The Pandemic Is Making Mental Health Harder for Black People Already Struggling to Be Well
Imadé Borha has been trying to keep her mind busy, but not too busy.
For 39 days after Gov. Ray Cooper issued the executive order that reduced North Carolina’s daily operations to a trickle, Borha sheltered in place at her mom’s Greensboro home, thankful to be safe and comfortable. Four months before the coronavirus threat exploded into a full-throttle pandemic, she quit her job as communications coordinator at the Mental Health Association of San Francisco to turn Depressed While Black, the online mental health advocacy community she founded in 2015, into a registered nonprofit. Now that the project is indefinitely on hold, she’s not pressuring herself to be a high-achiever.
The multipartite stressors of coronavirus news, physical distancing and active job seeking are already an emotional and psychological heavy lift.
“I’m just figuring out how to go from here,” said Borha, 32, who is also a freelance writer specializing in mental health, particularly in the Black community. Now more than ever, being intentional and discriminating with her time is an act of self-preservation.
In 2019, after eight years of pursuing a proper diagnosis, she learned she has borderline personality disorder, a mental health condition characterized by abrupt mood swings and intense emotions, feelings of insecurity, boredom or emptiness, and impulsive, sometimes dangerous behaviors. By the time she could put a name to her symptoms, she said, she’d attempted suicide and been hospitalized twice. Now the pandemic has disrupted the measures she implemented to keep herself mentally healthy a year into learning how to navigate her disorder.
“It’s been difficult because all the conditions of physical distancing can be potential suicidal triggers, like the self-isolation and the lack of going outside and being in public places.”
“It’s been a challenge because suicidal thoughts definitely thrive when there’s a sense of ‘this is interminable. This has no ending,” says Borha. “So the challenge for me is how do I create a sense of structure when there’s no structure? How do I create a safe space when I don’t feel safe?”
The whole country has had to adjust and readjust and adjust some more as state and federal leadership scrambled to respond to the rapid scientific and medical developments around the coronavirus. The navigation of it has been jarring and uncertain. It’s all new and strange, and it’s put a psychological strain even on people who haven’t experienced depression or anxiety before.
In a survey conducted by the American Psychiatric Association at the onset of escalating fears, constantly evolving information and 42 states’ respective stay-at-home orders, 36 percent of Americans said the coronavirus pandemic was having a serious impact on their mental health. At the end of March, when governors and mayors began urging—then demanding—citizens to voluntarily isolate, the national Crisis Text Line reportedly handled 6,000 text conversations, double the number they typically received in a week. For the one in five Black people who were already living with issues such as anxiety and bipolar disorder, and the millions more who have been inundated by the preliminary 30 percent infection rate that’s devastating the Black community, the crisis has also upended the normalcy that often kept them from spiraling into episodes and breaks with reality.
“Unfortunately, I see a lot of folks who have mental health challenges that they can’t deal with on their own,” Borha said. “I grew up with repressed anxiety and I just acted like it really didn’t exist. So the anxiety’s coming to the point where I need to treat it. I might need to get on medication.”
“A lot of folks are realizing that our coping mechanisms on our own are not enough to handle this crisis,” Borha said. “We’re going to need more, and I think that this is the best time to get it.”
Like 95 percent of the American population, actor and philanthropist Taraji P. Henson has been in the house. Pre-pandemic, she split her time between Chicago and Los Angeles, but when California’s Gov. Gavin Newsome executed the country’s first stay-at-home order, Henson was one of 40 million residents canceling plans and limiting travel. The shutdown of sets and studios happened so abruptly in March, she and her fellow Empire cast members didn’t even get a chance to film the last two episodes of the final season and say their emotional goodbyes after five culture-changing years together.
Experts project California’s film and television industry will be shuttered until maybe August, and Henson has a few new scripts with her to read. But she hasn’t been focused on work. The Golden Globe winner has struggled with depression and anxiety. In the midst of a worldwide crisis, she’s doing things that give her peace: painting her nails, braiding her hair, using the time to relax. Regular appointments with a professional therapist over the past two years—she purposely chose a Black woman—have helped her understand why her dark days were starting to happen more frequently.
“I just got to a place where I couldn’t handle it. Working out and all of that helps,” she said of the tips for overcoming depression. “But I needed to understand why I was feeling the way I was feeling. I have good days, I have bad days, but I know what to do when I feel those dark moments coming. I meditate. I have exercises to do. I take my mind out of things.”
Therapy also helped her father, Boris, a Vietnam veteran who was candid with his family about how psychiatric care navigated him through his diagnosed manic depression, now known as bipolar disorder. He died in 2006, but Henson saluted his stigma-breaking honesty in 2018 by naming her Boris Lawrence Henson Foundation in his honor. As unemployment, income loss and health care disparities doubled down on poor and under-resourced Black people in particular, Henson, a self-professed empath, couldn’t ignore the myriad pre-existing mental health traumas that are only being exacerbated by the coronavirus and its consequential issues.
On April 15, the foundation introduced the COVID-19 Free Virtual Therapy Support Campaign to offer registrants five free sessions with a licensed, culturally competent therapist. So many people signed up on the first day, the foundation’s website temporarily crashed.
“We’re not talking about people like me or people who can splurge and go to the Bahamas for vacation,” Henson said. “We’re talking about people who are suffering, people this government obviously don’t care about. These people don’t have means to the best health care, education or great paying jobs.
“They need intense help. These are the people we’re trying to meet, to help. Because those are the people that are getting left behind. And it’s just not fair because a lot of these people are essential workers right now.”
Since the launch, more than 1,000 people have registered. Henson, who is bankrolling the initiative and actively fundraising for financial support to sustain and expand it, also hopes folks’ ability to interact with a therapist virtually will eliminate their previous hesitation about mental health care.
“I’m able to have a therapist and she helps,” Henson said. “But I also take on people’s pain. I see other people suffering in isolation and that’s the worst. I just felt like I had to do something. Now is the perfect time to try therapy because you’re in the comfort of your own home.
“You can do things that you wouldn’t be able to do in an office,” Henson said. “You can go in a closet and turn the lights off and just pour your heart out. The therapists are there for you. You can indulge how much you want, what makes you feel safe. And I think that’s been a plus and something that’s definitely been luring people who may have had reservations before.”
Black Therapists Matter
It’s too early to really understand the toll the coronavirus pandemic has had on Black mental health.
At St. Elizabeths Hospital, the only inpatient psychiatric facility in Washington, D.C., serving mostly patients of color in a community that’s 89 percent Black, the absence of effective virus protocol is the latest on a list of ongoing complaints and potential violations. In early April, 28 patients tested positive for COVID-19. A month later, that number more than doubled to 79, with dozens more exhibiting symptoms. A federal judge ordered those who had been exposed to be removed from the general population in the 450,000-square-foot facility after a lawsuit was filed on patients’ behalf.
Despite the mountainous factors stacked against Black folks’ well-being, in general and in the pandemic, the coronavirus crisis could prove to be a pivotal moment for Black mental health, said Dr. Ayana Jordan, an assistant professor of psychiatry at Yale School of Medicine. The disproportionate impact on the Black community has thrown an international spotlight on the poisons of structural racism. Counties where Black people comprise more than 13 percent of residents have seen 52 percent of coronavirus cases and 58 percent of COVID-19 deaths. It’s not a question of if they will be confronted and deconstructed, but how, Jordan said.
“I’m happy to be a Black psychiatrist at this time. I’m always happy, but definitely now because there’s a community that really needs culturally informed care and really needs to be able to process with someone who intimately understands the issues that they’re facing,” Jordan said. “It’s not just a ‘I can empathize with you.’ It’s like, ‘No, I feel it. I get it as well.’ That’s translating to people asking for resources. I’m glad to see what Taraji P. Henson is doing to use her platform.”
Every day, Jordan engages with Black pain in the effort to elevate, support and heal people when they often need it most.
“People are not missing their appointments, you know? So much of the time I spend with patients is just checking in and saying, ‘How are you doing? I know you’re in treatment for X reason—whether it be substance use, an anxiety disorder, depression—but how are you doing specifically as a Black or brown person dealing with the tragedies of COVID-19?’” she said.
When statistics materialized to evidence that more Black people were dying of the virus across major cities such as Chicago and New Orleans, Jordan saw a shift in her patients. They were more apprehensive, somber, affected, she recalls.
Jordan worries about the still-unmet needs of would-be patients in the safety net system who can’t afford smartphones or laptops to access virtual therapy. There are some people who are on Medicaid or Medicare, for example, who don’t have the technology to use something like telemedicine.
“So I think another thing that has come out of this pandemic is the basic right to WiFi and the internet because that’s another reason why people can’t get access to information and mental health treatment,” Jordan said.
“New normal” has become a coronavirus-era catchphrase to the rebuild that will happen for the tentative millions who can’t believe the word of a government that didn’t see this coming. Borha is taking her time, adjusting as necessary, and it has nothing to do with what’s going on in the city around her. Before the pandemic broke the rhythm of her day-to-day life, she kept a busy schedule to distract herself from her struggles with unemployment and mental illness. The pandemic has reminded her to embrace the complex parts of herself.
“Part of borderline personality disorder is self-soothing, creating spaces where your body tells you that you’re OK,” she said. “I go to the park. I weight-lift at home with dumbbells. I learned how to play guitar. I’m trying to pitch stories and do freelance writing stuff. It’s pallid.”
Maybe, but in the moment it’s everything. It’s saving her life.
Janelle Harris Dixon is a Washington, DC-based writer and editor covering race, gender, culture and class.
Co-published with The Crisis.