pass a mental health law which requires 123 00:12:59,920 --> 00:13:06,740 that just like a physical exam, annually every single individual as part of the standard 124 00:13:06,740 --> 00:13:13,800 of care gets a mental health exam, I think that's going to actually start addressing 125 00:13:13,800 --> 00:13:20,600 the stigma issue that you bring up but do you think this law, and it's okay if you 126 00:13:20,600 --> 00:13:27,080 don't have an opinion about it, but do you think this law sort of went far enough in 127 00:13:27,080 --> 00:13:34,200 terms of a way of addressing this mental health issue, especially when it comes to youth mental 128 00:13:34,200 --> 00:13:41,400 health who feel isolated, alone, a lot of them are suffering from PTSD and depression. 129 00:13:41,400 --> 00:13:47,760 So do you think just a screening is enough or are there other components that this law 130 00:13:47,760 --> 00:13:52,800 could have incorporated in it in order to provide youth more support? 131 00:13:52,800 --> 00:13:56,760 No, I don't believe this is enough. 132 00:13:56,760 --> 00:14:03,020 Why I'm saying that is because if you do have a law but you don't have the infrastructure 133 00:14:03,020 --> 00:14:06,040 with the law, it really doesn't help. 134 00:14:06,040 --> 00:14:09,940 And I'm going to explain why. 135 00:14:09,940 --> 00:14:17,600 You have the law but you have the myself here in the Commonwealth that pays less than all 136 00:14:17,600 --> 00:14:20,400 the private entity. 137 00:14:20,400 --> 00:14:34,520 How that helps folks like the black community who really, most of their parents, they don't 138 00:14:34,520 --> 00:14:38,040 have enough income so of course they're going to have to have myself. 139 00:14:38,040 --> 00:14:46,160 Then myself doesn't pay the provider equally as Blue Cross, Blue Shell, equally as Harvard 140 00:14:46,160 --> 00:14:47,560 Pilgrim. 141 00:14:47,560 --> 00:14:54,360 So no provider wants to deal with myself, therefore you can have all type of problem. 142 00:14:54,360 --> 00:14:59,440 You can want any type of mental health screening but you won't get it because you don't have 143 00:14:59,440 --> 00:15:05,760 any provider in your system who wants to deal with your mental health issues. 144 00:15:05,760 --> 00:15:06,760 Do you see what I'm saying? 145 00:15:06,760 --> 00:15:07,840 Yeah, I totally see it. 146 00:15:07,840 --> 00:15:13,640 But are providers actually accepting mass health at all? 147 00:15:13,640 --> 00:15:16,840 Most of the providers don't and that's the crisis that we have. 148 00:15:16,840 --> 00:15:21,960 We have a lot of providers who refuse to deal with myself because myself is not paying well. 149 00:15:21,960 --> 00:15:29,440 So I think the issue has to be equally dealt with the fact that if you have a law, you 150 00:15:29,440 --> 00:15:36,760 have also to get the insurance, the public insurance to pay equally like the private 151 00:15:36,760 --> 00:15:41,400 insurance so people can get the treatment they need anytime they want it and anywhere 152 00:15:41,400 --> 00:15:42,920 they want it. 153 00:15:42,920 --> 00:15:50,840 Yeah, so Dr. Christine Crawford actually does share the same sentiment as you do. 154 00:15:50,840 --> 00:15:59,080 She thinks that stigma plays a big role in it and also the lack of providers and access 155 00:15:59,080 --> 00:16:09,640 to care whereby it's sort of impeding families from getting diagnosed and even receiving 156 00:16:09,640 --> 00:16:10,640 adequate care. 157 00:16:10,640 --> 00:16:11,640 Of course. 158 00:16:11,640 --> 00:16:15,440 But it's compounded by even provider biases. 159 00:16:15,440 --> 00:16:27,200 So she basically was talking to a reporter at ABC News and she brought another point 160 00:16:27,200 --> 00:16:33,920 to the conversation is why the general public doesn't seem to be aware of this gross inequity 161 00:16:33,920 --> 00:16:35,940 in the black community. 162 00:16:35,940 --> 00:16:43,160 So the question that I have is why do you think it has taken so long for this issue 163 00:16:43,160 --> 00:16:44,160 to surface? 164 00:16:44,160 --> 00:16:50,800 It only surfaced just this year by the CDC in February of this year. 165 00:16:50,800 --> 00:16:55,960 Yes, there's been a lot of evidence in the literature of other research work that signaled 166 00:16:55,960 --> 00:16:56,960 this. 167 00:16:56,960 --> 00:17:02,000 But why do you think that it's only taken this year for the CDC to really take a position 168 00:17:02,000 --> 00:17:06,600 on this and alert the general public that this is a real issue that's going to be very 169 00:17:06,600 --> 00:17:12,960 complex and that's going to take a lot of resources and a long time to fix? 170 00:17:12,960 --> 00:17:19,240 And why has it been so slow for people actually to see the urgency of it? 171 00:17:19,240 --> 00:17:22,520 Can you speak to that? 172 00:17:22,520 --> 00:17:34,240 It's sad, to me it's like a crisis that brings death that should be much more an alert to 173 00:17:34,240 --> 00:17:42,680 family because we should not be looking at death and not paying attention to it. 174 00:17:42,680 --> 00:17:44,640 It's really sad. 175 00:17:44,640 --> 00:17:51,960 We are so behind as being the number one nation and this is unfortunate and it doesn't make 176 00:17:51,960 --> 00:17:54,240 sense to me. 177 00:17:54,240 --> 00:18:00,240 It remains a fact that our society is fighting with themselves, struggling to acknowledge 178 00:18:00,240 --> 00:18:12,520 and accept the color as a factor, especially in 2023. 179 00:18:12,520 --> 00:18:16,720 They are making decisions and policies that are not favorable to the black community, 180 00:18:16,720 --> 00:18:22,080 which is completely to me absurd. 181 00:18:22,080 --> 00:18:31,640 But like the doctor is pointing at, even on a general practice, I do work sometimes in 182 00:18:31,640 --> 00:18:39,400 the emergency room, you see many, many people come in on a regular basis, come in with suicidal 183 00:18:39,400 --> 00:18:47,680 thoughts because they've been waiting for six months for a mental health appointment. 184 00:18:47,680 --> 00:18:50,680 What is that? 185 00:18:50,680 --> 00:18:54,360 We're not living in a rural area here. 186 00:18:54,360 --> 00:18:56,320 This is Massachusetts. 187 00:18:56,320 --> 00:18:58,060 This is what? 188 00:18:58,060 --> 00:19:04,080 One of the richest states in the United States and we have people waiting for six months, 189 00:19:04,080 --> 00:19:07,360 nine months, a year to get a mental health appointment. 190 00:19:07,360 --> 00:19:08,360 This is ridiculous. 191 00:19:08,360 --> 00:19:10,440 You're not going to mention some of the best hospitals in the country. 192 00:19:10,440 --> 00:19:15,200 I'm telling you, this is absolutely absurd to me and really this needs to be looked at 193 00:19:15,200 --> 00:19:19,800 and this needs to change. 194 00:19:19,800 --> 00:19:25,680 What do you think now needs to occur, especially with the urgency of the black youths killing 195 00:19:25,680 --> 00:19:28,800 themselves? 196 00:19:28,800 --> 00:19:39,280 What could we do now, whether it is individual or a community leader or a religious leader, 197 00:19:39,280 --> 00:19:40,960 what can we do? 198 00:19:40,960 --> 00:19:47,880 What is our capacity in terms of addressing this issue while we wait for more permanent 199 00:19:47,880 --> 00:19:54,680 solutions from policymakers and the scientific community, et cetera? 200 00:19:54,680 --> 00:19:56,440 Definitely this is the work of everyone. 201 00:19:56,440 --> 00:20:01,320 We all need to be aware of this crisis. 202 00:20:01,320 --> 00:20:10,440 We all need to put our hands in this game to try to bring a solution to it, whether 203 00:20:10,440 --> 00:20:12,040 or not you're part of a church. 204 00:20:12,040 --> 00:20:19,840 You need to be in your full alertness to make sure that the kids that's next to you, around 205 00:20:19,840 --> 00:20:25,080 you, that you pay attention to how they behave and how they're doing and their affect, how 206 00:20:25,080 --> 00:20:32,200 they look and how they talk to you and how they're presenting on a regular basis. 207 00:20:32,200 --> 00:20:37,000 You can question when you don't see them, when they stay at home and they're not coming 208 00:20:37,000 --> 00:20:40,040 to church and say, what's going on with them? 209 00:20:40,040 --> 00:20:43,520 When you're at home, you have your kids and they refuse to get out of bed. 210 00:20:43,520 --> 00:20:45,760 You want to know why is that happening? 211 00:20:45,760 --> 00:20:50,880 Is that, are they sick or what is the problem? 212 00:20:50,880 --> 00:20:56,960 As a police officer, you need to spend time with your community, learn to know your community 213 00:20:56,960 --> 00:21:04,160 because that's supposed to be the job of most police officers. 214 00:21:04,160 --> 00:21:10,640 Everyone needs to go to the basis, knowing to learn, learning what your position as a 215 00:21:10,640 --> 00:21:17,560 nurse, when I'm on duty, I'm smiling, I'm friendly, I'm trying to, and as I'm friendly 216 00:21:17,560 --> 00:21:25,040 going around, I'm assessing and monitoring everyone and I'm watching everyone and I'm 217 00:21:25,040 --> 00:21:30,880 paying attention to everyone that comes to me and I'm welcoming everyone and I'm making 218 00:21:30,880 --> 00:21:36,600 those as a clinical assessment on every second by second. 219 00:21:36,600 --> 00:21:39,460 So everyone needs to do their part of this game. 220 00:21:39,460 --> 00:21:50,040 When you're a teacher, you're a professor, learn to know your student and if the student 221 00:21:50,040 --> 00:21:55,240 has a problem, go on the side, find out what the problem is, how you could be helpful to 222 00:21:55,240 --> 00:22:01,280 them because sometimes you'll be surprised, the student in the school may be troubling 223 00:22:01,280 --> 00:22:10,200 by bullying, troubling by issues at home that you could be of a support but if you don't 224 00:22:10,200 --> 00:22:15,960 do your job, unfortunately you won't be able to be helpful if you close yourself and not 225 00:22:15,960 --> 00:22:23,360 opening yourself to be the person that can be helpful to that person, that person won't 226 00:22:23,360 --> 00:22:26,760 tell you anything and you will miss out on things. 227 00:22:26,760 --> 00:22:36,600 So we need as a society to wake up from that busybody thing and be open to be willing to 228 00:22:36,600 --> 00:22:44,200 bring support and help to each other and be helpful to each other and stop, I don't know, 229 00:22:44,200 --> 00:22:52,600 being so negative and trying to value the moment that you spend with each other and 230 00:22:52,600 --> 00:22:55,480 be supportive and helpful as much as you can to each other. 231 00:22:55,480 --> 00:22:57,440 Right, thank you. 232 00:22:57,440 --> 00:23:06,680 So I want to talk a little bit more about provider bias which is a big problem currently 233 00:23:06,680 --> 00:23:12,440 within the context of black youths because they don't receive the same quality of care 234 00:23:12,440 --> 00:23:13,800 as everybody else. 235 00:23:13,800 --> 00:23:23,840 I myself, I can admit to having experienced this in the healthcare system where I was 236 00:23:23,840 --> 00:23:30,960 not receiving the best care as a diabetic patient to the point that I needed to speak 237 00:23:30,960 --> 00:23:34,240 for myself and have it addressed. 238 00:23:34,240 --> 00:23:37,900 Now children don't have that kind of power, right? 239 00:23:37,900 --> 00:23:53,860 So how do they get allyship or support from hospital leadership when they feel that the 240 00:23:53,860 --> 00:24:00,780 actual provider is making them feel uncomfortable or not really providing them the best care? 241 00:24:00,780 --> 00:24:06,480 How would they even recognize if they are being given the best care? 242 00:24:06,480 --> 00:24:14,160 It's really tough to say. 243 00:24:14,160 --> 00:24:24,520 I often look at sometimes when you work around as a black person, you go on to start your 244 00:24:24,520 --> 00:24:31,360 work and you look at it around and you see yourself as the only black person. 245 00:24:31,360 --> 00:24:44,400 In 2023 you wonder why is that but it's hard to tell. 246 00:24:44,400 --> 00:24:45,520 I don't know. 247 00:24:45,520 --> 00:24:50,560 I don't know how this is possible and I don't know how this is allowed. 248 00:24:50,560 --> 00:24:59,320 I would strongly encourage the industry to understand that the diversity is a reality. 249 00:24:59,320 --> 00:25:00,740 It's happening. 250 00:25:00,740 --> 00:25:06,640 When you go to your emergency room waiting list you don't see just white people. 251 00:25:06,640 --> 00:25:13,160 When you look at all your data you don't have just white people coming to your hospital. 252 00:25:13,160 --> 00:25:20,720 So at the end of the day you need to know because you're serving diverse clientele 253 00:25:20,720 --> 00:25:25,560 you've got to have a diverse also worker. 254 00:25:25,560 --> 00:25:29,000 They've got to have somewhat cultural humility. 255 00:25:29,000 --> 00:25:30,000 That's right. 256 00:25:30,000 --> 00:25:31,640 And increase that. 257 00:25:31,640 --> 00:25:34,480 So I think that's one of the things. 258 00:25:34,480 --> 00:25:42,880 Unfortunately I think I remember one of the examples. 259 00:25:42,880 --> 00:25:48,840 When the people are reading patients coming to the hospital and they see African American 260 00:25:48,840 --> 00:25:54,360 with a history of whatever and then everybody's hair is pumping up and everybody's ready to 261 00:25:54,360 --> 00:26:02,800 put soldiers, soldiers and security all over the place because a black man is coming unfortunately. 262 00:26:02,800 --> 00:26:10,560 But at the end of the day the person that they think that's going to come as a terror 263 00:26:10,560 --> 00:26:12,760 can be a teddy bear. 264 00:26:12,760 --> 00:26:16,400 The person may be the most gentle person. 265 00:26:16,400 --> 00:26:17,920 But why do people think that way? 266 00:26:17,920 --> 00:26:18,920 I don't know. 267 00:26:18,920 --> 00:26:28,280 I think the people are so far behind in their thinking and judging people so radical, so 268 00:26:28,280 --> 00:26:29,720 weird like this. 269 00:26:29,720 --> 00:26:40,640 It's just so, it's impossible for me to get it and I'm not sure why they can't get it. 270 00:26:40,640 --> 00:26:47,740 Especially after you had a black president, after so many changes have been made in this 271 00:26:47,740 --> 00:26:53,600 country we are in 2023 you would think. 272 00:26:53,600 --> 00:27:02,240 People would be more accepting to dealing with so many different cultures including 273 00:27:02,240 --> 00:27:03,240 the black community. 274 00:27:03,240 --> 00:27:09,400 But to me it's just really a lot of questions in my mind when I see those things happening. 275 00:27:09,400 --> 00:27:14,160 But they are happening and we do our best. 276 00:27:14,160 --> 00:27:18,480 I do my best even as a director in a psychiatric hospital. 277 00:27:18,480 --> 00:27:26,040 Sometimes I go to the floor and welcome my African American patient and make them feel 278 00:27:26,040 --> 00:27:34,240 comfortable because I feel that it's okay to do that and that makes them feel welcome 279 00:27:34,240 --> 00:27:41,280 as well but I'm not sure why other people don't do it. 280 00:27:41,280 --> 00:27:49,040 Do you think there should be some sort of a toolkit like a social determinant toolkit? 281 00:27:49,040 --> 00:27:57,120 Well, which would incorporate some sort of a checklist for example that youths could 282 00:27:57,120 --> 00:28:07,360 have especially when they are seeking for help or undergoing mental health treatment. 283 00:28:07,360 --> 00:28:13,720 Like a checklist that they could check after each visit and sort of keep a record of what 284 00:28:13,720 --> 00:28:15,040 happened at that visit. 285 00:28:15,040 --> 00:28:16,040 How did things go? 286 00:28:16,040 --> 00:28:18,480 How did they feel? 287 00:28:18,480 --> 00:28:26,600 So that there's some sort of data at least at the individual level parents can collect 288 00:28:26,600 --> 00:28:34,160 and sort of help them identify whether or not there is a systemic problem with the treatment 289 00:28:34,160 --> 00:28:36,320 that their child is receiving. 290 00:28:36,320 --> 00:28:44,120 I kind of feel like as a child who is receiving mental health treatment I'm not exactly sure 291 00:28:44,120 --> 00:28:52,500 if they would even have the know-how on how to understand when they are being treated 292 00:28:52,500 --> 00:28:55,800 differently. 293 00:28:55,800 --> 00:28:59,000 Of course that depends on their age, right? 294 00:28:59,000 --> 00:29:06,760 Let me tell you something, the problem is not even, I don't know if the problem is the 295 00:29:06,760 --> 00:29:11,760 system versus the problem being the individual caring for those kids. 296 00:29:11,760 --> 00:29:13,800 And I'm going to give you an example. 297 00:29:13,800 --> 00:29:21,320 Over the past weekend I've worked with an individual person. 298 00:29:21,320 --> 00:29:32,040 He does have mental health with also some developmental issues but no one read the developmental 299 00:29:32,040 --> 00:29:34,320 issue, right? 300 00:29:34,320 --> 00:29:44,040 The developmental issue that he had made him had a lot of staring at you, a lot of, how 301 00:29:44,040 --> 00:29:47,280 do you call that? 302 00:29:47,280 --> 00:29:54,920 It's almost like a child because that's what developmental issues are, they regress, right? 303 00:29:54,920 --> 00:30:01,240 So he wants to be your friend, he wants to talk to you and he wants to have a conversation 304 00:30:01,240 --> 00:30:02,800 with you 24-7. 305 00:30:02,800 --> 00:30:11,680 However because no one pay attention to that they felt scared about him, that's number 306 00:30:11,680 --> 00:30:12,680 one. 307 00:30:12,680 --> 00:30:21,840 And when I saw him as threatening they gave him every single adjective in the book and 308 00:30:21,840 --> 00:30:27,160 that was a Latino kid, dark skinned Latino kid. 309 00:30:27,160 --> 00:30:34,260 So I kept reminding folks, hello, this kid had some developmental issue. 310 00:30:34,260 --> 00:30:41,240 So each time I said that, oh my God, and then by day three everybody was loved, everybody 311 00:30:41,240 --> 00:30:49,040 was like in love with him, working with him, the kid was very happy, life was good. 312 00:30:49,040 --> 00:30:54,680 But from the first two days I had to truly educate everyone one by one, one by one, one 313 00:30:54,680 --> 00:31:02,040 by one until they got to understand this kid is not a monster, this kid wasn't staring 314 00:31:02,040 --> 00:31:04,480 at them because he was a pervert. 315 00:31:04,480 --> 00:31:15,880 This kid wasn't trying to scare them or to get them scared or anything like that, he 316 00:31:15,880 --> 00:31:22,400 just wanted, because he's delayed, he just wanted their attention and wanted to be their 317 00:31:22,400 --> 00:31:27,120 friends and wanted to talk to them and nothing bad about it. 318 00:31:27,120 --> 00:31:35,920 And they all got the message by me educating them and then by the time day three was we 319 00:31:35,920 --> 00:31:37,960 all were friendly with this kid. 320 00:31:37,960 --> 00:31:47,440 So to me it's like, it really takes one person in that team to educate all of them should 321 00:31:47,440 --> 00:31:53,560 they really all look at the patient chart and then read the same thing that I read and 322 00:31:53,560 --> 00:32:00,920 then provide the same service that I was providing to the patient? 323 00:32:00,920 --> 00:32:02,520 Yes. 324 00:32:02,520 --> 00:32:11,080 Every individual working in healthcare should be going with that open heart, open heart 325 00:32:11,080 --> 00:32:17,680 and willing to care first before you have all these insane thoughts, you understand? 326 00:32:17,680 --> 00:32:25,120 However, at the end of the day to me it's like at least they were receptive to listen 327 00:32:25,120 --> 00:32:28,720 to what I was providing, what I was telling them. 328 00:32:28,720 --> 00:32:35,840 And that's why to me I always say to other folks that even though you come to a place 329 00:32:35,840 --> 00:32:45,400 where you feel there are negativity, there are bad, I don't know, ways of things, the 330 00:32:45,400 --> 00:32:52,000 way things are doing, just be the one that if you could be the one who could open the 331 00:32:52,000 --> 00:33:00,320 light, turn on the light and bring that education and get people to change and be good to those 332 00:33:00,320 --> 00:33:07,240 patients I think that's all I want from our colleagues to do. 333 00:33:07,240 --> 00:33:08,240 Do you understand? 334 00:33:08,240 --> 00:33:09,240 I totally understand. 335 00:33:09,240 --> 00:33:10,240 That's a good point actually. 336 00:33:10,240 --> 00:33:19,080 Yeah, there's definitely a need for additional training with mental health practitioners 337 00:33:19,080 --> 00:33:25,920 especially around the space of cultural equity and cultural humility. 338 00:33:25,920 --> 00:33:32,440 So that was a good example of how this kid was judged and as a result of that he didn't 339 00:33:32,440 --> 00:33:35,600 receive the best care because all you did was look at his chart. 340 00:33:35,600 --> 00:33:44,360 You saw him as a person, not just as this dark skinned kid who's staring at me looking 341 00:33:44,360 --> 00:33:45,360 crazy. 342 00:33:45,360 --> 00:33:46,360 And ready to hurt me. 343 00:33:46,360 --> 00:33:49,560 Yeah, so that was a really good example. 344 00:33:49,560 --> 00:33:51,920 Thank you for sharing it with us. 345 00:33:51,920 --> 00:33:58,080 So community health centers have the potential to advocate for policy and structures that 346 00:33:58,080 --> 00:34:05,460 promote health equity rather than perpetuate inequities in the system as you just demonstrated. 347 00:34:05,460 --> 00:34:13,080 So what actions can community health centers take to influence social change and address 348 00:34:13,080 --> 00:34:18,080 this issue at the systems level? 349 00:34:18,080 --> 00:34:23,520 First I think they need to do something better in the hiring process. 350 00:34:23,520 --> 00:34:28,720 Like I said earlier, they need to show some diversity among themselves. 351 00:34:28,720 --> 00:34:33,880 So you're talking about they need to have a more diverse staff? 352 00:34:33,880 --> 00:34:34,880 Correct. 353 00:34:34,880 --> 00:34:37,800 They need that would help greatly. 354 00:34:37,800 --> 00:34:45,960 Now that COVID is also over, they need to start going out and start back some community 355 00:34:45,960 --> 00:34:47,160 outreach. 356 00:34:47,160 --> 00:34:50,240 Be present in the community. 357 00:34:50,240 --> 00:34:53,840 Target this concern at heart. 358 00:34:53,840 --> 00:34:55,240 Be part of the community. 359 00:34:55,240 --> 00:34:58,640 Reach out of these families. 360 00:34:58,640 --> 00:35:07,240 Provide those education directly to the folks in the community, these black communities, 361 00:35:07,240 --> 00:35:15,240 and offer service that would help them understand what's going on and let them know that they 362 00:35:15,240 --> 00:35:22,560 are also as a support to them in case they have questions and so forth. 363 00:35:22,560 --> 00:35:32,440 And lastly I would say the community, those community services sometimes they offer very 364 00:35:32,440 --> 00:35:38,120 early in the evening, they should at least offer their lobbies in the evening as a place 365 00:35:38,120 --> 00:35:48,840 where people could congregate and even do their support group there. 366 00:35:48,840 --> 00:35:57,160 Because most people know those community health services in the community. 367 00:35:57,160 --> 00:36:08,320 So having a support group going on right there would probably, would be like an open eye 368 00:36:08,320 --> 00:36:14,840 for everyone and would allow people to just come in and not feeling pressured in any way 369 00:36:14,840 --> 00:36:25,840 to come and join and do many support groups, diverse ones, different evening and allow 370 00:36:25,840 --> 00:36:30,080 the community to join there and participate in those things. 371 00:36:30,080 --> 00:36:32,440 I think that would be very helpful. 372 00:36:32,440 --> 00:36:39,160 Do you think that those community health centers should also think about social impact investment, 373 00:36:39,160 --> 00:36:50,080 whether it is through their funds or whether it is there was grants or funds to sort of 374 00:36:50,080 --> 00:36:58,240 create community based programs to help support families more holistically or even advocate 375 00:36:58,240 --> 00:37:02,960 at the state level for certain communities that are experiencing these disparities in 376 00:37:02,960 --> 00:37:03,960 the health care system? 377 00:37:03,960 --> 00:37:06,800 Of course and some of them are so well connected. 378 00:37:06,800 --> 00:37:14,840 Some of them are so powerful in terms of the amount of patient they have, the amount of 379 00:37:14,840 --> 00:37:15,840 money they have. 380 00:37:15,840 --> 00:37:20,640 So they should probably do more investment in the community as they should because that's 381 00:37:20,640 --> 00:37:27,240 the goal of the community health centers to begin with. 382 00:37:27,240 --> 00:37:28,240 Well that's really great. 383 00:37:28,240 --> 00:37:34,400 Are there any last minute thoughts that you want to, anything else you want to say? 384 00:37:34,400 --> 00:37:44,760 I don't know, I think I would, it is as you look at the data, as you look at the information, 385 00:37:44,760 --> 00:37:51,400 it is, it took me by surprise to realize that we were so far behind. 386 00:37:51,400 --> 00:37:58,360 I thought we were a step ahead when I realized, when I read all this information. 387 00:37:58,360 --> 00:38:03,320 It was truly surprising to me to see how far behind we are. 388 00:38:03,320 --> 00:38:09,840 And I hope that a year from now we'll be so much more ahead. 389 00:38:09,840 --> 00:38:18,760 It hurts to see that our community, our people are still suffering and are still going through 390 00:38:18,760 --> 00:38:30,160 this pain after you have so many great philosopher, great people like Maya, like Oprah, so many 391 00:38:30,160 --> 00:38:37,920 people have spoken so widely and so much about mental health and to see people are still 392 00:38:37,920 --> 00:38:44,040 suffering and still going through those pain and not getting the help that they deserve. 393 00:38:44,040 --> 00:38:53,120 I think this is really uncalled for and whatever that we need to do as a community, whatever 394 00:38:53,120 --> 00:38:58,800 that needs to be done, myself I'm trying to work hard with my team right now to put together 395 00:38:58,800 --> 00:39:02,280 some clinics around to help the community. 396 00:39:02,280 --> 00:39:10,720 I'm hoping that Knock on the Woods that we are able to put that together so we can help 397 00:39:10,720 --> 00:39:19,960 those myself folks and help whatever that comes through the door and help our black 398 00:39:19,960 --> 00:39:26,200 folks to have black providers to help them so they don't have any issues on that. 399 00:39:26,200 --> 00:39:29,760 But we cannot lose any more lives. 400 00:39:29,760 --> 00:39:34,680 I think it's not right. 401 00:39:34,680 --> 00:39:37,480 It's in whatever we can do. 402 00:39:37,480 --> 00:39:43,120 I'm working with my institution right now to work with the leaders in the community 403 00:39:43,120 --> 00:39:50,640 to train them, to educate them about mental health so they can then in turn go back to 404 00:39:50,640 --> 00:39:59,880 the community and be able to assess and detect and prevent crisis from happening. 405 00:39:59,880 --> 00:40:08,360 So we are doing a lot of work to prevent and to be at least on the forefront of the crisis 406 00:40:08,360 --> 00:40:12,920 and prevent those from happening so we don't lose any more lives. 407 00:40:12,920 --> 00:40:20,160 But it's really hurtful at this point to see that we are still losing lives because of 408 00:40:20,160 --> 00:40:27,120 lack of knowledge and lack of support in this community and that's a shame. 409 00:40:27,120 --> 00:40:29,880 Hopefully we have all the support that we can. 410 00:40:29,880 --> 00:40:39,680 We have folks behind us to help us really help this community because enough is enough. 411 00:40:39,680 --> 00:40:44,160 We need to get the help that we need for our community. 412 00:40:44,160 --> 00:40:45,160 That's great. 413 00:40:45,160 --> 00:40:50,240 Well, yeah, it definitely is going to take a more collaborative effort to address this 414 00:40:50,240 --> 00:40:51,240 issue. 415 00:40:51,240 --> 00:40:53,840 It's going to be a long journey though. 416 00:40:53,840 --> 00:40:59,800 But I'm pretty sure that with people like you who are so dedicated to this cause and 417 00:40:59,800 --> 00:41:06,600 who are willing to come here and talk to us as well as training other people who might 418 00:41:06,600 --> 00:41:13,920 not be as well versed in this topic, in this area, urging them to see the importance of 419 00:41:13,920 --> 00:41:17,120 this issue and why it needs to be addressed, I appreciate that. 420 00:41:17,120 --> 00:41:18,440 I thank you for that. 421 00:41:18,440 --> 00:41:21,760 I would love to actually have you back to the podcast. 422 00:41:21,760 --> 00:41:25,760 I'll be more than happy and I will do my best to do that. 423 00:41:25,760 --> 00:41:26,760 Thank you. 424 00:41:26,760 --> 00:41:31,480 This is a very broad topic and there's so many aspects of it that needs to be covered 425 00:41:31,480 --> 00:41:34,760 which we can do in just one episode. 426 00:41:34,760 --> 00:41:43,560 So I'd love to have you back for future episodes about other parts of this issue. 427 00:41:43,560 --> 00:41:44,880 Thank you for joining us today. 428 00:41:44,880 --> 00:41:45,880 Thank you. 429 00:41:45,880 --> 00:42:13,880 Thanks.