By Nerrissa Crawford

Depression is a common mental disorder affecting 5.7% of older adults and still, this universal experience is underserved in African American elders. While navigating the process of aging, elders are battling with ongoing emotional symptoms of depression that have surfaced because of family history, the state of hardships throughout their lives, and constantly feeling like mental health is a taboo concept for the Black community (Johnson 2021). Treatment for depression is unavailable because of medical and therapy costs, studies suggest the cost of therapy sessions could range from around $100 per hour out of pocket (Churner 2020). This affects African American elders’ search for care that prompts them to discover alternative resources granting them the support that is inaccessible in the community; this increases a person’s risk of mental illness (Morin 2020). Specifically, for African American elders—their mental health is marginalized and excluded from society because of the lack of studies on depression in their communities. Depression is one of the most familiar health conditions in the United States and impairs one’s ability in everyday life tasks (Churner 2020). Untreated depression is followed by unhealthy aging, this essay will cover the factors that contribute to depression in African American elders—their ability to cope with hardships while having limited access to mental health care. Through the personal narratives of African American elders, we can understand how depression has impacted individuals, to explore the major misconceptions about mental health and those advocating for mental health care.

The major difficulties within the Black community are misconceptions about mental health and the perceptions about mental disorders as a sign of weakness. Historical evidence presents this idea of mental illness being forbidden in communities because African Americans have experienced mental illness abuse with discrimination and bias, which creates this myth that Black people cannot have a mental illness (Whitfield 2021). An interviewee from the Stories to Save Lives database references this idea in his discussion regarding how he overcame depression and sought help. Williams Sessions from Washington DC grew up in an abusive household with his mother and father. Sessions discussed feelings of loneliness and displacement throughout his childhood. Session also connects about having a sense of urgency to take responsibility for his mental health after recognizing his family’s reliance on home remedies, with which he realized the importance of normalizing mental instability at the age of 27 as a recovering addict (0:36:22.6). After witnessing his mother who had an addiction to alcohol and experienced extreme depression, sessions explain how this encounter influenced his beliefs about mental health as he talks about his mother, “came along during an era where mental health, especially mental health for the blacks, was like, a taboo, a no-no, you know. You just didn’t do that. It means you’re crazy or something like that” (0:07:57.1). This erroneous myth has been operating the African American community’s ideas about mental instability, and for centuries has impaired the older generation to seek medical attention. Compared to other generations, there is a gap between those who are more open about raising mental health awareness as the younger generation takes initiative through social media, but what about the older generation? The American Psychiatric Association reports that Generation Z in 2019 was more likely to receive treatment compared to millennials (Cuncic 2021). Session’s interview suggests that mental health in the Black community has been inaccessible for years, and this disapproval of mental well-being is rooted in unwelcoming attitudes about normalizing mental health.

Indefinitely, this leads to unhealthy aging in the Black community, individuals fail to realize the importance of mental health because mental wellness does not conform to the normalcy of the Black community— whereas a continuous cycle is created and individuals would rather depend on community resources such as the role of the church, to receive supportive stress-coping resources that they may need (Nguyen 2018). Additionally, Session mentions his love for the church and sense of belonging as he states, “Not only do I love church, but I love operating and working in the church, and I do a lot of that, yeah” (0:499:24.4). This example of the role of the church as an outlet for the older African American community. It is important to understand how the church is not just a religious institution, but a social, civic, and political institution that serves a range of communities (Lincoln and Mamiya 1990). Although the role of the church is an effective resource for the older population—there should be an intricate balance between community collaboration and professional mental health services to provide awareness and support for African American elders. In addition to the interviewee Williams Sessions—Stories to Save Lives also highlights Betty Jenkins, an African American older woman with experiences of depression, navigating to find serenity in life after the loss of several family members.

Betty Jenkins grew up in Rocky Mount with her family before moving to New Jersey when she was 21. Jenkins moved back to North Carolina when her mother and brother became sick. Jenkins discussed her endeavors with a decline in emotional health as she talked about the passing of her mother, sister, and second-oldest brother. Jenkins says, “so 2012, ’13,’14, ’15 was extremely rough for me. I know it took me probably two years, up until 2017, to get my thoughts correct, because I was seriously, seriously depressed after all them had died” (0:17:57.0). Meanwhile, Jenkins expressed that she decided to get counseling as stated, “I went and got some counseling, because my doctor’s office that I go to, they started bringing in—what do they call it? Psychologists, psychiatrists, whatever they call it. So I went there and I told them, I said, “I need to talk to somebody” and then I started going in, talking to them, and it helped a lot” (0:19:13.5). Jenkins brings up a critical point throughout the interview, she had to get to a point when she realized that advocating for her mental wellness was a priority however, she did not have access to that knowledge while dealing with the passing of her loved ones and experiencing depression. According to the Columbia University Department of Psychiatry, the Black community experiences a lack of access because there is a lack of culturally responsive mental health care (Vance 2019).

Within the Stories to Save Lives database—there was limited resources and conversations about mental health in African American elders, which is a problem within itself that presents the topic remains unexplored and undiscussed on the interviewees behalf. To explore the importance of support, Psych central includes an article about depression in the Black community medically reviewed by Jacquelyn Johnson. Johnson asserts “many Black people in the United States have internalized the need to lean into the expectation to always be strong, always be OK, and always be available for everyone else, despite the severity of what we may be dealing with” (White 2021). The National Institute on Aging provides an interview with Peggy Templeman, a 78-year-old retired social worker that experiences this internalized need to be strong and push others away in the process. Templeman says “I would begin to shun people, because I knew something was wrong and I didn’t want them to know” [0:24:00]. “It would come and then it would go for maybe over 40 years” [0:35:00]. This further connects that many African American elders tend to keep their difficulties with mental health to themselves because they do not want to be seen as a burden however, this can lead to unhealthy aging, as Templeman also connects about her triggers which included “high levels of stress, inner ear disease, and losing a valued psychotherapist” (00:01:33).

It is evident from these interviews and shared personal stories that mental health within the African American community of elders has been inaccessible and simply catered to other communities with differences in age gaps. Mental health care for the African American community should not be considered as a burden nor a luxury, and the longer we continue to rule out African American elders—as a society, we contribute to their health ailments. We must reconsider and reframe our thoughts and perceptions on mental health within the Black community to reframe the ways in which African Americans have been misled when considering mental health.

References

White, Taneasha. “Depression in the Black Community.” Psych Central, Psych Central, 9 Sept. 2021, https://psychcentral.com/health/depression-in-the-black-community.

Cherney, Kristeen. “The Cost of Depression: Medications, Therapy, and More.” Healthline, Healthline Media, 24 July 2020, https://www.healthline.com/health/depression/how-much-does-depression-cost.

23, Greta McGowan September, and Mearrha Apollon September 24. “African Americans and the Reluctance to Seek Treatment.” Counseling Today, 16 Sept. 2021, https://ct.counseling.org/2021/09/african-americans-and-the-reluctance-to-seek-treatment/.

Cuncic, Arlin. “Why Gen Z Is More Open to Talking about Their Mental Health.” Verywell Mind, Verywell Mind, 25 Mar. 2021, https://www.verywellmind.com/why-gen-z-is-more-open-to-talking-about-their-mental-health-5104730#:~:text=In%20a%20report%20released%20by,the%20Silent%20Generation%20(15%25).

Lincoln, C. Eric, and Lawrence H. Mamiya. “The Black Church in the African American Experience.” Duke University Press, https://www.dukeupress.edu/the-black-church-in-the-african-american-experience.

Vance, Thomas. “Addressing Mental Health in the Black Community.” Columbia University Department of Psychiatry, 8 Feb. 2019, https://www.columbiapsychiatry.org/news/addressing-mental-health-black-community#:~:text=The%20increased%20incidence%20of%20psychological,Black%20community%20by%20the%20medical.

“One Woman’s Experiences with Depression.” YouTube, 17 Oct. 2013, https://youtu.be/_thfjbAtTT8. Accessed 28 Apr. 2022.

Templeman, Peggy. “One Woman with Depression.” National Institute on Aging, 2014, https://www.youtube.com/results?search_query=depression+in+black+elders. Accessed 2014.

Nguyen, Ann W. “African American Elders, Mental Health, and the Role of the Church.” Generations Journal, vol. 42, no. 2, 2018, pp. 61-67. ProQuest, http://libproxy.lib.unc.edu/login?url=https://www.proquest.com/scholarly-journals/african-

“Southern Oral History Program.” 2018, https://dc.lib.unc.edu/cdm/compoundobject/collection/sohp/id/28319/rec/1. Accessed 2018.

Sessions, William. “Stories to Save Lives: Health, Illness, and Medical Care in the South.” Southern Oral History Program, 2018, “Southern Oral History Program.” 2018, https://dc.lib.unc.edu/cdm/compoundobject/collection/sohp/id/28319/rec/1. Accessed 2018.

Jenkins, Betty. “Stories to Save Lives: Health, Illness, and Medical Care in the South.” Southern Oral History Program, 2019, https://dc.lib.unc.edu/cdm/compoundobject/collection/sohp/id/28421/rec/1. Accessed 2019.