“Everybody has business they need to unload and spill,” said Erika Frazier. For her, it’s grief, the end of her marriage, the stress of being her parents’ caregivers, and the worry she wasn’t present for her two children during all those events. When Frazier’s mom died last October, she helped prepare the body for burial. Before that final act of love, Frazier had been running a kind of one-family nursing home for decades. When her dad died in 1996, her mother shut down. Frazier began mothering for her mother along with her children.
Now she feels lost. She can’t find the energy to find a counselor, and she’s struggling to process her feelings. Though her kids reassure her, she fears she failed them because her free time was often devoted to doing so much for her mother. She wants to find a therapist, but she isn’t sure where to start. It doesn’t help that it’s so hard to find a Black professional, someone who shares her cultural and racial experiences, near Crawfordsville, her lifelong home.
In her family “what happened in the house stayed in the house.” Therapy wasn’t considered.
Mental health has become less stigmatized over time, and for a while, Frazier and other Black women, like Vicke Hudson, found healing and solace in a group through Wabash Valley. The group was a space to process being a minority woman in rural Indiana.
Hudson also grew up here. Her family experienced segregation when Black Crawfordsvillians avoided downtown businesses, were turned away at restaurants, and excluded from other establishments. After civil rights legislation, her parents thought it would be better. Though it improved, Hudson and her sister still knew not to cross the street to play with White kids, unless everyone’s parents gave permission. When she was taunted, Hudson escaped in books. Hudson listened when her daughters and grandchildren talked about the isolation and bias they experienced.
Hudson and Frazier joined the group at Wabash Valley for the safe space it gave. At the time, Wabash Valley paid for a Black therapist from outside of the county to travel in and facilitate the group, but when the center added two new women with different needs, the group lost its purpose.
“Sometimes you need your own group, your own thing,” said Pam Darby, Crawfordsville Middle School Mental Health Specialist. “When a group gets stretched, it loses its purpose.”
Since then, Hudson and Frazier have struggled to find mental health resources. COVID complicated it further.
People of color have already found mental health challenging. Only one in three, Black or African-American people who need mental health treatment receive it, reports NAMI (National Alliance on Mental Illness). Here in Indiana, sixty-five percent of Hoosiers live in areas with a shortage of mental health care providers, according to USAFacts. To exacerbate that, only two percent of American Psychological Association members are Black or African-American. A lack of cultural competency in providers causes many to give up seeking help. Furthermore, a lack of insurance creates a barrier, and if a person lives below the poverty threshold they cannot afford out-of-pocket costs.
Many Black Americans turn to faith communities or other communities for support, which play a valuable role in mental health, but do not replace professional treatment. Sometimes it’s the only support accessible. For some, it's the only acceptable support. Therapy is often perceived as “asking for help,” which is hard for people who have been strong through so many struggles and traumas. In part, a shift in thinking about therapy from getting help to getting well,as one would seek with a serious illness, will help. Another solution is increasing the visibility of providers of color, which the APA is working to do with new dashboards like the Psychologist Locator.
It’s critical to personalize care. Claire Tchoula, a musician in Lafayette, shared her experiences with the caveat, “My Black experience is not the same as everybody else [who is Black].” Her family’s socio-economic status, access to insurance and providers, education, and the environment in which she was raised helped normalize mental health treatment for her. Initially, she sought a person of color to treat her. Then she found a therapist, older and White, who talks, listens, and teaches her in a way that resonates.
“I like the way she makes me feel,” Tchoula said. “In my personal experience, it is not necessarily important to have a Black therapist, but there needs to be more.” Tchoula looked at BetterHelp. There were only a select number, all very booked. She understands the distrust about health providers, an extension of the physical health history in the US. Tchoula prefers Black physicians and allergists when it comes to her physical health because she thinks about the Tuskegee Experiment, Henrietta Lacks, the AIDS Crisis, Black women’s mortality rates, and how Black people are treated as if they can better handle pain, but has found a fit with her therapist. It’s a matter of finding a good fit, and for some it means a provider with cultural competency.
Nun Katherine Weston, an LCSW in Indianapolis, praised the option of telehealth. She learned through the pandemic that treating traumatized patients via telehealth reduced barriers. Patients don’t have to psych themselves up for a drive across town, face traffic, and other stressors. She grew up in the AME church. Her father was a minister and encouraged her mother to get her degree in psychology. She converted to Orthodox Christianity before becoming a therapist, and in that spiritual tradition, the church is seen as a hospital. For her, mental health treatment and spiritual wellness support each other.
For Frazier, having someone recommend a Black provider, especially one who would offer telehealth, was a comfort. She is ready to see where God will lead her and what is next. Therapy is a part of that journey.
For her part, Hudson would still like to see her dream of putting together a center for comprehensive wellness and support out of Bethel AME in Crawfordsville. The pandemic interrupted her plans to establish Bandana Care. Why the name? Because bandanas can be used to wipe the sweat off a brow, bind a wound, and swaddle a baby. They represent care for strong people. Even strong people need support from time to time.