Good morning. This is Dr. George Woods, and we are here for what I think will be one of the most amazing conversations and presentations of this series, Black Minds Matter Too, and they do. Learning through the lens of an African-American family member, and we have Ms. Chi Chi R. Crowder, L.E., presenting today, and I'll tell you more about Ms. Crowder in a moment. I could go on for an hour, but I've got to bring it down so she can have her hour. Chi Chi, would you go on to the next slide so that I can cover some administrative issues? I am attempting to forward the slide with a little bit of... need a little bit of support to start forwarding, Ebony. So just click into your presentation. Click on the main slide. There we go. Now you should be able to advance. Okay. There you go. Thank you. I just wanted to... the presentation was funded by an initiative made part and possible by grant number, and you see the numbers, so I'm not going to read all those letters and numbers, from SAMHSA. The views expressed in written conference materials and publications, and by speakers and moderators, do not necessarily reflect the official policies of the Department of Health and Human Services, nor does it mention... nor does it mention of trade names, commercial practices, or organizations imply endorsement by the U.S. government. Before we move on, though, I also want to, for sure, mention the African-American Behavioral Health Center of Excellence at Morehouse. Next slide, please. You can get continuing education credit. The American Psychiatric Association is accredited by the AACCME to provide continuing medical education for physicians. The APA designates this live event for a maximum of one category one credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Next slide, please. So if you want to download handouts, Gigi has a fantastic PowerPoint. You can go to the handouts area of the attendee control panel. You see the area... the arrow to the left, which will lead you to an instant joint viewer. You can click the page symbol to display the handouts area. Next slide. For questions, and please participate because there will be numbers of questions and comments that this will promote, use the questions area of the attendee control panel on your desktop or the question symbol and the questions area. That will get you to the questions and we will be responding at the end of Ms. Crowder's presentation. Next slide. Ms. Crowder has no financial conflicts of interest to disclose, nor do I. Next slide. I can't wait. Welcome to a transformational experience. Ms. Gigi Crowder is a native of Oakland, California, home of identical 29-year-old twin sons and two bonus foster sons. She's executive director of NAMI in Contra Costa County and founder of Black Minds Matter II, committed to improving health outcomes for individuals and their families impacted by mental illness. Her primary focus of supporting efforts has been to promote non-police response for individuals experiencing mental health crisis. Ms. Crowder is one of the most dynamic speakers and thinkers in America today. And I want you to listen and learn from the powerful message she's going to deliver. Gigi, Ms. Crowder, please. Thank you so much. Oh, wow. Wonderful. I love hearing from you, Dr. Woods, always. And I want people to pay attention to the fact that the attempt for this training is to make it transformational. So I get to make up words, even though I'm not a faith leader, I get to make up words. And the action part is the part that I would like for people to carry with them. When we're doing these type of trainings, we can give you a lot of information, but within 30 minutes, you can forget it all and go back to doing things that you have in the past. But what I'm hoping is after today, you'll take actions that could improve outcomes for this target population we're focused on today. So I always like to start anything I'm doing with setting a tone for it. Some would say setting the atmosphere for what you're going to receive. And I'm blessed to have a niece who's gifted in spoken words. So I'm going to ask you to please listen with open ears to Ariel, and you'll get an opportunity to understand why this work is so important. Ariel. Hi, everyone. I'm delighted to be able to be here and share my poetry with you. Thank you to my auntie Gigi for opening the space for me and allowing me to share my gift with you as well. The poem that I'm going to share with you today is titled therapy. They say I should seek therapy. I don't need that. How do I tell my therapist I'm suffering from being black? I'm suffering because I'm black. I'm suffering and I'm black. I'm suffering but I'm black. I'm suffering. Doctor, it's gonna take more than a session to meet me where I'm at. I feel frustrated and I can't watch the news because I'm triggered. Walking down the street don't know if I'm the next victim. I need help. But will you listen? I need help. Do you hear me? People around me keep dying and I'm supposed to go on living. Is this how life should be? At home they're talking at me sharing wisdom. I hear them but do they hear me? I tell them I'm doing good because I know they won't feel me. They tell me I'm gonna be all right. But I'm gonna be all right. Got me crying like every night. Can you listen? I need an ear. Can you listen? I need to feel. I go to work and work twice as hard to get half of my colleagues. Then I drive home to be pulled over because they can't believe I can afford what I'm driving. And I got my mama on speaker because I'm not sure if I'll be surviving. Is this the life that you're living? Because I'm tired of being strong. Them telling me not to cry makes me feel my emotions are wrong. I've been holding the weight of the world for too long. When is it okay to say I don't feel safe? Without hearing boy back in my day. Well maybe that's why my daddy left. Maybe that's why my cousin is on drugs. Maybe that's why papa can't climb out the hole that he's dug and instead he's drinking himself to death because he don't know how to speak up. I need help. Do you hear me? I need help. Won't you feel me? I'm scared they're gonna tell me I'm crazy so I'm keeping the thoughts inside. The medicine makes me feel funny so I'm self-medicating to shield my pride. I'm eating so I don't cry. I'm smoking to stay alive. I'm smiling through my pain while masking thoughts of suicide. All this because I can't speak. But I know I'm doing right because when I cry out they tell me nothing's wrong with me. I need help. Do you hear me? I need help. Won't you feel me? I've been praying. I've been fasting and he told me it's okay to seek therapy. So I'm here fighting these stigmas so somebody will hear me. They say I should seek therapy. I don't need that. How do I tell my therapist I'm suffering from being Black? Thank you. No thank you Ariel. This is a really powerful words and I hear this daily in the work that I do in the African-American community where individuals who live with mental health challenges are fearful of getting the support that they truly need so what we try and do at NAMI and at Black Lives Matter too is to reduce the stigma and to validate individuals around the feelings that they have. So I'll share a little bit more about me. I started working in the mental health field straight out of college after graduating from Cal Berkeley and I didn't immediately notice any disparities and I didn't recognize that I was a family member when I decided I would major in psychology. It was only later that I started recognizing that mental illness shows up differently depending on the community you're from and cultural or ethnic community you're from. So I have an aunt who lived with schizophrenia and one of the biggest regrets in my life is that I was more focused on her weaknesses than her strengths. So I wasn't, I didn't have the opportunity to get to know who we called Miss Honey because she masked her psychiatric symptoms with substance use which we now know that's pretty common to self-medicate but we just, I just remembered her disrupting family functions from coming back in the middle of the party intoxicated. She lived with a diagnosis of schizophrenia. We had many trips to Napa in California to visit her in the state hospital and what stood out for me most was okay we got a long ride, there's many children but we got a coca-cola at the end of the ride. That's what I focused on and then as I started working in the field and working in programs I started noticing some of the disparities because we get these vocational programs and we'd have individuals no matter what their skill set, no matter how brilliant they were, the African-American males will always sit to the house and grounds or the janitorial crew and you would guess if you were guessing where the women were sent they were always sent into the kitchen and when they were African-American so I started seeing these disparities and I wondered why the clerical unit which we thought of the people who had intelligence despite living with mental illness were usually filled by our white American consumers or peers or survivors whatever terminology you'd like to use but then a great opportunity came for me to leave the clubhouse setting and the vocational program and go work for the county and I was working for the county for a couple of years and I had an opportunity to take on the role as the ethnic services manager so the ethnic services manager is tasked with ensuring the services are fair and equitable for our community so I was like wow great I get to look at these disparities and come up with strategies to make sure that we're meeting the needs of the Latinx community the LGBT community the Native American community the African-American community and the AAPI community great how would I do that I think I've identified their cultural brokers meaning the individuals who who can speak on their behalf because if I'm expected to train that our full system of care in three years I'm going to need support from those individuals I was doing what I thought was a pretty good job until I got to African-American and I kept recognizing that there was no specific funding to address the needs of African-Americans not a penny going to any program to specifically address so I noticed that we were only focusing on language barriers and not looking at at any of the cultural differences that would mean that individuals from the African-American community may benefit from getting their services delivered in a more culturally responsive manner so we had terminology like unserved underserved and we needed to lift up inappropriately served if you're in a county and the bulk of the services are being delivered to individuals while they're incarcerated that might suggest that the services are being delivered in an inappropriate manner so as I shared I had a nun who lived with mental illness and then when my sons and I moved to the suburbs in northern California I'd had great success with having a daughter who was able to go to Berkeley and then get her master's so my sons and this big house we were in were like hey we should get some brothers and we did and because both of those young men that I adopted and in our community we don't like using terminology foster so they're my sons I gave birth to two and then through divine intervention I was able to have two additional sons and one who came to be my son live with the diagnosis of bipolar disorder and that's while working in the field I got an opportunity to see the true disparities that exist and I'm going to say especially for African-American males I have many stories of trying to get support for my son and my son unfortunately being 51 50 because the counselor he was working with felt like he was a threat to her when he raised his voice well there's a lot of passion in my voice so I know how hard it may be sometimes for people to try and contain that energy and how sometimes it's misread as anger when it's not it's passion so and supporting John and supporting so many others and seeing the disparities I started narrowing my attention on doing campaigns that would allow me to advance the effort around Black Minds Matter too and so then I incorporated and got a I founded an organization specific to addressing those needs something tragic happened in 2019 that added more energy to that work and that was a young man by the names of Miles Hall was killed in Walnut Creek after his mother had come to NAMI which is the National Alliance of Mental Illness seeking support so I've worked with uh psychiatrists psychologists uh LCSWs MFTs all trying to train them on how to better meet the needs of African-Americans in that training and in the NAMI signature trainings we always said make sure you make contact with local law enforcement when you have a loved one who lives with mental illness so that they know that they're loved by a family and that you will take care of them well we shared the same information with the mother of Miles Hall and so she did make contact with Walnut Creek police but Miles was tragically killed by law enforcement and so I felt a burden to support her as well as Stephen Taylor's family who he was killed maybe seven months later and Tyrell Wilson so the nation was focused on the killing of George Floyd but I was carrying some pretty horrific statistics that when individuals live with mental illness they actually are more likely to be killed by law enforcement than any other population no matter what their ethnicity but then when you couple that with the horrible statistics that African-American unarmed and particular males are a lot more likely to be killed I knew that young individuals like Miles like Stephen and like Tyrell were at even a higher risk so I started shifting my focus to supporting efforts around a non-police response to those living with mental health challenges and then as I said in my own home as a family member I was hearing that my voice in supporting my loved ones with an s at the end who live with mental illness was not being embraced so I took on this this this role as a person with lived experience as a family member and I recognized that no matter what ethnic background the individual was from the family member voice was not being elevated in my opinion enough to be included in the treatment planning and the potential outcome so it was really important for me to elevate and so the green ribbon is the symbol for mental health but the black ribbon that I put behind it is the ribbon for social justice because I think one of the biggest social injustice we have is not meeting the needs of people who live with mental health challenges yet we now know that it impacts one in five individuals and I can't I don't even know anyone who doesn't know someone who lives with a mental health challenge does not mean that it's a severe mental illness but at the time that we're in COVID our call volume has increased dramatically around individuals seeking support because of anxiety and depression and me carrying information about the disparities that exist for African Americans I know that the impact will be greatest in the communities that are the most under-resourced and we'll talk a little bit more about that later so one of the things I also carry with me understanding that in this country African Americans have not always been greatly embraced I follow a Dr. Kenneth Hardy who says when a black mother gives birth to a male child her sleep is forever compromised I think it's also true when when parents have a of any color have a child who lives with mental illness because they're always thinking about that phone call that they may receive and so we're not getting into that REM sleep but when it's a black mom and she has to also worry about a child who does not live with mental health challenges but also may be in a place where they get off of a shift at 9 30 10 o'clock at night and they've already shared with her that they've been put over by cops many times or they've been in situations with peers that have not worked in their favor that is why a black mother carries a lot of extra burden and has the one of the highest rates of heart disease so today is about us better understanding the additional burdens that African Americans and family members carry and that's working together to improve the outcomes so I'm going to move to the next slide I'm going to give you some input about why we continue to struggle I don't believe we can begin to address the issues that will lead to better practices amongst mental health providers until we come to a point where all providers work toward being first racially sensitive to be racially sensitive you have to be able to acknowledge there is a problem and I'm going to give you an example I recently was asked to join a panel for Mount Diablo School District in California they said that they had recently received notice from the state that they were needing to work on the very disparate data that they had that out of 842 students that were African American 38 percent of them were had an IEP or were in the category of intellectually disabled so they wanted to pull together a focus group and they wanted some individuals and who I saw on the list were providers of mental health services throughout our county but what was disheartening for me is this was for targeting African American but I was the only African American in this focus group so it's like hmm how do you hear the issues and not have the folks most impacted by it present how can you call this a focus group so the first time we met I voiced my discontent and said no I think we need to do a better job of reaching more African American family members more African American providers of mental health services so we can kind of have a better idea what we're what we're struggling with so I said either that or you can just solicit me for a key informant interview because I speak to a lot of parents who have loved ones who do have IEPs, which is Individual Educational Plans, and they are in specialized programming at schools. But what became apparent to me is that the racial sensitivity wasn't there from the school district, because of how they set up the focus group, but also the money wasn't going to trickle down to where it was most needed, because they were spending most of their money on studying the problem instead of solving the problem. So I think it's my responsibility, and I shared my concerns. That's my effort at moving this group of people who are educating brown and black children who have horrific graduation rates and horrific tech scores, meaning that they're not doing well, how to be more racially sensitive towards solving the problem. Because the next part of that is once you're racially sensitive, it has to be followed by racial responsibility. We're past the time where we can say we don't see color. If you don't see color, you don't see the issues that make it different from my child, who I say my son's all brilliant, talented, beautiful hearts children. But if you don't see the additional burdens that they carry as black men, then you're not going to approach them with solutions that would benefit them if you're not doing it in a way that's sensitive. And if you're not taking responsibility for that as an issue, I will never blame one individual for why we have the disparities, but I will look at systems and I will charge people who are in decision making positions with being more racially responsible. And I did that and I continue to do that with my voice. I cannot be silenced around issues that will impact or hurt my community. And that's what led to Black Lives Matter, too, and the work that I continue to do. I'm going to move to the next slide. One of the ways you can be sensitive when you're working in the African-American community is to understand that traditional Western approaches tend not to work well for us. We did a survey on the chair of the California Mental Health and Spirituality Initiative because when I started looking at who were the cultural brokers, the individuals who can speak on behalf of a community, even in mental health, I kept being pointed toward the direction of faith leaders. So 80 percent of African-American mental health consumers that meet those receiving services and their family members across California reported that spirituality is important to them. And many went on to say that they felt like if they live with mental illness, if they were going to be better, it would be because God allowed it. So we couldn't ignore that. People, when in crisis, turn to their faith. And this held true, especially for African-Americans. I'm not apologetic about working with the faith community to spread, erase misinformation about mental health and promote accurate information so that individuals can seek out the services that they need. One of the other things that we noted in our survey was that 72 percent reported that they believe it's appropriate for the public mental health system to address spirituality as a part of mental health care. So a lot of times when you're working in public health settings, as I was doing with mental health, we were taught to not meet people completely where they were at. But I've been in so many rooms with individuals who were having a difficult time, who asked me as I worked in the field as a clinician to pray with them. And I had to tell them, oh, we're not supposed to do that. We can't pray, but I can lead you into the right direction. This doesn't mean proselytizing. This does not mean that you're telling people to go into a church service. We have to understand the difference between religion and spirituality. A lot of the work I do is connecting people with their purpose, and that's when I start seeing healing take place. And so what I'm hoping from this conversation, which will make it transformational, is that when any clinician, any psychiatrist, any psychologist, explore the individuals as the expert of how they think should be a part of the ingredients to their healing. We don't have all the answers, and they're the expert of themselves. And when you work with African-Americans, they do often want the role that their faith or spirituality play to be included as part of their treatment plan. We don't want to reject medication. We don't want to reject therapy. We want to include what's important to the individual. So 89 percent reported that that prayer for them was also a wellness tool. So we have to allow for that to take place. I don't get it, wasn't getting any funding from my county around addressing the needs of African-Americans. So I started a support group and we're actually meeting in my home. And I was providing a meal because a large volume of the calls that we were getting were family members who had a loved one. And a lot of moms and their children were almost always connected with the criminal justice system. Sadly, even Miles Hall started decompensating because in an effort to get support for him, his loving mom had to share the fact that he had a pocket knife, a pocket knife. And so that was how she was finally able to get him 5150. You know, the Warfare Institution Code, danger to self, others are gravely ill, but so often we have to sell our children in order to get them happen. You know that that creates a tension in the household. So. Sadly, after her letting the officers know he had a pocket knife so that he can get into psych emergency services, a letter comes from the DA's office saying that he was being charged with holding the weapon, of course, not of course. But because of his fragile mental health status, after he got that letter, he started to have to go to court, a feeling of hopelessness set in. And sadly, he started decompensating and ended on that tragic day in July of 2019, having a 5150 that resulted in him being killed by law enforcement within two minutes of them arriving. Which means that there's something inherently wrong with the person being shot and killed when they themselves do not have a weapon. But that's what we're doing. And I mean, in California with a new rule of law, actually, we're trying to get signed AB 988. I'm hoping individuals will from California and across the nation. Trump actually had this legislation, so it's bipartisan education legislation around having a better response to those who are in mental health crisis. So, what a lot of the parents in the group share is that they're the burden that they carry and they're aware of it because their cultural needs of their children aren't being met. They feel the impact of trauma is never considered. And so, systemic racism and trauma are all discounted. So, when you're looking at why we would have a system that has so many young people, especially African-American males in juvenile hall for committing or doing a bad act. And not recognizing that many of those young people live with, have experienced a trauma that should has gone unaddressed or actually live with some early signs of mental illness. And then some of it is just pure systemic racism. If you're in a county that's less than 10%, but your juvenile hall has over 60% black males, then you have to realize that there's something that went wrong. When you're in a country where children in preschool are being expelled and the numbers are showing that it happens more often to African-American children, then you're somewhere, something is not working well. And we have to look at root cause and start addressing it. So, we tend to operate with a one-size-fits-all Western paradigm that does not value the opinions of the black family. So, if I go and I sit in and I'm trying to share what might work best, I need an open space to do that. I need more people interested in hearing, this is what I think may work versus shutting me down because I do not have enough letters behind my name. That is why I embrace the L period, E period for lived experience. It's not a club any family member would want to join because when we have children, we want our children to thrive, to get the most out of life, to not be burdened with mental illness, which is so harmful. So many of the young people who I get calls from in my office, most of the calls are not from African-Americans. Most of them, because it's not me, are actually from white Americans who are middle and upper middle class and they want to know what's going on with their loved one. Well, often I will work with the families, but some, but pass them on. And then I work with the young person because mental illness is just so debilitating and they never plan that, they don't know what's going on. And so they need to know that there's still a purpose in their life and they're still lovable. And that's no matter what color they are. They need to know that our ethnic background, our language, they need to know that they have a purpose and they're living with mental illness and they may need to take medication. They need to seek therapy, but too often that doesn't happen in a culturally responsive way and that your lovable part does not, not just that your love, but your lovable part is not expressed to African-Americans and especially not males. And they don't feel it in society. So we have to do more work there to be responsible of embracing the fact that there's been a lot of damage hurt and we have to negate the past and look at the future for that individual. And I think you do that with being hopeful and meeting them where they're at. So we've been blessed at NAMI to receive a $500,000, half a million dollar, 18 month grant, and I'm going to use it specifically to work with the African-American community and staff it with individuals with lived experience. That means people who have their own personal challenge with the diagnosis of a mental illness and the family members, because when you get support from someone who's been through a similar experience than you, you tend to believe that if they got better, you can get better. So there's a place for trained psychiatrists, psychologists, LCSW, but there's also a place for individuals who have lived, like lived experience to aid and supporting individuals. And we're at NAMI, we're currently contract by FEMA and the California Department of Healthcare Services to provide non-clinical support and resources for African-Americans who are impacted by COVID, the COVID-19 pandemic. And we're getting calls from the African-American community. You know, there's a lot of fear. Well, if you've had systemic racism for such a long period of time, we now have individuals, and I've been saying, it's probably not fair for me to say it, but self-inflicted harm because they're not getting vaccinated because the distrust is that deep around this government and what it has done in the past. That the HIV AIDS pandemic continues on for African-Americans, and now we see the pandemic in my county, 50% of the individuals in the last week who were tested positive for COVID were African-American in a county that's less than 10%, and only 58% had been vaccinated. So we really have to roll up our sleeves and get cultural brokers and others out to share with individuals the importance of getting vaccinated. But this is a direct result of the distrust that a lot of African-Americans, and it's warranted, have toward systems. And so, for me, all of this is about mental health and mental wellness and getting people to a place of mental wellness where they understand they need to take the vaccination. And so we're happy to have gotten that contract and have it extended through February to do that work as well, specific to the African-American community, understanding that it looks different for African-Americans. The trust factor and other things we need to do differently and being able to put that in place. So, one of the things that we did when we recognize that African-Americans first turned to the faith community for support, as we develop a training called Mental Health 101 for African-Americans, we train faith leaders. And because so many people outside of the faith community work with African-Americans, we also created a training called Spirituality 101 for providers, for people who work with African-Americans, for them to understand why faith and spirituality is so important. To African-Americans. Then there's a program designed for children. We believe every child needs an IEP, not an individualized education plan, but an individualized empowerment plan. You're not going to have strengths in all areas, but if you identify an area that you do have a strength in, and you use buddy-type systems and other tools, you may be able to overcome the deficit, but you have to be affirmed that you're a winner, that you have purpose, and that doesn't happen enough. And so we talk about academic gaps when there's really a lack of opportunity gaps. And, of course, I shared that with the Mount Diablo school system, and I cited systemic racism as the number one factor to why they have the disparity that they have. And the Keepers of the Flock is a training we do through our mental health and a bridge over troubled waters. The role that faith and spirituality has played long term for African-Americans and for their family members. When those family members come to my support group, they often are talking about the only thing that keeps them going is their faith and their belief system and the coming together and scripture and prayer. So what is a mental health friendly provider? And that's anyone who's on here who has a responsibility to support the needs of African-Americans around mental health. You are mental health friendly if you are committed to eliminate stigma and discrimination and improving outcomes for African-Americans, peers, patients, family members, through utilizing what we call culturally responsive practices, and I'll share a few with you, and approaches that create a sense of belonging and inclusion in all facets of its treatment models and programs. We can't continue using a Western approach that does not impact. We can't continue giving out medications without considering ethno-pharmacology. And how will this person with this body structure, with this ethnic background, how are they going to respond to this medication? It's not and should not be a one size fit all. It should be tailored to meet the needs of the individual. So if you're doing that extra work being racially sensitive and responsible, you'll go the extra step to learn what might work better for the individual. So in Alameda County, in the winter of 2011, we actually did our own survey and study groups to try and figure out what could we do different to better improve the health outcomes for African-Americans. We identified the issues and the concerns. And even though it was done in 2011, has it gotten better? No. Just like the Surgeon General Report of 1999, things have only gotten worse for these communities. With all the talk about community-defined strategies and all of that, we still rely on things like evidence-based practices that often are one size fit all, that do not meet the needs of individuals. We had great improvement in medications through the 1980s and 1990s, but the additional ancillary services, but how does this person respond based on their ethnicity? That work has yet to take place. So it's still very much college studies are done. Medications must be white male 1825 when I was a student at Berkeley and ran out of money. I'm going to go over to Tolman Hall and I'm going to sign up for one of these studies. A lot of them I didn't qualify for because I didn't meet that narrow margin. And so I, you know, had to do without the slice of blondie pizza for a dollar because I did not meet that criteria. And that's still happening today because most studies are done on college campuses and they're not necessarily done with inclusion and meeting the needs of all in mind. So we did that study. We looked at inaccurate diagnosis. We looked at all the problems that would create that poor outcomes that African Americans experience. So one of the things that was really important was we wanted to look at historical trauma, discrimination, cultural stigma. We were looking at the over-representation, right, that African Americans too often are in the most restrictive environments and often in voluntary settings, we looked at the lack of including the family voice to share who this person really is versus what you're seeing. I often tell family members when their loved one, no matter what ethnicity or culture they are from, I will often say what you're seeing is the symptoms of an illness. Remember your loving precious son before this illness took over. So I'm often having to share that same information with providers of service. You know, what you're seeing right now is this person untreated for their mental illness, but his mom, his dad, his auntie, his grandma can share what he was like before the illness. So include them, work with them. And then I thought, again, there was a need for non-behavioral health community supports and specifically for me, opportunities to work with the faith community. So, our group was made up of Board of Supervisors, because you want that accountability. You want to be able to say, hey, supervisor, so and so worked on this project. And then the staff and the criminal justice organization, community based organization, other advocacy groups. What was important to me with the lived experience groups, the consumers and the family members, we had to also look at medical providers, because we know a lot of times when communities that are distrustful around mental health or psychiatric services, they will go to their primary care physicians to get their needs met. And sometimes it works, mostly it doesn't. And then we looked at it by breaking it down to subcommittees, because we knew it was important for us to follow this, even though communities of color tend to be more holistic in how they approach things, we knew it was important for us to do it by age group. And so we followed the California state guidelines for the age groups. And you'll note that for transitional age youth, we went up to 29, because we recognize too often individuals in the African American community get their diagnosis of having a mental illness where while incarcerated, while acting out in the school setting, and they don't get it while in the treatment setting. So 29 seemed more appropriate, although the money doesn't generally fund up to that age, we thought it was important to to recognize six to seven years later than their right counterparts. Okay, we use subject matter experts, we have focus groups, we looked at all the research that was out there that existed, and we looked at evaluations, and we really do this 18 month process, we really dove in deeply and had some really important keynote speakers at some of our conferences. I give a lot of credit to the direction I took this from who I think was a mighty oak tree, Dr. Carl Bale, and we work with Dr. Tony Iton, who participated in the unnatural causes research. And then we listened to faith leaders who people bring their problems to them, and we have focus groups with the unsheltered population, with different age groups and family group, the family group and what they were seeing and what they wanted to see done differently. And all of that was included in our report. We also looked at the challenges, the current landscape, the fact that fewer than 4% of social workers at this time nationally were African-American, only 2% psychologists, only 2% psychiatrists. In the United States, although I will say California has a larger number. And we start talking to how we can have specific targeted work toward having incentives toward hiring. I mean, are you advertising at historical black colleges? Where are you looking? Are you, do you have professional mentoring? Do you have opportunities for people who wanna go into field to see someone who's been working in the field professionally and with success? All of those are opportunities for us to have a more reflective, much more reflective service industry for those seeking out mental health services. I talked a little bit about the suspension rates already and the living with, these are things that we put out of the study, that African-Americans were likely to be incarcerated, that the depression and the personal weakness that a lot of times African-Americans view depression as a personal weakness. So therefore don't seek out services. And then the fact that so many of the individuals who live with mental illness self-medicate. And that's true across the ethnic board, but too often the compassion for a person who lives with a mental illness and is African-American and may be using different illicit drugs and alcohol to self-medicate, it's no compassion show to those individuals. And we saw that with the recent opioid addiction problem that there's money being thrown at solving that whereas it was not the same approach when crack was an epidemic in the African-American community it was criminalized. And we find that African-Americans who live with mental illness are criminalized. So in my mentioning that we were gonna do something that was transformational, if you're on the call, I'm asking you now, what do you think all people need to feel good about themselves and to thrive? Like to be at their best in wellness, just to feel whole. Write your responses in the question box. And a little later, when I wrap this up, we're gonna have Dr. Woods read out some of the responses. So why do people need to feel good about themselves and thrive? And this is true for people who live with mental illness, people who just in your daily walk, all people, what do they need? So please humor me and support me by putting your responses in the question box. Okay, so I'm focusing my attention now on children and youth because I think if you look at root cause and you look at correcting problems start early, we need more prevention programs instead of us when we start talking about defund the police and all of that, which I don't use that terminology, but I understand why people think that's the best place to go when a county or a city has a budget. If you have more preventative services, if you have a youth center, if you have things that go into keeping a person from being incarcerated, supporting a person in their mental wellness, you don't need the reactive jails and probation and all of those other systems as much. So if law enforcement was protecting and serving and not responding after a crime, we might have more better services. And when we start looking at children, we looked at inappropriate diagnosis, we looked at the over-representation in foster care and all the hurdles that family members face when their loved ones are in the juvenile justice system. The fact that children and family are often unable to provide historical background or context when they're asked for it. And that other Mount Diablo school district case was a similar, no family members were even included in the group, the African-American focus group. We looked at suicide rates among African-American children five to 11, and there was an urgent report that SAMHSA issued in July, 2019, it's gotten worse. Now COVID has contributed to it, but it was likely gonna get worse anyhow, because why? Because we're not looking at the issue for African-American youth and why they might feel sense of hopelessness. If you see a man calling for his mom, who's deceased and the children see that, the feelings and the man looks like someone who they can grow up to be, they're gonna carry some of that sense of hopelessness. So we just really want to be aware of everything we can do. First of all, to protect our children, but to show them that they're lovable, but to get them the type of supportive, neat things that would support them. And family members talk to me often about what they could have done different, but they rarely talk about what the system could have done different for their child to help them get to a better place of understanding, of, you know, no, it's okay that you didn't get 100% on that paper. I mean, I think I have enough time to share. One of my earliest disappointments in life was going into a classroom, deciding of my five sisters, I would be the smart one. I will be the one to get the straight A's and getting a negative or a negative two on two answers. And I think the first grade, because the teacher had asked us what time do we go to bed and maybe something about an eating utensil. And I kept putting down nine o'clock. I put nine o'clock down because that is the time we went to bed on most weeknights. My mom worked, my dad worked. It took her a while to get home. She had to prepare dinner. She had to go through homework with us. We went to bed at nine. The teacher told me the correct time should have been seven o'clock. And I thought, so early? You know, why would we go to bed so early? The street lights haven't even come on yet. We're outside playing after dinner. We're taking turns. My mom's doing her hair. And then I had to make a choice. Am I gonna give the answer that I know to be true? Or am I gonna give the answer that the teachers are looking for? The teacher who's not looking at cultural differences and the red lining and all the things that would position an African-American family to have at that time, both parents working out of the home and therefore their children going to bed a little later. I learned how to, some might call it cold switch. I learned how to give the teachers what they want. But then I knew not to go back and ask my mom, you know, why are you having us go to bed so late? Because I understood at a very young age that there were cultural differences. A lot of kids don't get that. So they will go back and they will insist with the teacher. No, it's nine o'clock. They might even look at the clock and take a, well, don't have cell phone back then. And say to the teacher, no, I know I'm telling the truth because we dare not go back and question the judgment and cast our parents in the light of being a horrible parent because they're not going, putting us in bed two hours before what this teacher had deemed to be the norm. These kinds of things break individuals down spiritually, mentally, when there's so much inconsistency with what's real for them, but what the classroom is asking for them. Not all kids have the ability to see as I did that. I'll give them what I want to get the A and it has horrible outcomes. So what we came up with recommendations for this age group was clarifying assessments and community appointed consultants. And so when you promote clarifying assessments, you take into account the considerations that I just said about both of my parents working. So you don't see all behaviors as defiant. You think about, oh, this kid may be acting out because he's suffered some traumas. And so instead of seeing it as this kid should be in IEP courses, this kid should have an IEP, excuse me. This kid is a behavioral. You focus on the way that kid presents and you come from compassion and you give them opportunity and you use individualized assessment tools. Then when you don't understand what's going on, you bring in a community consultant from their community who can better explain to you often in the African-American community when there's no more money at the end of the month. Yes, the dessert might be sugar on rice. Doesn't make sense, but it's the mom giving her children something with there's no money for the cookies, the cakes, the pie. It doesn't have to make sense, but you don't have to apologize and you don't have to make it a negative when you don't understand. I've been in many situations in my role as the ethnic services manager where I learn from the community. That's what being culturally responsive is. I don't have to have all the answers. I need to respond to what that community says is important to them through trust and belief in them versus me needing to be the guide and making everything about what makes sense to me or in the Western one size fit all approach. And that's where we've harmed a lot. Using natural resources, increasing referrals and information sharing among providers, families and others. So sometimes you have, oh, you got an appointment here, here, here, all at the same time. They're not sharing the information. And so a family is always feeling like what? Like they're in trouble with a particular agency because they didn't do this or they couldn't make it to that meeting. And if you share the information, you might get a better picture. You can't come in as a social worker and tell a family when CPS has got involved that the kid needs soccer classes and not look to see if they have the resources or can get the transportation. I'm in a county where most of the kids are told who live in the East are told they have to go to the West to fulfill some kind of probation without the resources to get there. So they keep getting violated. And so what do we want? We want a prevention program in the East, but we also want services out there so that the families don't have to struggle and always be out of compliance. That wears on you. And of course, we want to include not just the parent, but also the child in the treatment planning and the decisions about how their services will be delivered. And I came up with an approach just kind of on my own called I'm a Winner. That's a community defined that connects faith leaders and churches in the classroom. Because I saw this trend where we were having black males going to elementary schools. They said, oh, we don't want the police in there. The police is disruptive. We don't want them in there. But they were funding programs where they were having black males with the belief system. This kid is gonna act out. And when they do, we'll have a black male go and be the mentor. What about a nurturing room where we have more compassionate retired school teachers from their community and the church adopts the school where the kids are not doing well and they are feeding positive when young kids. And I'll say most kids are having a difficult time. They act out or they say they have a stomach ache and they parent all this stuff. It's nothing like a going into an environment with someone who's nurturing to be there for them. And I'm looking at the time and I'm running out. It's just so much to share, but you guys have the handouts. So we know that we have to do a better job now because of this and learning that studies are already showing that it's the African-American students who will likely come out of this COVID-19 far, far behind their peers because of what? Economics and resources and opportunities, okay? So the I'm a winner program, just that the affirmation sharing with the individual. And we really have to get a handle on trauma-informed care too, because we can't express to the person that they're the worst thing that has ever happened to them. You're not your trauma. So you're a king, you're a queen, you're a winner. And then restorative justice approaches have proved to be successful as well as mentoring. Instead of an IEP, we have to do individualized empowerment plans. Instead of pushing STEM before a child is ready, African-Americans have benefited greatly when they have included high STEM. The H is for history, the I is for innovation. So instead of just the academic part, let's do the high STEM part so that they can see examples of individuals from their background who've done well. And then there's goal setting and rights of passages that many young people missed out on because of COVID. So we have to find creative ways to put that in place. Why? Because black minds matter too. So I think we have enough time, Dr. Woods, for a few questions. Dr. Woods, are you with me for the opportunity to go and maybe hear some of the questions what people put when I asked the question, how do people thrive? How do all people thrive? Gigi, there was one response and the response was safety. Safety, okay. We didn't have a very active group of people. What I had before I posed that question before, all people need to feel loved and lovable. All people need compassion. All people need to feel protected and safe to thrive. Gigi, can I just comment quickly? Yes, of course. I took 22 pages of notes. As usual, I am so honored to learn from you. And I learned so much from you. And I wanted to, this goes back to two things that I wanted to ask you about. When you came close to talking about your grant, for example, or other structural relationships that you had, there were terms that really offended me like non-clinical or non-behavioral. That somehow what you were doing was not clinical or not behavioral. I was deeply offended by that because I felt like what you're doing is exactly what's needed more than a pill, more than a 50-minute session, which you were meaning. Can you talk about how you see your role as being clinical and as being behavioral? Well, I haven't sat in rooms with individuals with a lot of letters and sometimes loans behind them. I know that the work is impactful that we do, but when we apply and we leave with lived experience, it's seen as non-clinical because you don't have the degrees to support it. Yet it is very impactful. So I appreciate what you're saying, but I have applied and got funding through COVID for a non-clinical support for the African-Americans where we have a lot of non-clinical support. We're just sharing the resources. But when our counselors, our crisis counselors are on the phone with those individuals and giving them the tools that they need to make it through the night, it is very clinical. It is very supported by long-term research from their personal experiences. What's interesting is we just got a grant and I'm gonna focus on individuals who have been incarcerated. So a young man caught me looking for work and he thought the answers he was giving me would discount his ability to work for me. And they were everything I needed. A black male, 37 years old, who's been incarcerated not once, but twice, who lived with a diagnosis of bipolar two disorder. Why? Because I work with so many younger people with that diagnosis who don't take their meds, which he does, who understand that role that he can play as being an example or a testimony to it does get better. So he thought traditionally he wouldn't be valued, but he's one of the most valued, he'll be one of the most valued individuals in our organization and will probably have much better impact than any other role for these individuals who keep having repeat visits to psych emergency services because they don't take the meds, they don't see a way out of this diagnosis. Well, when you're addressing a structurally racist organization like the American Psychiatric Association, it's very important to me to call out the other types of the other structurally racist situations and to the idea of having to get money by calling myself non-clinical because you are organizing in the community and you're doing actually the clinical work that we're not doing is so very, very important. Go on. Well, in California, we just passed a peer certification bill that allows individuals who have lived experience to build Medi-Cal. So we're making progress in California toward understanding that living experience can sometimes be much more needed than what had been taught in the DSM-IV or what has been five, whatever number we're up to with that. And then that it's a combination of the tools. We're never gonna reject the role that a psychiatrist, a psychologist or a licensed master-level clinician plays, but we need to also include a more holistic approach and make space for lived experience. So one other quick comment. Tell me about loved versus lovable. Well, we throw out the word love so easily. It's everywhere. I love you, I love you, I love you. But if a person doesn't feel lovable, like people that they carry the tools for someone to see them and just love them, they have to feel it. And so you have to go a little deeper with pointing out to them their value in this world, how they contribute to your happiness. And that is not one-sided, that they have the greatest power in being lovable, meaning people gain something from their presence. Hope that. Somehow I missed that in medical school. Yeah. Yeah, somehow I missed that. Well, I just wanna once again, thank you. We're over our time. I wanna thank you and honor you for educating us once again and humbling us because we need it. Thank you. Thanks. I hope that many people will get this recording. And I know I wanna get my hands on it and send it to people who I feel need to have participated today, but I know how busy we are, but they will have an opportunity and possibly a quiz from me. Got it, got it. Well, take care everyone. And we'll see you at the next webinar. It's Gigi Crowder, one of the special people in our community. Thank you so much. Thank you. Take care. Goodbye, everybody. ♪♪

Black Minds Matter

African-Americans

Culturally responsive mental health services

Family voice in treatment planning

Disparities in accessing mental health care

Systemic racism and mental health

Trauma and mental health outcomes

Holistic approach to mental health care

Spirituality and faith in African-American community

Non-behavioral health community supports