From
The Plain Dealer. In the picture, Damaris Abreu, a volunteer at the National Alliance on Mental Illness in Cleveland, updates the donation board August 19, 2010 for the organizations upcoming 2.5 mile NAMIWalks for the Mind of America event October 2, 2010. Abreu, living with a bipolar disorder, works as a volunteer for the organization as NAMI seeks to engage Cleveland's black and Hispanic communities in order to de-stigmatize mental illness.
A local mental health organization holds a workshop that gives people a hint of what it's like in the head of someone with mental illness,
The group, the National Alliance on Mental Illness Greater Cleveland, recently adapted the session to reach Hispanics -- who, along with blacks -- often view mental illness as a sign of weakness.
In an exercise on schizophrenia, volunteers stand behind the participants and say aloud admonitions such as: "This person was sent to you by the devil." "Do not listen to the things this person says."
The sentences, in English and Spanish, are repeated often. Louder and louder.
"It's like an explosion," said Daniel Quinones, a retired factory worker, who participated that day.
Quinones said he learned that people robbed of their ability to think clearly can do terrible things they really don't want to do. He had signed up for the workshop at the Hispanic Senior Center after he suspected a family member had a mental disorder.
NAMI, a national mental health advocacy group, has been in Cleveland since the mid-1980s. It aims to help people who live with mental illness, as well as their families, through support groups and education. Starting in 2006, the Cleveland branch's largely volunteer staff stepped up efforts to crack the puzzle of engaging the black and Hispanic communities.
Both groups have a checkered history with the medical profession. Cultural attitudes, distrust, a language barrier, denial and limited resources contribute. But unlike heart disease or diabetes, mental illness carries a stigma that makes it something many people would rather ignore.
"What African-Americans tend to do is say, 'This is the way things are, and I just have to deal with it,' " says Marsha Mitchell-Blanks, a part-time coordinator for NAMI's multicultural program.
That viewpoint also overlooks environmental factors such as crime and discrimination that can predispose people to anxiety, depression and other conditions, says Evelyn Rivera-Mosquera, a NAMI bilingual outreach coordinator.
Religion also can get in the way of treatment. In some congregations, mental problems are viewed only as a crisis of faith.
"I have gone so many times to Hispanic churches, and they've preached from the pulpit, 'Don't trust psychiatrists. Trust God,' " says Damaris Abreu, a NAMI volunteers who has a bipolar disorder.
"You wouldn't tell a diabetic to stop taking insulin," she said.
Statistics indicate mental illness should be taken more seriously among blacks and Hispanics.
National survey data published recently in the Journal of Psychiatric Research showed that blacks were more likely to have chronic depression and less likely to have depression treatment than whites. A nationwide study in 2009 by the Centers for Disease Control and Prevention said Hispanic students had the highest rates for suicidal thoughts and attempts among high school students.
What can start out as minor stress or emotional issues "can lead to severe mental illness if we don't deal with it," Rivera-Mosquera says.
For those with little money, mental health is an even lower priority.
"If you're poor, your first thought isn't, 'Let me go get therapy,' " saysKacie Armstrong, an elder in the Glenville New Life Community Church, a black Presbyterian congregation. "My first thought is, 'I need to feed my children.' "
General distrust of the medical community by blacks and Hispanics is fueled by histories of racism and maltreatment.
The black community's qualms are partly due to the Tuskegee experiments, Armstrong says, referring to the 1932-1972 U.S. Public Health Service study in Alabama that withheld medical treatment from 399 black men with syphilis in order to study the untreated disease.
In 2005, a Harvard University study found that 61 percent of black people surveyed felt blacks have a harder time getting health care than white people.
The language barrier compounds the reluctance of some Hispanics to contact health care professionals, much less about mental health. A shortage of bilingual staff makes it difficult for Spanish speakers to communicate with physicians and other professionals, said Rivera-Mosquera.
She often refers clients to agencies that provide services in Spanish, such as the Murtis Taylor Human Services System and Applewood Centers, Inc.
Blacks and Hispanics can be hesitant to listen to someone from outside their community, Rivera-Mosquera said. To establish credibility, she and Mitchell-Blanks first visit people in neighborhood churches and schools to discuss community concerns with their leaders.
The approach, referred to as cultural competence, builds trust and eases people into talking about mental health.
Mitchell-Blanks met Rev. Toby Gillespie-Mobley, an associate pastor at Glenville New Life, through a church member. She proposed a partnership with the church.
She and the pastors hosted a dinner and introductory workshop for the congregation in April. About 30 people attended. Discussion ranged from recognizing signs of mental illness to navigating the health care system.
Retired teacher Deborah Chambers said the workshop was beneficial.
"I came away with an understanding of where I can go if I needed to help somebody, and understanding that other people had gone through the same things I had," said Chambers, who has a relative that struggled with suicidal thoughts.
NAMI then returned for the church's three-day Bible camp in July to talk about the differences between healthy and toxic relationships, and how they relate to mental health. Each day averaged 90 participants.
The Cleveland public schools have allowed NAMI to hold several classes aimed at Hispanic families, including a Spanish-language class for parents with children who have mental health issues.
Fourteen parents completed the nine-week course this year.
NAMI also promotes their services within Hispanic community centers. One example is the workshop Quinones attended.
NAMI wants to reach more of Cleveland's ethnic minorities, but budget cuts holding it back.
In the past two years, its income from state and county channels has dropped about 30 percent, says Michael Baskin, the executive director.
"If it wasn't for some of the volunteers we have, we would not be in business," Mitchell-Blanks says.
From The Plain Dealer. In the picture, Damaris Abreu, a volunteer at the National Alliance on Mental Illness in Cleveland, updates the donation board August 19, 2010 for the organizations upcoming 2.5 mile NAMIWalks for the Mind of America event October 2, 2010. Abreu, living with a bipolar disorder, works as a volunteer for the organization as NAMI seeks to engage Cleveland's black and Hispanic communities in order to de-stigmatize mental illness.