The definition of mental illness has a racist history rooted in slavery
By Frederick H. Lowe
CHICAGO–Horace Howard has been committed to Tinley Park Mental Health Center five times for auditory and visual hallucinations and once to Cermak Health Services, a psychiatric hospital operated inside Cook County Jail, where he was diagnosed with bipolar disorder.
His history of psychiatric hospitalizations notwithstanding, Howard, a 1994 DePaul University political science graduate, refused to believe he was mentally ill.
“Mental illness is a stigma that means you’re crazy, and I’m not crazy,” he said.
Howard, who is 57, exemplifies why mental illness is a silent epidemic among African American men, and why it is difficult, if not impossible, for some mental health professionals to reach black men, although they have convinced themselves or have been forced by others to seek help.
Many black men strongly believe any psychological challenge they may suffer is based largely on a history of not being treated as human beings by white society and not because they are suffering from a brain disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM), the standard classification system for psychiatric disorders developed by the American Psychiatric Association.
DSM II, which was published in 1968 during the most turbulent period of the civil rights movement of the 1960s and 1970s, however, enabled users to the “pathologize protest as mental illness,” as stated in the book “The Protest Psychosis: How Schizophrenia Became A Black Disease,” by Jonathan M. Metzl, associate professor of psychiatry and women’s studies and director of the Culture, Health and Medicine Program at the University of Michigan. Black men who participated in the civil rights movement were diagnosed as violent paranoid schizophrenics, wrote Metzl.
Daniel Jean, a licensed clinical professional counselor and former director of the Woodlawn Adult Health Center, where Howard was a patient, said black men equate being called crazy with being seen as violent and dangerous. The Woodlawn clinic was one of six city-run public mental health clinics closed in 2012 for budget reasons.
“It means they cannot be trusted,” said Jean, of the way society perceives black men with mental illness. “It also means they cannot take care of themselves because they are unstable. African-American men don’t believe they suffer from depression; they don’t believe they should cry because they are told to ‘man up’ and solve their own problems.”
Racist roots of mental illness
Although some African-American men reject the idea they are mentally ill, the seed of mental illness was planted deep in our consciousness hundreds of years ago during slavery, explained Marcus Murray, co-founder of Project Brotherhood, an informal group of African American men who meet Thursday afternoons in the building that formerly housed the Woodlawn Adult Health Center to discuss common problems.
“Black men suffer from post-traumatic slave disorder; it is ingrained in our consciousness that we were slaves, and we watched helplessly as our wives and daughters were raped,” Murray explained.
Slaves who escaped bondage were called crazy or mad by plantation owners and physicians, Metzl wrote. “It was well-known, of course, that race and insanity share a long and troubled past,” he wrote. “In the 1850s, American psychiatrists believed that African American slaves who ran away from their white masters did so because of a mental illness called draptetomania. Draptetomania is now considered the edifice of scientific racism. Medical journals of the era also described a condition called dysaesthesia aethiopis, a form of madness manifested by ‘rascality’ and ‘disrespect for the master’s property’ that was believed to be ‘cured’ by brutal whippings. Even at the turn of the twentieth century, leading academic psychiatrists shamefully claimed that Negroes were psychologically unfit for freedom.”
Metzl’s book, which was published in 2009, is supported by more-recent studies.
A 2011 article in Psychology Today reported that African-American men suffer from posttraumatic stress disorder (PTSD), which is characterized by depression, anxiety, nightmares, insomnia and hypervigilance. The disorder is further complicated by low self-esteem and feelings of humiliation because of daily encounters with racism, including micro-aggressions.
Examples of this occur when women clutch their purses in fear when they see a black man walking along the street or when security guards follow black men in stores because the guards believe African Americans are there to steal, not to shop. Black men experience this treatment in stores on a regular basis, and sometimes it results in legal action.
Macy’s, one of the nation’s largest retailers based on annual revenues, last August agreed to pay a $650,000 fine after an investigation by the New York Attorney General reported that black shoppers faced heightened surveillance by the department store’s security guards at the retailer’s 42 New York stores, including its flagship store in New York City’s Herald Square.
The investigation reported that security guards followed black shoppers at a far higher rate than white shoppers. This is the second time the N.Y. Attorney General’s office has investigated and fined Macy’s, which owns stores in Chicago, for its treatment of black shoppers.
Looking at the causes of mental illness differently
The official definition of mental illness has changed over the years to include more focus on life experiences.
In DSM IV, which was published in 1994, mental illness is defined in part by a manifestation of a behavioral, psychological, or biological dysfunction evident in the individual.
DSM V, which was published in 2013, defines mental and psychiatric disorders as the consequence of clinically significant distress, which impairs important areas of functioning.
I’ve had personal experience with the retrograde ways the medical profession has treated mental illness and also with the way subtle racism by the white medical community inadvertently supported by African Americans has undermined the psychological well-being of black men.
When I was an undergraduate, I worked as an orderly at the Veterans Administration Hospital, a psychiatric hospital for veterans, in Lakewood, Wash., near Ft. Lewis U.S. Army base and McChord Air Force Base.
At the time, the two were among the largest military installations in the country. The government combined the bases in 2010, thereafter calling them Joint Base Lewis-McChord.
Many of the patients had served as ground troops in the Vietnam War, where they suffered horrific experiences. They were treated mostly with electroconvulsive therapy, and Thorazine, an anti-psychotic drug that was given to some patients four times a day. I know this because I accompanied the nurse on my assigned ward when she dispensed the medicine. I read medical charts and wrote daily reports about patients’ behavior. This was long before posttraumatic stress disorder became a familiar term in the American vocabulary.
I also noticed more than 99 percent of the veterans who sought treatment were white, although an extremely high number of black men fought in Vietnam, which was referred to as the nation’s first truly integrated war.
Why didn’t more black men seek treatment? I am sure the answer was the wary attitude held by many in the African-American community toward mental illness. In addition, many black people did not know how or where to seek help.
Many of the older black men who worked as orderlies with me at the VA hospital, most of them retired U.S. Army veterans, would often say if a black man came to the VA seeking help for mental illness, he was ‘really sick’ because we were strong enough to endure white racism. Many years later, I realized they were echoing the sentiment of the times, one still prevalent today.
Black communities often had their own methods of treating mental illness
For example, jazz musician Thelonious Monk’s father suffered from mental illness. When he was psychotic, he would shout and become violent. His relatives would lock him in the family barn in Rocky Mount, N.C., until he eventually settled down, according to the biography “Thelonious Monk: The Life and Times of an American Original,” by Robin D. G. Kelley.
Murray, the co-founder of Project Brotherhood, said, “Sixty percent of black men suffer from mental illness caused by the stress of living in a white world where it is difficult for them to find work so they can take care of themselves. They and their families often live in gang-infested and crime-ridden neighborhoods with questionable police protection. Even black men who are working and living in low- or crime-free neighborhoods also suffer from racism.”
Murray’s views are echoed by Dr. Waldo E. Johnson Jr., a University of Chicago professor and editor of the book, “Social Work with African American Males: Health, Mental Health, and Social Policy.” Johnson said black men often see themselves as being undervalued and viewed suspiciously as criminals, regardless of their circumstances.
Jean noted that despite his education and standing, women in Hyde Park, a so-called liberal neighborhood in Chicago, still clutch their purses when they see him on the street.
A self-help group for black men
Murray added that most of the black men who participate in the group sessions offered by Project Brotherhood are suffering either from depression, a mood disorder that is one of most prevalent forms of mental illness, or bipolar disorder, a form of mental illness that is most challenging to diagnose because individuals can seem perfectly “normal” one minute and manic the next. He calls the meetings “rap or testosterone sessions, not social support groups,” because black men reject that designation as too closely associated with white women.
“Initially, they say, I don’t suffer from depression, but if someone asks, ‘What about this?’ The men start talking,” Murray said.
Howard believes that his diagnosis is a result of white racism.
“It is a stigma against African American men,” he explained. “We have suffered through slavery. We have fought in America’s wars, yet we still have a high jobless rate and they [whites] call me crazy. They think all of us are crazy.”
Badonna Reingold, a licensed clinical social worker and vice chair of the Community Mental Health Board of Chicago, first introduced me to Howard at the Living Room Café, 806 E. 64th Street.
The café, which is operated by the Inspiration Corp., provides free hot meals four days a week and canned foods to many former patients of the now-shuttered Woodlawn Adult Health Center. Many of the people who eat there receive food stamps and monthly disability checks of a little more than $700, but they often run out of food before the end of the month. The café is designed to appeal to visitors. The wooden tables are lacquered and beautiful murals hang on the walls. The café also has computers that customers can use to look for work.
Howard, who lives in an apartment near the café, has closely cropped hair. He is dark-skinned and has intense eyes, and his body movements draw immediate attention. Howard moves his big arms, shoulders and hands as he speaks. The night I met him, he was wearing a bright red jacket that seemed to accentuate his movements. Several times during the interview, he stopped talking to tell another café patron he needed to speak to him.
Reingold described Howard as a powerful speaker who took a leadership role in fighting the closing of Woodlawn Adult Health Center in 2012.
Glenn Ford, Jr., another patient at Woodlawn, who has been diagnosed with bipolar disorder and schizoaffective disorder, also attributed his illness to white racism but he says he can’t blame everything on racism.
“Blacks have had terrible things done to us,” said Ford, who goes by the African name Ummi Yaya. The damage is both physical and psychological. “Black men are called thieves. White men are called embezzlers,” he said. “I am not crazy. I’m just trying to fit into an insane society.”
He added, however, that he has caused some of his own problems.
“I drank and smoked weed,” he said. “I stopped taking my medication, and I got involved in get-rich pyramid schemes. So I brought a lot of these problems on myself. I can’t play the victim all of the time.”
Acceptance of mental illness
David Mailey, a former Woodlawn client, who published the Woodlawn Connection newspaper, said he eventually accepted that he was mentally ill after being diagnosed as schizophrenic.
“If you hear it from enough different people, you begin to accept it,” Mailey said.
He added, however, that he believes that part of the cause of mental illness among black men is a racist system that prevents them from getting jobs to take care of their families.
Mailey has never held a paying job, although he volunteered for a total of 25 years at Osteopathic, Michael Reese and Mercy hospitals in Chicago.
As we sat together in the Robust Coffee Lounge across the street from the Woodlawn center, he proudly showed me photographs taken of him receiving awards for his work in the hospital mail rooms.
Howard is a member of a politically prominent Chicago family, and he says that a lack of common sense caused some of his hospitalizations.
Once, he urinated on the sidewalk in front of the Chicago Police superintendent’s home. On another occasion, he threatened a well-known Chicago politician, following the death of Harold Washington, Chicago’s first African American mayor.
“I got upset. I should have just accepted it [Mayor Washington’s death],” Howard said.
The closing of the Woodlawn clinic has disrupted Howard’s treatment. He told me he is using alcohol and drugs to self medicate after being turned away from the Greater Grand Mental Health Clinic, 4314 S. Cottage Grove because a psychiatrist had quit.
Howard says he is scheduled to see a psychiatrist in April at the Heartland Alliance Heartland Health Outreach, 4750 N. Sheridan Rd., on the North Side.
He said it takes him 1hour and 15 minutes to reach the clinic, riding the 63rd Street bus and the Red Line to the Lawrence Avenue stop.
In comparison, the Woodlawn clinic at 6337 S. Woodlawn was a 10-minute walk from Howard’s apartment at 6100 block of South Kenwood.
Lowe is a Social Justice News Nexus Reporting Fellow through the Medill School of Journalism at Northwestern University. This article was produced as part of that fellowship.