In My Right Mind

Depression

I met a senior woman last summer who told me over lunch how she plans to avoid dementia and stay sane in a world of trouble. “The Bible says ‘thou will keep him
in perfect peace whose mind is stayed on thee,’” she quoted Isaiah 26:3 to the best of her recollection.

I winced, a little embarrassed at her reliance upon the scriptures to answer the very complex issues of mental health and wellness. African Americans have been tagged
with the reputation for dodging professional intervention, opting instead to pray over everything. (See the articles beginning on p. 16) Believers sing “I woke up this morning
with my mind stayed on Jesus” and routinely testify that “I am clothed and in my right mind.”

For me the tension is one of balance and application. I believe God is able to heal my mind just as surely as He is willing and able to heal my body. Certainly medical
intervention is needed, however, when believers suffer with mental illnesses such as clinical depression or unmanaged bi-polar disorder. We all see how delusions and distress can disrupt a productive and satisfying life. Suicide is the gravest example of that.

Failing to discuss, disclose, or treat the illness is no virtue.

Balance should also be applied when citing negative statistics regarding African American mental wellness. The rates of mental illness are similar to that of other groups, but African Americans are more likely to suffer alone. For every three mentally ill African American, only one receives treatment according to the American Psychiatric Association. And, it is true that the same population is more likely to discontinue treatment early and forgo followup care.

Could there be justifiable reasons why African American discontinue mental health treatment and care? Is there something about that care that may unnerve some would-be consumers of therapy? The answer to this issue was made clear to me after

Dr Gina Duncan
Dr Gina Duncan

talking to Gina Duncan, a psychiatrist, associate dean of admissions for Georgia Regents University Medical School, and a leading voice in cultural competency,
spirituality and mental health.

For example, Blacks are more likely to be misdiagnosed. Black and White patients who present with similar symptoms often come away with very different diagnoses: the White patient is diagnosed with a mood disorder or depression while the Black patient is diagnosed with a serious psychosis such as schizophrenia. Exhibiting too much anger, mistrust, and anxiety because of a life experience rife with social injustice
and racism, is to walk away with a diagnosis of paranoia.

Further mental illness still carries a measure of stigmatization in the Black community. No member of a community that has already been stigmatized wants more of that, said Duncan.

On balance, the collective strength of the African American culture has proven to be a healing balm to sociological pain, mental stress, and illness. Researchers have long identified characteristics common among African-Americans that promote wellness and defy sociological stressors. These strengths can be adopted by anyone. Take special note of which ones top the list:

• Pervasive religious commitment
• Belief in the efficacy of prayer
• Practice of confronting problems rather than shrinking from them
• Leaning on the counsel and support of the community for help
• Resistance to stereotypical labels from outside, and credence given to voices within the culture and community
• A sense of “collective identity” with many “collectively defined interests.”
“Such psychological and social frameworks have enabled many African-Americans to overcome adversity and sustain a high degree of mental health.” according to the African American Outreach Resource Manual, Chapter 3.

There is an intersection of spiritual and mental health, said Duncan, and she considers it part of her calling to educatepractitioners and patients alike. Spiritual problems can lead to mental health problems, she acknowledged. Effectively assessing one’s spiritual status can help prevent and help improve mental health problems so they do not become a major disorder.

Competent practitioners evaluate patients globally, taking into account biological, mental and psycho-social aspects of the patient’s life. A less life threatening diagnosis can be treated with psychotherapy in accordance with a patient’s wishes, taking into account his or her special needs.

Perhaps the senior citizen I met that day for lunch had an objectively reliable mental health plan. There is nothing wrong with engaging the Creator to heal us body, mind, and soul.

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