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In Fall 2020, WUSF began reporting on how distribution of the COVID-19 vaccine exposes inequities in Florida's health care system. Our stories focus on the voices of residents in communities of color and how Florida's handling of the coronavirus pandemic and vaccine distribution affects them.WUSF’s reporting on disparities in health care access is funded in part by the COVID-19 Response Initiative of Charles & Margery Barancik Foundation and Gulf Coast Community Foundation.

The pandemic strained mental health for Black Americans. It’s also amplifying calls for change

Three Black men sit in folding chairs inside a barbershop and are in the middle of a discussion about mental health.
Octavio Jones
/
WUSF Public Media
S. Kent Butler (center), president of the American Counseling Association, led a group of men in a conversation about mental health at a barbershop in St. Petersburg, part of the recent Healing While Black summit.

The COVID-19 pandemic continues to stress the mental health of many people. But it's been especially hard for some Black Americans, who have been disproportionately affected by the virus and already faced barriers to care.

Vickye, 52, has Lupus, so like many people at risk for severe COVID-19, the St. Petersburg resident spent most of last year at home. She avoided getting sick, but quarantining took a toll in ways she said she couldn’t have imagined.

"You were trapped with yourself, you couldn't go anywhere, so you had to face yourself and face your demons and whoever you were trapped with their demons too," she said.

Vickye was trapped with an abusive wife, which is why we're not using her last name. Verbal assaults turned physical, until this past February, when Vickye said her now ex-wife shot her six times for threatening to leave.

Vickye has recovered physically for the most part and the case is working its way through the Pinellas County court system. But her emotional wounds are taking longer to heal.

RESOURCE: If you or someone you know is suffering from domestic violence or a mental health crisis, call 2-1-1 for help. More resources can be found at the end of this story.

Woman sits at a picnic table outside. She can be seen from behind.
Stephanie Colombini
For St. Petersburg resident Vickye, quarantining during the pandemic meant being trapped at home with her abusive then-wife. She said she's struggling to find consistent care now to treat her trauma.

Vickye received free counseling from local support groups for a while, but those sessions ran out. Her struggle now, she said, is to find a provider in her price range.

"They're [experts] saying, 'Get help, get your mental health,' however there's no one to take you if you don't have insurance or you can't afford a private one or whatever,” Vickye said. “So that's where I'm at right now as far as trying to deal with my anxiety and my PTSD, is just getting into counseling."

Data from the Centers for Disease Control and Prevention show significant increases in mental health concerns throughout the pandemic, and Black and Hispanic Americans were often more likely to have needs and less likely to receive treatment than non-Hispanic whites.

CDC Mental Health Survey
Centers for Disease Control and Prevention
The CDC findings from earlier this year are consistent with similar surveys the agency conducted at previous points of the pandemic.

The CDC also says Black and Hispanic people were twice as likely to die from COVID-19 and nearly three times as likely to be hospitalized with the disease than whites. They were also more likely to lose work or have demanding frontline jobs.

"Stress related to the uncertainty and the impact of self-isolation, worrying about the transmission of COVID-19, concerns about job security, all likely exacerbated the feelings that people had," said Reggie Williams, vice president of international health policy and practice innovations with the Commonwealth Fund.

"I think a lot of us don't deal with our trauma and our grief because we're just meant to go on."
Vickye

Barriers to care

The murder of George Floyd and other police killings of Black individuals – and the civil unrest that followed – added more trauma.

The Commonwealth Fund surveyed residents of the United States and other high-income countries last year about their health concerns and Williams published an analysis of the mental health results this October.

It found more than 50% of Black Americans who reported having mental health needs also had cost-related problems accessing health care, second only to Hispanic Americans. Black respondents were also most likely to have multiple chronic health conditions, and had the highest rates of avoidable emergency room visits.

"And so Black people as well as Latino people are facing real barriers in getting the care that they need for their mental health concerns as well as their broader, overall health concerns," said Williams.

Bar graph that shows how Black and Hispanic Americans were more likely than white Americans and residents of other high-income countries to experience cost-related barriers to accessing care.
Commonwealth Fund
Americans with mental health needs were more likely than residents of other high-income countries to face financial barriers to care, with Black and Hispanic people struggling the most.

This year, the nonprofit Mental Health America ranked Florida 49th in the nation for access to care when looking at the 50 states and District of Columbia. Only Alabama and Texas performed worse. The ranking accounts for things like mental health workforce availability and access to insurance and treatment for both kids and adults.

And there are other barriers. Vickye said societal pressures on Black people also make it harder to seek help.

“As a Black woman, no matter what you go through, what trauma, you still have to deal with the kids, still have to cook, still have to clean, you have to put on this mask like everything is alright, like there's nothing that can hurt you. You know, you have to be Superwoman,” she said. “And I think a lot of us don't deal with our trauma and our grief because we're just meant to go on."

“Healing While Black”

Resilience is something members of the Black community should be proud of, according to LaDonna Butler, a licensed counselor who founded the Well for Life in St. Petersburg. The organization serves as an integrative healing space for Black and indigenous people of color.

But Butler, who holds a doctoral degree in counselor education and supervision, said assumptions about that resilience can perpetuate stigma about mental health and create gaps in care.

"Because when people believe you are so strong they often don't create systems or strategies that will allow you to seek help with the great pride that you have,” she said. “And when people don't feel seen, heard or respected, they're less likely to get help."

LaDonna Butler speaks in front of a podium.
Nicole White
LaDonna Butler spoke at the Dr. Carter G. Woodson African-American History Museum during the Healing While Black summit this summer.

This summer the Well for Life hosted a three-day summit called Healing While Black that brought residents, clinicians and community-based organizations in the Tampa Bay area together to raise awareness about mental health for people of color.

It involved training sessions on providing culturally-sensitive care but also community events like a "Brown Girl Brunch" and BBQ luncheon at a barbershop to have tough conversations about mental wellness in safe spaces.

“Every time I walk out of my house, I know I'm walking out as a Black man, and I know that doesn't mean I'm going to walk back in.”
S. Kent Butler

Inside St. Petersburg's Central Station Barbershop & Grooming on a late July afternoon, S. Kent Butler, President of the American Counseling Association and professor at the University of Central Florida, led a dozen or so men in a discussion about mental health. The buzz of a trimmer occasionally accompanied the conversation as a few attendees got their hair cut while they chatted.

"How do we break that stigma about going to see a counselor?” said Butler, who holds a doctoral degree in educational psychology. He added that some people associate seeking mental health treatment with weakness.

Maress Scott, a St. Pete resident and anti-gun violence advocate suggested Black men be more vocal about their emotions and encourage younger members of the community that it’s OK to seek help.

“When I’m vulnerable I become in touch with who I am, when I become in touch with who I am, I’m able to be in touch with my child and in touch with my wife, and I’m able to reach other men in ways that they never thought could be reached,” said Scott, who brought his young grandson to the event to learn from what the group had to share.

Man sits in a barber chair with an apron on while a barber cuts his hair. Other man sit in chairs around them.
OCTAVIO JONES
Antonio Brown, owner of Central Station Barbershop & Grooming, cuts S. Kent Butler's hair as they chat with other men about mental health.

The continuous trauma of racism

Some men reflected on their childhoods and how the difficult circumstances their families were in forced them to toughen up at a young age.

One man named John Muhammad looked back even further. His voice rose as he argued white people have created many of the mental health challenges Black Americans face through a history of slavery, Jim Crow laws and other forms of oppression.

"Through breeding and systems and processes and torture and enforcement and lynching and fear,” Muhammad said. ‘And we've got all this in our DNA and we're trying to figure out why the Black man don't take care of the Black woman or the Black woman don't respect the Black man – look at the bigger picture and the pathology and you see where it started and you see where we are.”

And the men said racism continues to plague mental health in the Black community.

Butler talked about how police violence against Black people makes him feel anxious in public even when he knows he's not doing anything wrong. He told the men in the room Black people don't just have post-traumatic stress from past injustices, because the hardships keep on coming.

"It's real, ‘CTSD.’ Continuous Traumatic Stress Disorder,” said Butler as members of the group nodded their heads in agreement. “That's all we have in our community. CTSD, not PTSD. It's continuous.

“I say this all the time: Every time I walk out of my house, I know I'm walking out as a Black man and I know that doesn't mean I'm going to walk back in. And that's continuous, that's what that anxiety is."

Butler told the group it's important to acknowledge those emotions and give themselves permission to heal. Many men walked out hugging each other.

Two men, one wearing a face mask, sit in a barbershop and talk to each other.
OCTAVIO JONES
John Muhammad (right) attended the Healing While Black event and said America's long history of racism has shaped mental health in the Black community and continues to pose challenges.

Looking ahead

Experts say one positive thing that has come out of the recent civil unrest over racial injustice and the COVID-19 pandemic is that more people are having these kinds of conversations about mental health and improving equity.

LaDonna Butler with the Well for Life said she's been especially inspired by young people.

“They're talking about counseling and mental health at rates that I've not seen,” she said. “So I think it's also brought to our tongue the power of mental health and the importance of really taking care of yourself because we really do matter."

Embracing mental wellness is important, but advocates say serious changes also have to be made to the health care system and other areas of society in order to ensure everyone gets the help they need.

Butler has been advocating to bring what are known as trauma recovery centers to the area. They offer comprehensive services to survivors of crime and other forms of trauma, from counseling, to legal aid and emergency relief, and have seen success in other states like California and Illinois.

Butler said she also wants to see more community spaces encourage mental health discussion so people can relate with others and connect to resources in places where they already spend their time, like beauty salons and churches.

Integrating mental health care with other services is one of the recommendations Reggie Williams with the Commonwealth Fund makes in the report he co-authored on mental health needs in the U.S. and other countries.

Harnessing primary care providers, federally-qualified health centers and pharmacies to address mental health concerns in addition to patients’ physical concerns would help identify issues early and make treatment more accessible, Williams said.

It’s also critical to expand the mental health workforce and the use of digital technology, he said. Lastly, he said, communities have to address the economic and social conditions that can exacerbate people’s anxiety and depression, what he calls the social determinants of mental health.

“Do people have roofs over their head? Do they have food in their bellies? Do they have a sense of fulfillment from the work that they may be participating in?" Williams said. "Those things all become extremely important when you think about addressing mental health services.”

Advocates say they hope the increased attention on mental health drives policymakers and other community leaders to invest in these solutions and commit to making mental health care more equitable.

Mary Shedden contributed to this story. 

Mental Health Resources

If you or someone you know has a mental health need, contact 2-1-1, a 24/7 helpline.

The Tampa Bay Foundation for Mental Health created a resources page with links to local clinics that provide mental health services and national organizations that can provide more information.

Mental Health America has a Tools 2 Thrive series that provides information, tips, and practical tools that people can use to improve their mental health.

In late 2020, WUSF began reporting on how distribution of the COVID-19 vaccine exposes inequities in Florida's health care system. Our reporters and editors first spent several months listening to groups invested in the health of communities of color, giving them a chance to share how Florida's handling of the coronavirus pandemic and vaccine distribution has affected them.

Our stories reflect reporting within the community, public records requests and other interviews designed to put the pandemic and health disparities in context. We’ve reached out to government and official sources and let you know when information we requested was not provided, or if sources declined interview requests.
Stephanie Colombini is an award-winning journalist who reports for Health News Florida. She has been the lead reporter covering the coronavirus pandemic. During her time at WUSF, Stephanie also covered military and veterans’ affairs as part of the national reporting collaborative the American Homefront Project and produced the station’s flagship public affairs program Florida Matters. Prior to joining the station in 2016, she reported for WCBS 880 and WFUV in New York City.

Kerry Sheridan is an award-winning reporter and co-host of All Things Considered at WUSF Public Media. She covers education, health and science. Prior to joining WUSF in 2019, Kerry reported for Agence France-Presse from 2005 to 2019, reporting from the Middle East bureau in Cyprus, followed by stints in Washington and Miami. Kerry earned her master’s degree from the Columbia University Graduate School of Journalism in 2002, and was a recipient of the Pulitzer Traveling Fellowship for Cultural Reporting.

Julio Ochoa is an assistant news director at WUSF and the award-winning editor of Health News Florida, a collaborative statewide news project. He also reports on health care with a focus on policy. Prior to joining WUSF in 2015, Julio worked at the Tampa Tribune, where he began as a website producer for TBO.com and served in several editing roles, eventually becoming the newspaper’s deputy metro editor.

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