My name is Raul Andrews. It's my privilege to serve as the executive director of your foundation. This is the Mind, Body, and Soul session. This is the last of the 15 sessions that the foundation has had a privilege to host. A quick overnote about how we got here. As many of you know, in San Francisco, we launched the Mental Health Care Works Campaign for Humanity. At that time, we did not have a national campaign around public global mental health awareness and literacy. It was a way to not only redefine our role in the House of Medicine and the community writ large about how to deal with all of the anxiety and depression that we're seeing up, down, and across the globe. As we launched the campaign, in the first hundred days of Mental Health Care Works, we had 32 million audience impressions from community members by paid, earned, owned, and social media channels in the first hundred days. We know we only have 39,000 members, so it wasn't like we were just recycling across the membership. People wanted help and they wanted more information because they wanted to get well, they wanted to be whole, or they wanted to make sure that those they love had a chance to be whole and well. By November of 2012, 31, 2023, we had eclipsed 54 million audience impressions. As of the end of the year, in November, when we went to components, we had reached 54 million impressions in that campaign, and the reality of it is we declared then that by the time we came to annual in May, that we would be at 100 million impressions. It is my privilege to report for those of you who haven't seen any of our material, that we are now at over 240 million audience impressions for the campaign, and that is a credit not only to our membership, every division in APA has got a responsibility and a role on the team in the Mental Health Care Works campaign. It was the first time that the foundation, Your C3 Charity, had been the tip of the spear, and so when we're out there, we operate on five pillars because I know many members lament that they know we have a foundation, don't really know what the foundation does. So we have a bold mission and vision to promote mental health and well-being where we live, where we learn, where we work, where we worship, and where we play. So if you ask us to do anything outside of one of those five components, we can't do it with consistency or excellence, but we might try. But the biggest thing that made the Mental Health Care campaign so important is that out of all of the great work that the foundation was doing before the pandemic, we had never reached a million audience impressions from the community. So we needed something to put us on the front doorstep of the House of Medicine. That's what Mental Health Care Works campaign has done, and so as a result of that, we were at Mass General and other places in November of 2023. People had seen some of our campaign material inside and outside of industry, and they said, well, what are you doing about suicidality of young men and African-American and black men and boys? Now, they're asking an African-American black executive director of your foundation, what are we doing about it? And I'm like, well, obviously, we're working on whole health, and I gave them the five pillars, and they're like, yes, but does your campaign have room to take on something like this? And we knew about John Henryism, as a matter of fact, I probably suffer from John Henryism, but as I tell everybody on my team and as I tell this panel of pastors and doctors, you know, I don't pray for a full cup. So don't come to me and say, Ron, you can't pour from an empty cup. What I pray for every day is a cup. And if you give me a cup in whatever form that is, I promise you I'm going to find a way to fill it up every day, and I'll come back tomorrow and put some more in it. But I need a cup. And so that's what we had to do for the House of Medicine, because we have to be the front door of the House of Medicine for people to be whole and well. And so they gave us a grant to start My Brother's Keeper, it's a pilot grant, where we actually were going to micro-target some of our assets in the campaign about the suicidality of black men and boys. Now the second leading cause of death for our 15 to 24 African-American black men and boys. Some of it is truly death by suicide. Some of it is death by community consequences. So the hashtag movement, also sometimes when African-American men and boys die, even though it might have been a death by suicide, it's attributed to gun violence and not suicidality. So the data doesn't point out that it's three times the national average and double what it is for our African-American women and girls. The other thing, because of John Henryism, and you're going to learn a little more from our subject matter experts about who John Henry was, if you don't know the legend John Henry. The reason why John Henry is important is because he was a formerly enslaved pylon driver on the railroad. Went out of West Virginia and he wanted to beat the steam engine. And so industrial technology was coming in. We got a faster way to build a railroad track. And John Henry took it upon himself to say, no machine can beat me. No machine can beat man. And so he actually did beat the steam engine in driving pylons into the track. And then he died from exhaustion and a heart attack, Dr. Keller. And so the reality of it is, was he leveraging technology or was he fighting technology? In the world of AI, are we going to learn as much as we need to learn about AI? Are we going to take it upon ourselves that real Raw can beat Raw AI? And what the purpose really is, is for Raw to figure out how to leverage AI so that he can host 15 sessions and a benefit on Monday night and still be here for you whole and well. Maybe my feet don't feel as good, but I don't have a podiatrist in sight. But these are the kind of things we want to do. So what we did is we crafted a mini campaign inside the My Brother's Keeper campaign around mental health care works. And what we've done is worked with some leaders inside the APA, as well as some clinicians and some non-clinicians outside the APA. And the APA Foundation Board approved matching funds so that we have some sustainability to the campaign. Because part of the challenge with pilots is either they never really meet their full promise or by the time the pilot runs its course, you run away from it because you're like, well, that was just what we were doing for the moment. You can't beam in and beam out and we need to be able to go in community to deal with these issues. So one of the things we did this year, when I went to New Orleans, we were in Morial Convention Center and we were in Marriott. But we never went to Ward 9 as part of our test. We were really in New Orleans. You know, with all the systemic inequality in San Francisco, I was heartbroken running back and forth between Moscone and the host hotel there. But we weren't really on the east side of San Francisco. So what your foundation was able to do while you were getting your CMEs that I need you to get is we had a special Ray of Hope session in community on the first day of this annual meeting where we went uptown to Harlem. Now, let me tell you why My Brother's Keeper is so important. You wouldn't think this was impossible, driving while black. I'm in a taxi cab driving. I'm in a taxi cab. This is where My Brother's Keeper really comes to life. I'm in a taxi cab driving to Harlem from midtown. Do you know we got pulled over in a taxi cab by the cops? So this is what I need all of us to understand. When you say you have a board meeting, when you say you have grand rounds, when you say you have a session, all you're worried about is whether or not you can get in the line and out of the Starbucks or whether you spill something on yourself. Do you know what it takes to get up in the morning to have to drive to a meeting and you're looking in your rearview mirror the whole time wondering whether or not you're going to get pulled over for no reason at all, even though you have a presentation to some esteemed panel or some esteemed board? That's not what I'm focused on. The last thing I thought, Pastor Mike, when I was going uptown on May 4th was that I'm in a cab. I made every arrangement. I didn't even go with an Uber. I wanted to be extra cautious trying to get to the session. I didn't want to be a hashtag. I didn't want any misunderstandings or failings. So I'm going to get in a yellow cab with a medallion. What could possibly go wrong, Dr. Dunlop? I get pulled over. I want to say it was oh, dark 30. I mean, it was 7.30, quarter to eight. And I thought that the police officer took his own sweet time trying to make sure that the cab driver was okay and he have all his credentials. I need license and registration to turn off. I mean, it was just, and I'm in the back trying to get ready to do a presentation, watching a cop castigate a cab driver. So I'm supposed to be thinking about my audience. I'm supposed to be thinking about my team. I'm supposed to be thinking about proceeding with excellence for you. And I'm traumatized before I even get there. But I've been driving and riding for over 40 years, so it wasn't new to me. But it's just not supposed to happen. But you need to know what's on mind. So when people come in rushing and they look like they're a little bit out of sorts and, you know, recognize that what happened from the time they got up in the morning to the time that they got to the boardroom to the time they got to the clinic to the time they got to the chapel, a lot of things might have happened. And even more could be happening when they leave. And it's not just whether or not I'm going to get across the bridge on time. So these are the things that make John Henryism so important. So briefly, what we're going to do is we're going to give our panel a chance to introduce themselves as they provide their remarks. But I just want to let you know who we have here. So we got Dr. Sidney Hankerson from Mount Sinai. Many of you know Dr. Hankerson. He's an esteemed APA member. He was one of our Distinguished Service Awardees at this annual meeting. And Dr. Hankerson is going to be helping us coordinate and moderate this session. But he was one of the first doctors in APA to reach out to me in the first 10 days when I joined the APA Enterprise family in September of 2021. And we spent about an hour on the phone just trying to help me understand the components and the culture and the climate of APA in September of 2021. For those of you who don't know, I was coming here from AARP in executive leadership, and I had spent 15 years at AARP and never planned to leave. And before that, I had spent 16 years in the private practice of law. So while I'm well maintained, I'm a lot older than I look up here on this podium. But the other thing that makes John Henryism so important, one of the questions we ask in John Henryism for our young black men and boys, will I make it to 30? And if I make it to 30, will I live to see 60? And you know what the morbidity and mortality tables look like. The odds are not against, they're not in favor of just making it to 30. But by the time I go from 31 to 59, with all this John Henryism, when they cut me open, I look like I'm 89. And so when we see high incidences of stroke and heart attack and so forth and so on, it's all of these things that are in play. So we're going to lead off with Pastor Mike Walren. He leads the First Corinthian Baptist Church in New York, in Harlem. He was one of our community partners, but he's also a host. And he and Dr. Hankerson will talk about how they created the Hope Center out of what really had been an annexed ministry, because they saw the great need in their congregation and community to do more than just talk about mental health and well-being from the pulpit. And they started doing that before the pandemic, but they really saw the rise afterwards. But they'll also share parts of their own journeys as they've tried to soldier through. And then we have young Nick Fletcher, chief resident out of Michigan. Dr. Fletcher recently was elected to the Board of Trustees. He's over in Area 4. He's one of our rising stars in the association. And Dr. Fletcher is a fellow in the APA, APA Foundation family, and he actually is the chair of our public psychiatry fellowship cohort. I've been working with Dr. Fletcher for two years, and I can tell you that the pipeline program is working because he's a product of it, and some of you are as well. But I hadn't been here to see the maturation, the development, and the insights. So now to watch Dr. Fletcher not only rise to the Board of Trustees, but I met four of his trainees, four of his interns, just here at this meeting that all were able to be here, and to watch him lead and become a leader of leaders in the House of Medicine and in this wing of the House of Medicine is just really impressive. And then we got Dwight Kemp here. Dr. Kemp is one of the strong minds in all of psychiatry, but particularly impacts of equity. And the nice thing about the way Dr. Kemp handles his business, he's not going to beat you up over the fact of stats. And as a retired lawyer, that's important to me because when woke culture and all this anti-DEI efforts, so forth and so on, the outlawing of affirmative action, you know, I don't talk about in law when I'm in legal circles any of these popular cultural words. What I encourage and invite everybody to do is go read the 1957 decision of Dred Scott versus Sanford. Just read Dred Scott about what was expected of African Americans at the start of this great country, and what was expected for the progeny of African Americans or Negroes as it was provided in Dred Scott. And basically, even though we talk about a living document in the Constitution as we get ready to commemorate the 70th anniversary, believe it or not, of Brown versus Board of Education on May 17th of this year. Believe it or not, Dred Scott, the Chief Justice of the United States says, not only were you never contemplated in the moral and the political and economic fabric of the United States, your heirs aren't either. And but for the 13th, 14th, and 15th Amendment, Dred Scott has never been abrogated, overruled, or vacated by the Supreme Court. Let me say it again. But for the 13th Amendment, the 14th Amendment, and the 15th Amendment of the United States Constitution, even though they can overturn all these other cases, no Supreme Court has ever overturned Dred Scott. So don't get stuck in all these popular cultural words and these cancer culture and all that. Just when you get a moment, go read Dred Scott and recognize it's still law in the books, but for a constitutional amendment. And then last but certainly not least, because we have a multidisciplinary panel, I brought a heart surgeon in from Louisiana, Dr. Antoine Kemp, triple board certified, a heart doctor. And one of the things when we talk about our work on collaborative care and other things like that, the reason why we believed it was important is because mental health and heart health are inextricably tied. You're not going to be whole and well if the mind's not right and the heart's not ticking. And what Dr. Keller talks about is how the whole house has to be made healthier to be whole and well. And so if you only can have, regardless of social determinants, this recipe for what you do in the morning. As I like to tell him, I haven't finished a plate of food since he got here. I've eaten three meals with him. Everything I wanted to look at was on the plate. But just being around a doctor probably saved me a couple of hours of life. Because I don't want to go see Dr. Keller. I'm glad he's there if I need him, but I'm not rushing to your door. So you can see the agenda. We don't have any disclosures that need to be made, but we are going to walk through some personal journeys. I'm going to give an overview so everybody gets better acclimated around John Henryism, the impact of racism on whole health, and then talk about depression and suicidality. Before we do that, though, I want to turn it to Dr. Hankerson, see if he has any remarks so you can get your CME credit, and then we want to go directly to Pastor Mike Warren so he can talk to us not only about professionally as a faith leader, what he's hearing, seeing, but also his own personal journey. So come on up, Dr. Hankerson. All right. First and foremost, good morning, everyone. So good morning, everyone. We are in the midst of Pastor Warren, who is the pastor of the historic First Corinthian Baptist Church in Harlem. So I thought we'd start with a little call and response this morning. But first and foremost, I want to thank Raul Andrews and your leadership through the foundation and your insistence that this panel today be a part of this conference. So thank you for that. My role is easy. Raul kind of went over the agenda. I am just here as timekeeper. So we're going to do like the Oscars, 12 minutes for all of our speakers, and we'll hear some music. So I'd like to ask the audience just to kind of hold all of your questions until the end after everyone is presented, and then we'll take time for questions. So first, starting with Pastor Warren. Well, good morning. No, I'm here. I'm fine here. Good morning. So grateful to be here and part of this amazing conversation and panel. And as Raul and Dr. Hankerson said, they wanted me to kind of share my mental wellness journey. I currently serve as a senior pastor of the First Corinthian Baptist Church in Harlem. This is my 20th year as pastor, and I'm also the chair of the board of the FCBC Community Development Corporation, which, among other things, houses the HOPE Center. The HOPE Center was launched in 2016, which is a freestanding mental health facility in Harlem, which offers free wraparound services to the community. In fact, Dr. Hankerson is the medical director for the HOPE Center, and we have been doing some amazing work since the launch. And I'll kind of tell the story how we got to the HOPE Center through my own personal journey. In August of 2014, there was a death by suicide of a very famous person, and I think all of us know him, heard of him, Robin Williams. I was a fan of Robin Williams, but I began to read articles about his journey, about his life that led to that moment. And there was an article I read written by a friend of his, and there was one line that I read in that article that really moved me to tears, because it spoke to what I had been experiencing for years. And the person who wrote the article said that for years, Robin Williams' comedy had been a salve, a balm for so many people, how many people had been healed through his comedic genius. But he then said, but the tragedy of my friend Robin was that Robin Williams did not have a Robin Williams to heal his psychic wounds that led to his early death. When I heard that, it moved me, because I have been a pastor for now a total of 28 years, and in that season, it was a moment when I began to realize that oftentimes, those of us who serve as pastors don't always seek help the way we ought to, because we are the persons that so many come to in need of help, and we take on so much and often do not think about what we need at the time. The congregation I serve now, when I arrived in 2004, I had about 300 members. Today, it has over 12,000 members. And that journey of itself was one that contributed to some of my mental health issues. It was in 2011 when I had a suicidal ideation, first time in my life, never even thought that that was something I would experience. I was in Seattle on a needed break. I checked into the hotel on the 22nd floor of this particular hotel, and I went out on the balcony. What I heard subtly that day, as clear as I'm talking now and hearing now, was a voice that simply said, encouraging, well, not encouraging, it was encouraging me to do something, and the voice said to me, if you jump, you can survive. It was as subtle as that. If you jump, you can survive, and at the same time, I felt a tremendous force in my spirit almost pulling me back into the room, and I remember closing the door, and I laid there in fetal position on that hotel room floor for countless hours, afraid to get up, because I had never experienced anything like that. And in that moment, you begin to think something is definitely wrong, and something had been wrong for a long time with me. I was, at the time, in the throes of an undiagnosed, deep depression that had its origins in something that really started at my birth. I was born with a rare condition called common variable immunodeficiency, CVID. Did not discover that until I was 45, misdiagnosed for 36 years, and what CVID is, basically, I was born with little to no antibodies, which then explained so much. When I was 10, I had a surgery for removal of a tumor, and at that time was the first time we heard a word called sarcoidosis. Many doctors believed, at the time, that I had sarcoidosis, even though now, as I look back, it was almost impossible that I had this, but they were locked in on this diagnosis, and it stayed with me from the time I was about 9 or 10 until about 45. But what did that mean for me growing up? They were treating me with medication that, at the end of the day, was really working against me. Two, by the time I was 35, I had been hospitalized 15 times, and by the time I was 44, I had experienced sepsis 3 times in my life, and 2 of the 3 times was MRSA, was the bacteria. Should have died at least 2 of those times. Was at the point of death, in fact, the doctors told my wife to call our children at the time because they didn't think I would make it. So 15 hospitalizations, sepsis 3 times in my life, countless times of being sick, and I didn't know that that depression really began as a child. What it did was, at 10 years old, I went to the school doctor, the nurse, and said I wasn't feeling good, which was typical because I often didn't feel good but couldn't explain what was wrong. And she said something to my mother when my mother came to pick me up that I heard, and I was a very smart, young man, very inquisitive, and she mentioned this word, hypochondriac. I heard that word, and I went and looked this word up. And when I looked up the word, I was committed to not being, what that word said, anxious about my health, over-exaggeration about health, and so at 10 years old, I learned something that stayed with me for the next 30 years, and that was to camouflage my pain, to not talk about it, to not share it. Because my role was to show that I was normal, that I was okay, and in the process, really falling in line with John Henryism, I started overcompensating most of my life, proving that I was okay, not talking about the times I was sick, not talking about the times I was hurting, because I didn't want anybody to think that I wasn't quote, unquote, normal. That stayed with me all of my life. The problem was, is that all those years of overcompensating to prove that I was okay, to prove that I was fine, actually worked against me, and made me more sick. It made me not attentive to what I was dealing with. That was my entire vocational career, preaching, counseling persons, teaching, but sick most of the time, not feeling well. There were times where I preached on Sunday, after I preached, and left the church, went right to the hospital, to the emergency room, because I was sick, and it happened countless times, but never talking about it, never sharing about it. The word therapy never came on the table, because in many African American communities, there's a tremendous stigma around, we all know, around mental health. That stigma had impacted me, until 2011, when I had that suicidal ideation. I came back home terrified, not knowing what to do at that moment. One of the persons who worked on the staff of the church, I'd heard her talking about her therapist. She'd always say, my therapist this, and my therapist that. I approached her, and asked her, in privacy, still with some shame, who her therapist was, and how it had helped her. She told me. I contacted the therapist, that was towards the end of 2011 and 12, moving into 12. That person is my therapist, to this day. I hit the jackpot, at the first try. She has been, she saved my life. I didn't understand, at the time, what was happening. I was battling depression. I was constantly sick. I also, as a child, was a sickly child, with an abusive father, who was physically abusive. All of that had been working against me, not knowing, while I'm trying to prove that I was okay. I had the first breakthrough, I think, towards the end of 2012. What I realized then, is that here I am, the pastor of this amazing congregation, and I was suffering. There had to be other people in this congregation, who were suffering the same exact way, and like me, was suffering in silence, not talking about it. The first thing I did, was went to the trustees of the church, and said, I want to hire a therapist on staff. They didn't fight it. I told them why. I was very transparent about it. We hired this therapist in 2012. Her name was Joyce Johnson. Dr. Hangerson worked with her. Then around 2014, the same time I had this experience, with Robin Williams' death, I was standing in the lobby of the church, because Joyce's office was in the church. The person who came in, didn't recognize me, but I heard her at the reception, whisper Joyce's name. She had shame about coming to see Joyce in the church. At that time, I thought, we need a space, apart from the church, where people felt comfortable going. We had a good friend of ours, a trustee of the church, who was a developer, who ended up becoming lieutenant governor of the state of New York, but we were able to get a space around the corner from the church, literally three minutes from the church. That's when, in 2016, we opened the Hope Center. Between 2012, with Joyce Johnson, and 2016, we had done a lot of work with Dr. Hankerson. I don't remember how we met many years ago, but I know that Dr. Hankerson and some of his colleagues did a lot of mental health first responder training at the church, which was revolutionary. It really began to shift the culture in the church, where mental health and mental wellness was part of the narrative of our congregation. It was something that I was very open about, because with clergy, it's one thing to give a head nod to mental wellness. It's another thing to create a space of conversation in the church, and also provide resources for that. I was very open from the pulpit. I preached about my battles. I preached about depression. I preached about my anxiety. I talked about my suicidal ideation, which was very vulnerable at the time, especially when you're viewed as the leader of this large congregation in many ways. But it was healing, because many people after that came and shared their journeys and their stories. While I was in the midst of my healing journey, we're dealing with the needs of the people in the congregation through therapy. Then, in 2016, we opened up the Hope Center, which stands for Healing on Purpose and Evolving. Now, we offer full wraparound services to this community. What is key is that it began with my own pain, and my own suffering, and refusing to suffer in silence to this day. It's still a battle in many ways, because my journey continues. In 2017, they finally found out what I had. Since then, it was on a treatment plan, where every three weeks, I get an infusion of synthetic antibodies to give my body a sense that I have an immune system. But in 2018, I had a major setback, because my condition also causes granulomas. I had a granuloma in my brain that caused a massive hemorrhagic stroke, which is a blessing, because I don't look like it today. When I woke up from the stroke, I could not talk. I could not move my left side at all. I can talk clearly now. I'm very mobile, which, as the doctor said, was an amazing ... He never said miracle. He said, it's amazing that this has happened. I'm grateful, and I will say that what we've done at FCBC, that's the church, is really create an amazing culture where healing is at the forefront, and mental wellness is at the forefront. The executive director of the HOPE Center is Dr. Lena Green. She's actually presenting now, who's an amazing woman, a tremendous woman, who's really expanded the bandwidth of our HOPE Center and our mental health awareness. What I will say in closing is that sometimes, the path of transformation and healing for many begins with the honesty of one. I can say that is the case in our experience. It began with me sharing my experience, my narrative, that led to where we are now with our HOPE Center and the work we do with not only Dr. Hankerson, but with RAHL and the APA Foundation. I'll stop there. Thank you so much, Pastor Mark. Dr. Hankerson, for our clinicians, for our members, talk briefly about, as we get ready to transition to Dr. Fletcher in the video, but talk briefly about the doctor side of this whole HOPE Center experience, because one of the things you recognize when you work with Pastor Mike and Dr. Hankerson, you realize that you're not just doctors. You do have other interests, but the most important thing you need to carry out of here, we're not human doers. We're human beings. Dr. Hankerson. Sure. First, for those who may not be familiar with the black church or with houses of worship in general, when Pastor Mike shared his personal story of seeking therapy from the pulpit, that was revolutionary, because, as he mentioned, pastors are, in many respects, so respected, so revered, that you carry so much. It was just transformative for him to be that transparent and talk about therapy from the pulpit. I think everything that we have been able to do in terms of mental health is a direct result of his transparency. When the HOPE Center was created, what we did was implement mental health first aid. We trained over close to 300 people in the congregation in mental health first aid, which really increased the mental health literacy. Then we did other research studies. That's another thing that his leadership has done, has allowed us to do research. Now First Corinthians is part of a NIMH-funded R01 study, where we have trained community health workers to screen people for depression and anxiety, provide motivational interviewing, and then connect people to care. Then at the HOPE Center, we've been tremendously grateful to the APA Foundation, because we now have two psychiatry residents from Mount Sinai that are providing direct clinical services, addiction management, and psychotherapy free of charge at the HOPE Center. All notes are integrated into EPIC, so that it's free integration into the EHR. Our goal is really to make the HOPE Center just a very robust clinical enterprise, where we're implementing evidence-based interventions. Dr. Hexton, thank you for that. That's what we do, but this is what your donation does when you give to your foundation. We're able to give experiential experiences outside rotation to our trainees. We've got our AV techs on alert. Dr. Fletcher, why don't you come up? We've kicked out all the videos, so we make sure we can get some feedback from you, but one. Let's get this going. Welcome, Dr. Fletcher, please, from Michigan. Thank you. As a child, you would wait and watch from far away, but you always knew that you'd be the one to work while they all play. You, you'd lay awake at night and scheme of all the things that you would change, but it was just a dream. Here we are on the way down. We are the warriors that built this town. The time will come when you have to rise above the best and prove yourself, your spirit never dies. Farewell, I've gone to take my throne above, but don't weep for me, cause this will be the labor of my love. Here we are on the way down. We are the warriors that built this town. Here we are on the way down. We are the warriors that built this town. Here we are on the way down. We are the warriors that built this town. Here we are on the way down. Fast, easy, action. Thank you. Thanks, appreciate it. Thank you. Let's give A.B. a little hand. So, you know, one of the reasons I wanted to show that is as I was looking up John Henryism, doing a little bit of research, I saw that video and initially I was like, wow, you know, that is, you know, you just, it feels amazing and strong. You feel like, okay, he's able to do anything. And then I get the sense of, you know, the terms that came to me seeing that was, you know, get rich, die trying. No pain, no gain. What doesn't kill you makes you stronger. Then we got black girl magic. Go big or go home. I'll sleep when I'm dead. And keep grinding. These are things that we tell each other and those all fall under the folklore of John Henry. And there have been ballads and songs for over a century about his greatness. He's been seen as a transitional kind of from industrial, from machine to versus man. He's been epitomized by coal miners, railroads, steel men, even the civil rights movement. He's been described as a six foot six, 250 pound man, renowned for his ability to drive a railroad spike into the ground. And in this ultimate battle of man versus machine, he raced the steam power drill and beat the machine only to die with a hammer in his hand. Now, just for correction, he didn't actually race the machine by driving spikes into the railroad. He actually beat the machine by driving a steel rod into a mountainside where they would then use it so they could load dynamite to blow up the mountain and the rocks. And so he was able to drill or push the spike 14 feet while the machine, I think it was nine feet, and it would always break apart. There's two narratives about how he came to be. There are two narratives of the man himself. The one is that he was born into slavery between 1840, 1850, North Carolina or Virginia. And following the Emancipation Proclamation of 1863, it's believed that he joined thousands of black railroaders looking to improve their station in life. So you see him, you kiss his wife, and he kind of goes off and, you know, trying to improve on, you know, where he was and what he did. The other narrative is that he was a former Union soldier imprisoned for theft while on a work assignment in Richmond, Virginia. And the foreman, or the prison chief, he would lease out the soldiers, I mean, lease out the inmates, and they would work on the railroads. And each one still, you end up with a man who works himself to death. And so where do we get this narrative of John Henryism? John Henryism is a term established by epidemiologist Sherman James. Duke University in the 1880s described a strong personality disposition to engage in high-effort coping, mental and physical, against social and economic adversity with physiological consequences, end quote. The vast majorities of studies of John Henryism assess the correlation between psychosocial stressors, hypertension, mental illness, and premature death. In his 1983 study, he had 132 Southern working-class black men between the ages of 17 and 60 were administered the John Henryism scale. The scale was used to measure the extent to which these men believed that they could control their environment through hard work and determination. Those who scored low on educational variables, intelligence, and high on John Henryism had significantly higher levels of diastolic blood pressure than those who scored above the median on both measures. Essentially, these men worked themselves to death, and they sacrificed their health for success. And it is with that I will turn it over to Dr. Kemp and allow him to illustrate how that is affecting black men today. Good morning. It is a great honor to be with you all today. I count it a privilege to stand here with these distinguished men, all black men. It's incredible to have this opportunity. So rare to be able to sit with other accomplished, well-respected, distinguished black men. But that's not because there's any lack of black men who are hardworking and dedicated and loyal and committed. The reason why what you see before you is rare is because of societal ills. It is not a product of the quality of the black men that exist. Thank you. So I've been invited to discuss anti-black racism in the United States and its impact on the health and mental health of black men in America. Tall order. I was hoping you would laugh. It's a tall order for so many reasons, but among those reasons is that the category of the black man is a heterogeneous category, encompassing multiple ethnicities, including African American, Caribbean American, Africans who migrate to the U.S., and others. There are also complexities of these intersecting identities like gender, sexual orientation, and concepts of masculinity, among others. The intersectionality of these identities influence exposure, experience, and effects of anti-black racism in America among black men. So before I move forward and discuss racism and its impact on this group, there's something we need to establish, and that is what is race? Race is a social construct and has no genetic or biologic basis. The Human Genome Project of 2003 firmly established that all human beings are greater than 99% identical genetically, and there is no biologic basis for race. In the words of Dr. David R. Williams, the Florence and Laurel Norman Professor of Public Health at Harvard University, the fact that you and I know what race we belong to tells us a lot more about the society than about our biologic makeup. There's another sociologist I'd like to quote, Dr. Ruben Brumbat. He's a professor at the University of California, Irvine, and he might put it this way. Race is a pigment of our imagination. So if race has no biologic basis, why track it? Why study it? Why do we incorporate it into categories for areas of interest? It's true that race is, in fact, a dynamic category that changes over time based on the sociopolitical values and interests of a society at a given time. Race serves a purpose. It tells us who the in-group and the out-groups are, how resources are distributed, what category of individual it's okay to objectify or oppress or mutilate, mistreat. Yes, race fails to capture biological differences, but it remains an important category because race predicts consequences for virtually every domain in American life. According to the American Psychological Association, refusing to measure and assess race will only maintain the status quo and will not move us into the direction of achieving racial equity in society. W.E.B. Du Bois was among the first to describe health disparities of blacks compared to whites in the United States, in part as a product of social conditions. He described what we now call the social determinants of health and mental health. However, even after adjusting for education, income, and other social determinants, there is still a residual effect of race that impact health status for black men and other minoritized groups and genders. Because of structural racism and black men's unique history in the United States, black men's mental health is more complex than some health disparity literature would suggest. The health and mental health of black men in this country is intimately tied to factors such as historical and contemporary vilifying of the black man, as well as social, political, and economic exclusion. One notable example of the social consequences of American vilifying of black men is the experience that Mr. Andrews spoke about earlier today. The experience of being concerned about police brutality among black men and boys. An example of the structural racism exemplified and experienced, I'm sorry, experienced by black men is noted by the American Association of Medical Colleges when they published data that just 10 years ago, 2014, there were fewer black male physicians in medical matriculants than there were in 1978. The American Association of Medical Colleges published these data that just 10 years ago, in 2014, there were fewer black male physicians in medical school matriculants than there were in 1978. So when we talk about social, political, and economic exclusion, this is just one clear example. There's a wide body of literature that can be read, very robust. The idea that racism has consequences for health is not new and has been around for 10 decades. But the mechanisms of observed outcomes were elusive. However, scientific advances and interdisciplinary research in genetics, epigenetics, and social sciences have produced the hard scientific evidence linking racism to actual disease processes. These are processes of inflammation, overactivation of the hypothalamic pituitary adrenal axis, generational trauma, inheritance through germline inheritance from both mother and father, among others. There is a robust body of literature documenting that even chronic, minor, ongoing experiences of incivility and discrimination have long-term negative health outcomes. From a health standpoint, among black men, there is greater cardiovascular risk and disability related to disease, as well as higher mortality compared to whites. In mental health, among black men, depressive symptoms are more difficult to treat, more disabling, persistent, than they are in white individuals. And as we move forward in the presentation, Dr. Keller, our esteemed cardiovascular surgeon, is going to talk more about the cardiovascular impacts of racism on black men's health. And we'll have our own Dr. Sydney Hankerson speak about depression and suicidality among black men. It has been my honor to be before you. Thank you very much. Good morning. Thank you very much for the opportunity to be able to come and talk to you a little bit about what I do. I'm a cardiac surgeon. I'm not a psychiatrist. Although I did receive honors in my psychiatry rotation at Mr. Duke's medical school. So I hope you will indulge me a few minutes so that I can bring everything together and give you a pathophysiologic basis for cardiovascular disease that works when you're trying to navigate treating patients who have had cardiovascular disease and maybe have had their cardiovascular disease compounded by these microaggressions and psychosocial interactions that they have in their daily lives. It is one of the most humbling things for me to meet someone and to essentially crack their chest open and hold their heart in my hands and perform open heart surgery on someone and for them to trust me to do that after only having met me minutes before. I can imagine how much of a daunting experience it must be from a psychological perspective to face their prospect of mortality and significant morbidity and life changing life altering consequences of this problem that they find themselves having. So I take that interaction very seriously. And I think it's important for everyone to understand how these pathophysiologic ramifications of cardiovascular disease have their roots in psychosocial adaptation and coping mechanisms prior to the event. And so one of the things that really is important to me is understanding how we deliver health care in underserved communities, rural communities, urban communities that have a paucity of health care providers, let alone doctors, nurse practitioners, assistants and so forth, mental health professionals, and how these things impact people's cardiovascular health after I see them. One of the things we do is we take artificial intelligence technology into the communities that we think are at risk and we show people how to promote their own self-care and wellness from a cardiovascular perspective across the spectrum of the possibility of therapy, whether it be cardiovascular therapy with medicine or whether it's psychological therapy with support groups and so forth. So we want to promote as Mr. Andrews is trying to promote with the association and understanding that we have to take care of the whole house in order to be able to accommodate things that happen along the way that are inevitable. We have a lot of risk factors that we as cardiovascular professionals talk to patients about. Some of them are non-modifiable. We can't pick our sex. Usually we can't pick our race. We can't pick our genetics. You can't pick your parents. But there are a lot of things that we can modify. And in cardiovascular medicine, we talk about modifying those things at the end of the stage. We modify blood pressure with antihypertensives. We modify cholesterol and dyslipidemia with the various agents. We teach people to take their medicine for their diabetes because it has the significant possibility that could increase their lifespan and promote wellness in that way. We have a lot of things that are aimed at the end stage. But we don't have very much that is aimed at the constant acute and chronic stressors that people go through in their lives on a daily basis. So we want to try to understand how we can integrate some of those self-care routines into people's daily lives so that they don't end up developing cardiovascular diseases at an accelerated rate. So as a scientist, it's important for us to understand how we get to where we are. And most of you will recognize this, those of you who went to medical school or are clinical psychologists, that there are few things that we know with more certainty in medicine than the hypothalamic pituitary axis and the impact that that has on the human body. We have been dealing with this problem since there were humans as the fight or flight response is integrally associated with this pathway. You have a stressor, which is perceived in the brain, and you have signals sent to the hypothalamus, the pituitary, and subsequently to the adrenal glands to secrete catecholamines, the fight or flight response. We deal with these fight or flight responses on a daily basis, especially when we talk about social and institutional interactions that we have as we navigate life in this complex society that we live in. We have good evidence in the literature that shows that increased catecholamine exposure and cortisol, humoral factors in the blood, can cause inflammation, endothelial dysfunction, elevated blood pressure chronically, a lot of oxidative stress. And this leads to injuries in the endothelium of the blood vessels, which cause deposits of fat in the media, which eventually leads to advanced atherosclerotic plaques, which leave you at risk for heart attack and stroke and congestive heart failure and a myriad other cardiovascular problems that impact people, specifically people in underserved communities and racial and ethnic minorities at very high levels in this country. This is something that we can't get away from. And it is a survival mechanism that is evolutionary in some aspects because it allows you to be able to get away from those stressors if you need to get away from those stressors in the short term, but certainly has long-term consequences. Now, how does this impact mental health? Well, having the prospect of having open-heart surgery or having the prospect of being debilitated for the rest of your life because of a stroke is a significant psychosocial stress, obviously. And facing these prospect of recovering from these problems is a very daunting thing, as you can imagine, and something we don't give enough credit to because of the fact that we are focused on the end result. How do we give this patient more blood flow? Or how do we recover this patient from the stroke? We don't focus on the kinds of things that cause their atherosclerotic process to accelerate over the course of their lives. And one of the things that we have found in our community work is that we go into the community and provide artificial intelligence technology to people for free, to churches and community centers. And 90% of the people that come to be evaluated by us are women. Only 10% of those people are men. And so we have a significant deficit in engaging black men into a healthcare process that they can matriculate in order to live a healthy lifestyle and reduce their risk of cardiovascular disease, which is the number one cause of death in America today. We've gotta find some workable solutions to be able to mitigate the progression of this disease process. And indeed, more than 50% of the people that we see in our community programs feel that their health is preordained, that there's nothing that they can do because their father had this problem, their grandfather had this problem, and their great-grandfather had this problem at a very early age, so they figure they're gonna have this problem too and there's not much they can do to change that. So we have to do a better job at engaging the community to break these chronic cycles of microaggressions and stress that cause people to have feelings that they don't have any impact on their own health and wellness. One of the things that I think is important for us to focus on as the title of this talk is suicidal ideation in people with cardiovascular disease to understand how cardiovascular disease puts you at risk for having these suicidal thoughts or indeed committing suicide. There has been a significant increase in the number of papers recently in the cardiovascular and the psychology literature which draw an association between cardiovascular disease and suicide. And there have been some very interesting learnings of late that I think we can apply to our everyday lives. The most significant point in someone's life, especially as it relates to the potential for suicide, is when they first find out that they have cardiovascular disease. And as I've described, you can imagine that there are a number of things that might go through your mind when you realize that you've had a heart attack and that you face the possibility of your mortality and a lifestyle that is going to be drastically different from the one that you've had up until that point. So it's really important to have an intervention if you're going to have an intervention early on. And this certainly does trail off as the days go by. However, it's important also to know that the more admission someone has for their cardiovascular disease subsequent to that initial admission, the rate of suicide actually goes up, especially if they have a large number of admissions to the hospital in a very short period of time. So obviously these are people that present at end stage and have been neglecting their cardiovascular health over time. So really important to understand the relationship between cardiovascular disease, the precursors from a psychosocial perspective, and how to care for someone who has had cardiovascular disease so that they don't end up in a John Henry type situation where they are at the end stage and there is nothing left for them to do. Thank you very much for your attention. Thank you. Okay, so I am going to kind of translate the impact of John Henryism into, you know, psychiatric condition of depression, as well as suicidality, which is at an all-time high among black boys, and then talk about some community-based interventions to try to address this problem. So the relationship between race and depression is actually a pretty complex one. There's actually what we call a depression paradox in the literature, because African Americans or black adults in this country are exposed to more risk factors that would contribute to depression, such as lower socioeconomic status, but actually have a lower prevalence of depression compared to non-Hispanic white adults. This data is from a nationally representative survey where you can see that, you know, across the lifetime, African Americans have lower rates of depression than their white counterparts, as well as lower rates of 12-month depression. And these findings can be replicated through the National Comorbidity Replication Survey, pretty much every survey that has been conducted. However, when black Americans are depressed, black adults are more impaired. So this data shows results of Sheehan Disability Scale results among black and white adults, and you'll see that black adults have more impairment or higher scores of disability in work, in relationships, in social functioning, as well as in overall disability. So black adults with depression are more impaired. And you know, as Dr. Kemp just really eloquently described, structural racism is a key driver of these inequities, because we are all aware of how black adults have lower rates of mental health and psychiatric treatment than white adults. This is a framework that colleagues and I published in the American Journal of Psychiatry a couple of years ago that shows how structural racism, which impacts access to education, housing, over-involvement with the criminal justice system that we see in black adults, combined with cumulative trauma, which consists of historical trauma like Jim Crow, segregation laws, redlining, combined with kind of exposure to adverse childhood experiences or ACEs, interacts with interpersonal acts of racial discrimination, like microaggressions that Raul described earlier. All of these factors work singularly and in combination to contribute to the intergenerational transmission of depression in black Americans. And so a big part of this intergenerational transmission of depression, due to issues around structural racism and John Henryism, the notion that we just have to keep pushing to overcome these structures, has contributed to a crisis of suicidality among black youth. So this is the cover of a report that was put out by Congress several years ago. It was led by Dr. Michael Lindsay. I want to acknowledge his expert leadership. Pastor Walwin was actually a part of this commission that Congress put out this report to really address the rise of suicide in black youth. For the first time in our country's history, black boys between the ages of 5 and 12 have higher rates of suicide than white boys. And so when you think about that and we think about all of the structural drivers and ways of trying to cope or unhealthy ways of trying to cope, such as John Henryism, that contributes to this rise of increased suicidality. So my research is designed to really try to figure out how can we address some of these structural and call out some of these structural factors in partnership with trusted community entities. And so all of my research studies use principles of community-partnered participatory research. This is an evidence-based model of community engagement that was developed by a psychiatrist, Ken Wells, and Dr. Loretta Jones out in Los Angeles. And so the core principle of community-partnered research is that mental health clinicians and academicians partner in tandem with community members to develop and implement and then test interventions. And you see really the four cores of community-partnered research are on the screen. And in multiple clinical trials, you know, community-partnered research has been shown to increase participation of communities of color in clinical trials, to increase trust with the process of doing research, to build capacity of the local community, and importantly, clinically, to reduce disparities in clinical outcomes. And so I'm just going to highlight two of the two ways that we are actually leveraging principles of community-partnered research in partnership with houses of worship and through basketball leagues. So in terms of, you know, just the bedrock of the African-American communities, of many communities, it is indeed the black church. African-Americans are the most religious group in the country by virtually every measure that is used in terms of, you know, affiliation with this religious group, acknowledging that religion is important, and church attendance. And while since COVID, church attendance across the country has declined, African-Americans have had the slowest rate of decline of church attendance, which really highlights the importance of the church in the black community. And so one of my early studies was to try to see if it was possible, using principles of community-partnered research, to implement a validated depression screening measure. And so we conducted the first church-based depression screening study using the PHQ-9, and we implemented the PHQ-9 in three different churches in New York City, one church in Harlem, one in Brooklyn, and one in Queens. And we used the accepted cutoff score for positive, you know, depression screen or clinical symptoms with the PHQ-9 being a score greater than or equal to 10. And the thing that is relevant for this discussion, and that was probably most surprising to us, was that men in this sample, and we screened 122 people across these three different churches, men had higher rates of depression than women. And in virtually every epidemiological study across the globe, women have two times the rate of depression as men. Now this was not a representative sample, you know, we did these screenings at health programs and other kind of church-based events, but when we talked to the participants after they completed the screener, the men in particular said that they felt safe to be open and honest about how they were feeling within the context of the church, and they felt like they would get help. And so I think this highlights, you know, we talked, we opened with the depression paradox of lower prevalence of depression in black Americans compared to white Americans, and I wonder if some of that is related to John Henryism or underreporting in national samples. Because in the context of a trusted environment, men had higher rates of depression than women. And so just a couple of ways that we have tried to do that, you know, in partnership with Pastor Walron and with Raul, is to really develop novel ways of engaging men. And I think that First Corinthians, you know, to Pastor Mike's just credit, again, his transparency has just really created a culture where men feel comfortable sharing their emotions. So a couple months ago, Raul came up from Virginia, from the foundation's headquarters, and we had what's called a healing conversation. So this was a conversation where men just came, we talked, we shared some of our personal mental health challenges, and created really a kind of impromptu support group for brothers to just talk about different ways that they have coped with stress and created a network of support and care. Another thing that First Corinthians, in partnership with the HOPE Center, the clinic, and you see Dr. Green here in this picture, who is the executive director of the HOPE Center. Another thing that under Dr. Green's leadership and Pastor Walron's leadership that we have done to specifically engage men is have this series called In the Den. And that's where, I won't say this too loud for the cardiothoracic surgeon in the room, but we go out to a cigar bar and just hang out. Pastor Walron kind of says a few words to just, you know, kind of set the stage. And it's just a low-key way for men to connect, to talk, and it creates informal opportunities for men to have meaningful connections and engagement. So the last way that we're trying to address kind of the rise of suicidality and depression in black youth in particular is this program called Brothers Connect. So I was fortunate to get a grant from the Scarlet Feather Foundation to really implement this program. So this is a suicide prevention program, which is going to be developed specifically for black males ages 13 to 19 in partnership with YMCA Basketball Leagues and Boys and Girls Clubs. That's why you saw the picture of the basketball before. So Connect is an evidence-based intervention that has been implemented in the Air Force and in schools. It's based on sources of strength. Some of you who work in schools may be familiar with sources of strength, suicide prevention program. So Connect, the Connect intervention was adapted from sources of strength and is this group-based intervention. And so in Brothers Connect, we are going to be implementing these group-based interventions into YMCA Basketball Leagues and Boys and Girls Club. And this is a strength-based, you know, intervention. It really, as opposed to a deficits-based one, and really focuses on building and fostering kind of the natural social networks that youth have. So the Connect training modules are three kind of groups that last two hours each. And we're going to use principles of community-partnered research to create a community coalition that will oversee this project and will kind of adapt some of the Connect training modules specifically to address trauma, to address racial discrimination, and other issues that youth of color bring up and want to be integrated into this program. And so you see the four cores of the Connect programs. It's kinship, purpose, balance, and guidance. And so we don't specifically talk about stigma using kind of the mental health for all approach, not naming depression per se, but really focusing on these four core strengths and also accounting for issues around racial discrimination, trauma, and other issues, you know, determined by the coalition. So our goal ultimately, you know, through this line of research and engagement is to create community-based networks of care so that men, wherever they go, whether it's the barbershop, whether it's the church, whether it's the basketball leagues, have the opportunity to be touched by evidence-informed interventions to identify folks who may be experiencing depression or other mental health challenges, get them the supports, you know, in real time, and then get them connected to mental health professionals if they'd like additional support. So that's all of our prepared slides, and now we'll open it up for questions and answers from the audience. So we do have time for questions or comments. Please line up, identify yourselves, and we'll look forward to hearing from you. Thank you for coming here. Yes, Doc. Wow. Thank you so much. My name's Monty Brower. I'm a psychiatrist in our public mental health agency in Washtenaw County. It's landing next door to Ann Arbor, and, you know, I'm so grateful to have among my patients black men who have been willing to trust me to be their doctor. It's an amazing privilege, and the things that they have shared with me in that trust have been just wonderful to be with, and hopefully, you know, I've been able to be helpful to them. But, you know, one of the things that occurred to me and that I'm really excited to hear about is, gosh, you know, these men need some fellowship in this community, and yes, many of them have their churches to one degree or another. There are things going on for them, but, you know, what you all were talking about in terms of bringing black men together I think is something that is desperately needed, and it's this intermediary space between, you know, explicit mental health care and the community and its resources that there's this, I don't know, I sort of feel like there's this space in between there where that meeting and support needs to take place, and, you know, I would love to know ways that I could facilitate that for these men that I'm meeting in what I think of as my community. So that's my question to you. I mean, I heard some of it today, but more ideas, especially for men who, you know, as I'm sure you can imagine in the community mental health setting are coming much more from experiences in the criminal justice setting. I do mostly dual diagnosis work, so there's a lot of substance abuse issues. Trauma is huge. So I just want to put that out there and ask for some suggestions, and thank you very much. Thank you. Let's give him a hand for stepping forward, please. Dr. Fletcher, that's area four. Would that appeal to you if you guys could get together and maybe the foundation could find a way to make a bridge? I'd be more than happy to. Go ahead, Dr. Fletcher. I actually live in Grand Rapids, so I'll come through, and I'm in Detroit training. So I'd be more than happy to help. Hello. My name's Lucy Kolkovich. I'm a consultant and rehab forensic and general adult psychiatrist from London, England, and obviously I've worked with a lot of black men. I was just thinking about your 23% PHQ-9, more than 10, and I was kind of thinking about what the cardiologist was saying and what we know about long-term conditions and how depression is much more common in all the long-term conditions, including asthma, you know, diabetes and all that. And I was thinking, obviously, the access to care is not just in mental health. It's across the whole spectrum. And I just wondered if you'd explored that 23% incidence, trying to see how that correlates with long-term conditions and the incidence of long-term conditions and whether not getting the access to those is exacerbating what is already happening in terms of the sociological and psychosocial environment and the microaggressions. I just wondered if that's something which you're exploring. Dr. Hankerson? Sure. So that study that we published was just to show the feasibility of screening for the PHQ-9, so we didn't collect a lot of medical data. In the R01 that I have now, every participant gets the Charleston Comorbidity Index, so we are measuring chronic medical conditions. We're also using the NIMHD kind of social determinants of health measures. We're looking at the Williams Everyday Discrimination Scale. So we'll have a much more robust picture of, you know, social factors that contribute to this and medical factors. Because then you need to then somehow engage your general physicians, family physicians to enable that to sort of, you know, be part of the things they focus on, isn't it, when, yeah. Okay. Thank you. Thank you. So it's been an honor to listen to each and every one of you. My name is Gina Orton. I am a psychiatrist, and in my over 20 years of practice, I've worked largely with law enforcement in the Department of Veterans Affairs. And so I've been privileged in that over 90% of my clients have been men, and it's been a very powerful and interesting experience for me. What I would like to say, though, quickly before I offer my question is that I have found that every ethnic group and racial group and any other division we want to falsely come up with has stigma about reporting mental health, and it's not just the African-American community. And then that leads me to my question. When we talk about there is more homicides among young African-American men and now there's increasing levels of suicide, we know that part of the struggle, particularly for African-Americans who can trace their lineage historically back to slavery, that there's this huge undergirding of shame and disgrace and the carrying of that intergenerational burden. So what I've had some clients say to me, and perhaps this has something to do with men, not wanting to report illness and mental health concerns, is when that information comes out, when they read about it in the newspaper or they hear it from an actor or actress who's speaking about the issues in the African-American community, it's like proof. See, there is something wrong with us. And so how do we message this in a way that it doesn't increase the shame? Am I making sense? I was just trying to develop the question. And so now our young black children and particularly boys have now outstretched white boys in committing suicide, but what's not being said is that the suicide rate among whites has been tremendous. White males and Native American males have a tremendous suicide rate, but now we're saying, you know, now black people are increasing and nobody is saying that we are catching up with others who have a tremendous suicide rate. So what is going on there and how is that being examined? And perhaps a unifying effort might be to say, hey, we're all struggling with suicidality. What's going on here in the United States of America with all men and maybe bring that together. But what I'm hearing from clients is, see, there is something wrong with us because we commit more of this and more of that and we die more of this and more of that. We take more drugs. We commit more crimes. Some of that is the truth and some of that is not. But how we're—I think I made my point. The point was—Dr. Kemp, any remarks? Thank you so much for your question. As you were talking about the men that you work with and talking about, you know, hearing statistics about increased rates of suicide or some other, you know, negative outcome and perceptions about, see, there's something wrong with me. That is a reflection for how we, as minoritized people, have been enculturated in this society. It is certainly not a reflection of who we are, which I know you know that. One of the important parts of my section of the talk in discussing the social construct of race was to really highlight that the negative outcomes that we see in minoritized populations is not a product of who they are innately. It is a product of the society. It is a reflection of the historical injustices that they've experienced. It is a reflection of the continued, ongoing negative messages about who we are. And what you just really described was internalized racism, which is not a them problem. It's a society problem. But then, okay, I said that. How do we correct it, right? Dr. Hankerson, when you were talking about some of the programming that you were doing and talking about focusing on the strength-based aspects, that's where we go. That's where we go. We won't be able to convince those young men that they're, you know, just by talking to them. But by highlighting areas where they have strength, that's a start. That's a start. And I do want to make clear as we bring up our next question, the Mental Health Care Works Campaign is a multicultural, dynamic, general market campaign. So if you've been to Starbucks and you saw Rob, Rob is the prettiest guy you've ever seen. He looks like Petrus' husband a little bit. Rob has no, he is general market. You know, when you see Sarah, who suffers from OCD, you know, she's a young white mother trying to figure it out. So, you know, one of the things that you see in the video, for those of you who went to the open and plenary and saw the video, it is the most diverse, inclusive commercial video promo for awareness, literacy, and engagement that is out there. But what we have been told by industry, among other things, is when African American men and boys decide to harm themselves, they use the most violent means possible, maybe because they have ready access to guns and knives that they don't manufacture. So how do they get here? How do these tools of destruction get to places where people are suffering from social determinants of health? And what happens when we have these power of our stories, the reality of it is we have to beg people to come. I mean, the nice thing about the general market, if you tell them you're going to feed them, you guys will pay me $360 and come to Cipriani and party with me on a Monday night. You'll party with me all night, right? And some of you, did you have a good time? But then you have people who are like, well, that's not really for me. I'm like, if I can't even feed you, you know, now I'm asking you, if you need help, I'll give you help. So let's bring up, we got the last two questions. Can I? Yeah. This is just to piggyback on what Dr. Kemp said, and I think you can't undervalue or underestimate the importance of what I'm about to say, and you know this. But when you said that you have black men saying, see, something is wrong with me, right, as you said, and now you begin, as you said, to realize what other groups are suffering with suicidality as well. Something is wrong with me, I think, has to be prefaced with something has happened to me, especially within the African-American community. We may have the same, and we all know this, but I think it's worth saying in these contexts that there may be certain harsh realities that we all share, but the origin of the harsh reality is radically different. And then the normalization of trauma in our community is radically different than others because of the kind of social construct and social precedent set. So I think that you have to be able to have those kinds of conversations to help people understand, oh, there's nothing, there is some things that may not be well, but that lack of wellness has a historical narrative that has to be contextualized. You cannot approach the mental wellness of black men and decontextualize it historically. You can't. So it becomes critical to do that work at the same time while healing, and also to what you said, I think one of the greatest partners you could have in any community are churches. For one particular reason, it's hard to break in because the truth is that many churches are led, of course, by pastors, and many pastors across the board don't want to talk about mental health issues, even while they're battling mental health issues, don't want to talk about it. But in the black community in particular, it is still a trusted institution that if we begin to build those kind of cross-cultural collaborative efforts, something profound can take place in those communities. It takes work and a willingness that also requires sustained engagement and a lot of emotional stamina. Thank you, Pastor. Two more comments, and then we're going to close out. So thank you for being patient. Thank you all very much for your presentation today. This question is particularly regarding Pastor Mike's experience as a child diagnosed with CVID and just predisposing and perpetuating depression and anxiety. What would you have appreciated in hindsight? I'm a resident psychiatrist from Michigan, candidate for a child and adolescent fellowship. What would you have appreciated in hindsight that would have been asked, would have been discovered? What better questions can we ask for our black child and adolescent population that could help this tendency to mask or this— Yeah. —this masking that occurs? Well, two things. The obvious thing is if someone would have made a better diagnosis, right? That's the obvious thing because I think there's a part of what happens in all cross communities where some doctors get locked in a diagnosis, and that's what happened to me. I mean, there were some obvious glaring things. If you have sarcoidosis, you're not going to have a history of infections, right, at the same time, so somewhere along the line, there were some doctors who didn't look at what was being presented before them and deal with that. The other thing is, I think, to deal with me. I think what happened to me at 10 and 11 was that my voice and my ability to try to communicate what was wrong with me was not valued as much. And what happens is when your voice is not valued or taken seriously, right, you do what I did and many people do, you shut down. And that's not just with medical issues. That goes with emotional, with psychological issues. We shut down, but children will shut down, especially when, you know, labels are attached. So in my case, I wanted—when I heard that word hypochondriac, I then went on a mission to show that I wasn't a hypochondriac, which in the same time silenced my voice because I was afraid to share what was wrong. So I think when we talk with children who suffer from medical issues chronically, I think they have to feel, one, safe, two, and the safety is connected to making sure their voices are valued and not minimized or diminished. Because a child is not going to say—go to you and say, hey, I have an infection in my gallbladder. They're going to say, my stomach hurts. And that has to be—and they have to feel as though their capacity to communicate what is wrong with them is valued even when it's wrong. All right. But to the power of universality of these issues that has been discussed, Pastor Mike, one of the things that we got to take away from here, Donny Hathaway died by suicide in New York. But Pastor Mike's inspiration for his epiphany did not come from Donny Hathaway. He said Robin Williams was his source of strength and pain. So, I mean, I think the images we were out there—and a good thing for your foundation. I know some of you don't know what we do. I was at MTV yesterday, and one of the things I told MTV with Rachel Gearhart is if you don't help us, you know, every good session we do gets set back by every episode of a show when you marginalize or diminish the significance of, you know, whenever they show somebody going through anything. That's a mental health story. But they're not talking about it like that. So, the last comment, and then we're going to close it out. So, thank you again for waiting on your patience. Thank you so much, gentlemen, for your discussion today. My name is James McKnight. I'm a psychiatrist who lives in the Harlem community, and child and adolescent psychiatrist also. In fact, Dr. Hankins and I trained together at Emory. And I've had the opportunity to attend our past pastor's church here, and both in person and virtually. And I must say that he's a wonderful pastor in our community. We love him dearly. But I wanted to mention that you mentioned that we go to church more than anyone. And so, my question is, we understand clinical depression, of course the physiological part of clinical depression. And I was quite alarmed. And you and I, as a child psychiatrist, we kind of know that the rate of suicide among particularly African-American boys has been rising quite a bit. And I woke up this, yesterday morning, and on the news, they said it's astronomical. But we know that also, the sense of hopelessness, dealing with those microaggressions every day can be quite difficult. So, my question to you is, Dr. Hankinson, is there a study that looks at men who attend church versus those who do not attend church? Those who go to church and they get that, from Pastor Mike, that hope and dealing with that hopelessness, they get that hope, I know I do when I listen to him. Is there a study that looks at that, so that we might be able to say, well, men, maybe some of you, and I attend your church, there are a lot of men in your church, which is awesome, which is great. But maybe that's something that we can look at. And if not, do you plan to look at that? Well, I'm not aware of that study, so I don't want to misspeak. But I think, you know, that would be an amazing grant to look at. Yeah, I do think that would be a great thing to look at. Tell my son not to give me a call when the meeting is over. And let's figure out if this isn't something that the foundation shouldn't help you look at. But we are at the hour, and we do appreciate your attendance and your participation and your patience. This is a unique opportunity. It's a unique time. But the one thing that's not unique, all of you have to go to med school. All of you take the same MCATs. You take the same boards. You do the same rotations. You do the same fellowships. You match on match day. And yet, the outcomes are different, depending on zip code. How does that happen? Everybody went to the same training. They had the same. Sometimes you went to one med school, and your residency is somewhere totally different. And yet, at the end, the outcome is different. We got to do better if we know better. But I think one of the things that was raised here with Dr. Kemp, got a lot of men going to church, probably not as many as we'd like to believe. But the reality of it is, if they don't have male men doctors, then that makes it harder for them to show that there is strength in vulnerability. Whether that's at MTV, in the ED, or up here on this panel at the APA annual meeting. But we have to be comfortable that there is some strength in that vulnerability. And I know we all struggle with that. So let us go forth from here knowing that in less than, or just about a year's time, we'll be in Los Angeles. And I have already been to Compton in preparation for what we're going to do when we go to Los Angeles, and I met with some OGs. When I was there, and, you know, just a short story before we close, they said, well, Mr. Raw, what you going to wear when you come out here? Cultural competency. I said, well, I'm always in uniform. They're like, well, no, you can't come up to Crenshaw, Compton in a suit, because everybody's going to think you're 5-0. Does everybody know what 5-0 is? They're going to think you're a police if you come in a suit. So you can't come there. They're like, well, you know, we don't have to talk about colors, right? I'm like, no. And I'm telling you, I wore the blackest of black New York black that you've ever seen. But we had a great time, and we're going to have a great time when we get to Los Angeles. But I want you to leave here. Let's get better today so that we can make sure all our tomorrows are better than our yesterdays, be safe going home wherever home is, hug somebody. You've been gone a long time, and if you need something from your foundation, we are available to you. If somebody asks you, what does the foundation do? The only thing I want you to do, I heard something about mental health care works. This is our campaign for humanity. You don't have to tell them everything else. That's our job. That's what you expect us to do. And I'm also privileged to tell you that the most famous person in the history of the foundation is here. Rachel Gearhart is back here. Everybody, including the 13 founders, knows Rachel. So if you really want to have a relationship with the foundation, you better get to know Rachel. Thank you.

Mental Health Care Works Campaign

global mental health awareness

African American men

audience impressions

community engagement

My Brother's Keeper

mental health crises

suicidality

John Henryism

sustainable initiatives

church-based initiatives

peer support networks

systemic stressors

Raul Andrews