The Black Mental Health Crisis

Sage Elsesser’s mental health was already in a fragile state when the pandemic hit. The 23-year-old black student from Los Angeles has been coping with his anxiety, depression and subsequent substance abuse for years. Growing up in a poor, mostly African American, neighborhood in Los Angeles, he never had the economic resources to get help. He began monetizing his love of skateboarding as a teenager, more recently turning it into a full-time career as a way to pay for his life, but mostly in order to afford the excessive cost of therapy.

As a child, Elsesser recalls the alienation he felt as a young black man. He remembers all of the warnings he received, about cops, medical professionals, and other authority figures that could have a racial bias against him and might use that to disenfranchise him or his friends. He grew up as the only man in his four-person household. Today, he is financially responsible for both his mother and his 19-year-old little sister.

Back in the fall of 2019, Elsesser had one of his worst panic attacks yet. He called 911 from his Brooklyn apartment. He was living alone at the time and had neglected his mental health due to managing a busy work schedule along with being a student.

“I just needed a break, and I felt really alone. There’s no one to call with this stuff. My friends back home have kids to worry about, some don’t even have a steady roof over their heads. I never worry my mom with this stuff, so I called for help.”

Above: Sage Elsesser

Once Elsesser’s breathing was calmed down, he was admitted to the psych ward where he explained to the nurses treating him that he suffers from severe panic attacks and wanted to speak to someone. The doctors treating him said they would require blood work before proceeding. Elsesser expressed that he was uncomfortable with this and asked if he could go home with some referrals for mental health professionals. A nurse then said he was acting aggressively and ordered a 5150 hold on him, an involuntary hold for individuals who are deemed to be a danger to themselves or others.

“Even with everything I was taught when I was younger, all that hypervigilance, I still had faith that when I needed help, I’d be treated like a human being. Even after I was treated like an animal, my only two thoughts were; ‘would this be happening if I was a white woman?’ and ‘Doctors like these are the problem, this is why black people fear seeking help for mental illness.’ What a shame.”

In January of this year, Elsesser’s mental health was in the best place he had ever been. He found a black therapist that he finally felt understood his concerns on both an emotional and cultural level, something he sees as “beyond important for black males navigating these issues.” He enrolled himself in a rehabilitation program to treat his substance abuse issues. By the time the pandemic hit, Elsesser was not only feeling stable and supported, but was sober, for the first time in almost a decade. Then the pandemic started.

The mental health fallout of this pandemic can’t be overlooked and has different effects for black people that must be considered, said Andrea Brown, the executive director at the Black Mental Health Alliance, a youth organization providing mental health help to Black communities in Baltimore.

“The collateral damage of Covid for black people looks very different than they do for our Caucasian counterparts, and they even look different for brown communities. The interesting dynamic is it’s not just Covid, it is now this heightened infiltration of racism in black communities. So, on top of the fear and isolation we’re experiencing from the pandemic, we’ve got another source of fear and isolation.”

Some of the obstacles to seeking treatment include the low numbers of black mental health practitioners, the cultural differences in what mental health treatment looks like for communities of color, as well as the pre-existing historical trauma that leads to often untreated PTSD amongst black and brown communities. All of which have been intensified by the pandemic.

“The amount of people asking us for referrals to mental health resources has tripled. So, July alone, we probably had about 300 referrals from across the country saying, “Can you please find me somebody that looks like me?” said Brown.

In a matter of weeks, Elsesser watched his mental health deteriorate once again, and this time he didn’t have the same support system available to him. His skateboarding work was reduced, as was his income. The bills at home were larger than ever without his mother working as often. Mainly though, he felt as if he was being more triggered than ever before.

“I was in the last week of my program when the protests started. You get used to the fact that very little has changed, but that doesn’t mean it doesn’t still hurt. Then I have to watch another black man lose his life at the hands of police, again, and I’m just thinking to myself this is impossible. How do I learn to cope?” Elsesser said.

He was experiencing the same Covid-induced anxiety we have all been battling with on an exacerbated scale. Elsesser had to watch his peers risk their lives protesting against racism and police violence amidst a global pandemic. He also expressed the constant fear he feels seeing black COVID-19 statistics, which consistently show that black people are dying at the highest rates due to lack of access to proper healthcare and being under-insured.

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Elsesser’s own experiences have inspired him to work in mental health in the future. He plans on reaching out to kids like himself from low-income neighborhoods that suffering in silence is not the only answer. There are ways to overcome the stigma of seeking help and actually receiving that help, despite having little to no money and access.

“In my community, I was always taught that it was not manly to be emotional. We’re the most at-risk demographic throughout this pandemic. We have a history of racial trauma we come here with. It’s just not something you do or talk about, but we need to.”

In Los Angeles, the Violence Intervention Program (VIP), an organization that treats victims of family violence and provides care for 70% of children going into foster care in the area, has actually seen a decrease in referrals during the pandemic. Of the 20,000 children VIP sees per year, about 90% are black, the group says.

Anne Nadel, VIP’s development and communications manager, explains that a major barrier to their work in identifying and providing aid to at-risk children and families is the lack of social workers, teachers and other mandated reporters out in the world seeing children.

Nadel believes that the economic upheavals brought upon by the pandemic are a major contributor to an impending mental health crisis that will dissimilarly affect the mental health of economically vulnerable communities

This dramatic shift from emphasizing the importance of catering to the health of the mind through therapizing and developing coping mechanisms to making sure a family has the basic necessities they need to survive illustrates the direct impact the pandemic has had on low-income communities and often communities of color seeking mental health treatment.

Nadel sees this through her work at VIP, emphasizing that “if you don’t allow a family to be fed, basically fed, clothed and housed, there’s no way that you’re going to make progress on the mental health side.”

For black men like Elsesser and others in his community, this pandemic has created an economic and social landscape that makes the already challenging issue of seeking mental health treatment exponentially more difficult. They are juggling balls that white people haven’t even had to think about, and with fewer resources available to get help.

When asked where we need to go from here, Elsesser reconciles, “We need more black therapists. We need more black people opening up about their mental health, especially during this pandemic and the protests. We need more people allowing black men to be vulnerable. We need less people seeing someone like Kanye West having a bipolar episode and making it something to laugh at. We just need to do better.”