So, good evening. My name is Rory Reese. I'm a faculty member at Morehouse School of Medicine in the Department of Psychiatry and Community Health. I'm your moderator today for our Striving for Excellence service, Addressing Mental Health Disparities Among African American and Blacks Through Patient Care. This is a collaboration between the Morehouse School of Medicine, African American Behavioral Health Center of Excellence, and the American Psychiatric Association. Our presenter today is Lauren Carson, who's going to do a little bit of double duty, and she's going to help me move through these first couple of slides. Lauren's title for her presentation is Understanding African American Female Mental Health. Lauren, if you could go to the next slide, please. So funding for the Striving for Excellence series was made possible by a grant through SAMHSA or the United States Department of Health and Human Services. The contents are those of the authors and do not necessarily represent the official views of, nor represent an endorsement by SAMHSA, HHS, or the U.S. government. Next slide, please. The American Psychiatric Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The APA designates this live event for a maximum of one credit for physicians. So this credit can be claimed only for the credit commensurate with the extent of the participation in the activity. And next slide, please. And these are instructions about how to download the handouts from Ms. Carson's presentation so that you have them at your disposal as she's moving through her slides. I'm going to leave this up here for a second just so people can digest and take that in. And then, Lauren, if you could go to the next slide. And then towards the end of our presentation, there will be an opportunity to participate in a Q&A period. And this gives you instructions about how to do that from your desktop or how to join through instant join through webinar. So again, we'll give folks a few seconds to kind of digest those instructions. And now to our, your timing was great. Let's talk a little bit about our presenter. Lauren Carson is an Atlanta native and a University of Virginia alumnus. She is the executive director and founder of Black Girls Smile, a nonprofit organization dedicated to promoting positive mental health education, resources, and support. Through her work with Black Girls Smile and as a mental health advocate and speaker, Lauren has been featured at the South by Southwest Conference, the Clinton Global Initiative University, the American Psychiatric Association, Refinery29, among others. Previously, she had been identified as a young nonprofit professional network, 30 Under 30. Lauren continues to lend her voice and platform to mental health awareness and empowerment of all, especially minority communities, women and girls. And as a side note, I met the presenter, I met Lauren over a decade ago. And even then she was doing heavy lifting in her grassroots efforts aimed at promoting health literacy and behavioral health, particularly among black women. So she, I've not been in touch with her for a decade, but she has clearly been doing her thing and I'm excited to learn about the work that you've been doing in the time since we last connected. And the floor is yours. Awesome. Thank you so much, Dr. Reese. I fondly remember connecting over a decade. I really commend you on the work that you do in this field as well. Guys, I am so excited to talk to you further about African-American female mental health. So I, as Dr. Reese said, I've been in this field for quite some time. I will do a further little introduction in a second. But what I really hope you guys take away from this presentation today is a better understanding of research findings, statistics, and even some gaps in research that are relevant to the mental health and wellbeing of African-American women and girls. Also being able to identify some of the unique stress factors that impact the mental health and wellbeing of young black women and ways that we can reduce the mental health distress. Also ways that as providers, you can be racially and culturally sensitive and considerations also treatment alternatives when working with African-American females in a therapeutic environment, therapeutic relationship. And then lastly, abilities to identify some resources and some therapeutic tools that can aid in the relationship working with young African-American women and girls. As Dr. Reese said, I am the executive director and founder at Black Girls Smile, Inc. I also do youth and adult mental health first aid training. I do CIT training. I have been featured several places. But I think what's most important to my experience is that I have over 15 years of experience advocating at the intersection of race, gender, and mental health. And that's really at the crux of what we'll be talking about today. I also, to give you a little bit more context, when I'm adding some personal tidbits to provide some flavor to some of the information that we're learning today, I am a 15-year-plus mental health consumer, meaning I have been in therapy, worked with providers on a personal and professional level for over 15 years. And I am someone who has lived experience with clinical depression, anxiety, and suicide attempts and how the intersection of race and gender really impacts mental health and well-being for me along my journey, but also things that I've seen in my work in this field for quite some time. Let's first look at the statistics. I always like to start at kind of point A. And these are some statistics that you guys may know, things that you may not know, but are really important to highlight. The first being that Black women are more likely than their white counterparts to experience maltreatment and domestic violence, especially during childhood or adolescence. And as we all may know, that can lead to PTSD symptoms from trauma exposure and traumatic experiences. And despite the statistics that Black women and girls are more likely to experience trauma, things like maltreatment and domestic violence, they are less likely than their peers to actually seek treatment for PTSD. And as we know, that then becomes a continuum where we see individuals that are not seeking treatment and then their warning signs and symptoms are starting to become more severe. And we're also seeing longevity pretty lengthy for Black women and girls when it comes to PTSD. Another statistic that's really worth noting that can increase the likelihood of any individual experiencing mental health issues is the rate of sexual assaults among Black women is about 3.5 times higher than that of any other demographic group in the U.S. But Black women are also less likely to report the assault and receive treatment for any mental health difficulties that may stem from a sexual assault experience. Additionally, Black women and girls are more susceptible to racial trauma, racial violence, experiencing symptoms of depression, about 20% more likely than their White counterparts to experience depression, also more likely to experience postpartum depression and not receive treatment as well. And then one of the things that I always put an asterisk by is the psychosomatic symptoms. Black women are the largest demographic to report psychosomatic symptoms, so manifesting mental health issues physically. We may hear things such as headache, backache, muscle tension, gastrointestinal issues, digestive issues. These are things that in many cases, Black women are reporting to their OBGYN or to their primary care physician, and they may automatically go to treating these symptoms. We need to ask some more questions about what are some things that you may be experiencing with your mental health? How are things going at work, at home? How are you taking care of yourself? Because psychosomatic symptoms can be very high among Black women. I'd also like to talk about kind of the youth and adolescent demographic, young adult. Black girls have disproportionate rates of suicide completion. This is actually increasing daily. The suicide rate among Black youth overall has been increasing over the last 10 to 15 years. It started to plateau slightly for Black male adolescents, but we're seeing that continuing to climb among Black girls. We're also seeing very high suicidal ideation rates. This is self-reported, and this is nationally, but we're also seeing higher rates in more urban communities as well. We also see things around adultification. This has become quite a buzzword when talking about the mental health and well-being, but also things like the prison to school pipeline, disciplinary issues, disproportionately being doled out to African-American girls, and a lot of that is resulting from things around adultification. This isn't just external issues that we're seeing, such as disciplinary issues, academic performance slipping, and high school dropout rates, but this is also impacting the mental health and well-being of Black girls when they feel that adults are seeing them as older than they truly are or treating them as adults when they are still youth. We also see high rates of trauma, low rates of seeking treatment. This is still going to disproportionately be less than their White counterparts. We do see common statistics around other demographic female groups, such as the Latinx community, but it is significantly less than their White counterparts. We also see high rates of depression, similar to Black women. Black girls have high rates of depression. This is something that I can definitely speak to personally. I was diagnosed with clinical depression when I was 15 years old. At the time, I kid you guys not, I went and Googled online Black girl depression and nothing came up. My naive brain thought that if you see nothing on Google at the time, even back 17 years ago, if I didn't see it on Google, I had to be the only one that was experiencing mental health issues and depressive issues as a young Black woman. This is something that has not been addressed as in-depth, as expansively as it should be, and is really contributing to some of the statistics that we see at the top, the suicide completion, the suicidal ideations. I think it's also worth noting that high achievers, specifically among young Black female youth, experience high rates of anxiety from academic pressure, pressure from family, and feeling like they have pressure to succeed and to represent their race and community. These things can lead to, again, depression, anxiety, and other mental health difficulties overall. We don't want to just overlook individuals that may be succeeding academically. We also want to look at those individuals, specifically among Black female youth, that being a high achiever within our community can also cause increased anxiety and pressure and stress. What are some of the stress factors? Now I've talked about some of the statistics. What are some of the things that really poke at young Black women and girls and can cause mental health issues, whether it's depression, anxiety, PTSD, other mental health disorders that we see impacting our community significantly? First looking at Black women, things around cultural stigma, that's including societal stigma, so things that we hear out in society, things that we see through media depictions, but also self-stigma, when we start to internalize the stigma that we hear in society, we hear within our community, and we start to feel that about ourselves. We also see things around the strong Black women syndrome or sisterella complex. These are two terms that have been coined in the 80s that really speak to some of the experiences that Black women have, and it speaks to the cultural nuances to our relationship with others. With the strong Black women syndrome, you're seeing that in many instances, people feel like Black women don't have emotions, that they can get through anything, that they're extremely resilient. They're not necessarily the demographic you need to check on. They are the group that if you are on the job and you need someone to pick up the slack that that is who you go to, but having all of that pressure starts to weigh on you. It feeds into the stereotypes that Black women have to take care of everyone else before themselves, and that speaks to the second term we see here, sisterella complex. This is when Black women are disconnected from their own personal needs. They feel like they need to take care of everyone else. They don't even know what they need to be well overall. You may see things like compromising sleep to clean up the house, to take care of various things, neglecting nutrition, neglecting their physical health to make sure that they're taking care of others. There may be some guilt and shame around that as well, again, going back up to the cultural stigma. Then we also see disproportionate rates around trauma. That's racial trauma, complex trauma, and also family trauma as well. Looking at things like generational trauma, these are things that disproportionately impact Black women and really impact their mental health and well-being. We also, again, as mentioned before, work in academic pressures, and this includes racial and gender issues as well. This isn't just the pressure to succeed at work, but this also can be the pressure to get along with colleagues, not feeling like you fit in in corporate America or in environments where you may be the only one or one of a few. It could also be things around microaggressions or macroaggressions that are frequently happening in the workplace for Black women. Going back to, I think a lot of these are linked together. We see things around the strong Black woman where in the academic or the work setting, there is increased pressure. There's increased responsibilities that are placed on Black women. When we do start to struggle, we see that people are not as open and empathetic to us taking a break or to taking a step back, and thus, we don't feel comfortable taking a step back and taking a break. We all probably at this point have heard about Simone Biles taking a step back from the Olympics. This is something that I don't think outside of 2021 we would have seen from a Black woman to take a step back and to help herself first, but also in doing that, she also helped her team. She was able to take a step back and realize, I'm not at my best, so for my team to succeed, for me to succeed, I need to take a step back and focus on my mental health and well-being. These are new dialogues among Black women and girls. These are things that specifically in a therapeutic environment, we can start to address and start to break down. We'll talk about some of the ways you can do that. Also worth noting, some of the external stress factors, things like media representation, socioeconomic issues that we see disproportionately impacting Black women, so that may be lower than the poverty line, having home security issues, having health security issues, also increased health issues, things like hypertension, diabetes, and heart disease. These are all potential risk factors for experiencing mental health issues, and they're things that disproportionately impact Black women. Also, in the past, we see things like adverse relationships with healthcare professionals. That could be historical, but it also could be very personal. We find that specifically when you're talking about pregnancy and giving birth, at times, patients don't always listen to Black women. They don't believe us when we're saying that we're in pain or that something is not right. I think that it's even interesting to say that because I have these few images on the right-hand side to really highlight these are the depictions that we see of Black women in the media to that first point, but also looking at Serena Williams, someone who is very well-known, is a big figure in overall society, but specifically in the African-American female community. She even, during birth, providers were not believing that she was in pain. She had to scream from the rooftops before she received treatment, and she actually had some serious health issues that were being overlooked after she had given birth. These are the type of relationships, and these are the type of things that providers should be aware of that really impact Black women's mental health and well-being as individuals, but also their relationship to therapy and seeking assistance. Some of the issues specifically looking at Black girls, this image on the right-hand side, I think that this is a great image to really depict what adultification looks like. Again, you're seeing that too often Black girls are seen as grown or adults compared to their counterparts. This leads to teachers, to school professionals doling out more harsh or harsher punishments, seeing the joy or the laughing or just childlike activities and behaviors of Black girls as aggressive, as something that requires discipline. These are the things that really can impact the mental health and well-being of a young Black girl to think, why is this happening to me? Why am I being treated this way? This feeds very nicely into the second point here, that fear-based parenting. I can remember as a child when I would want to wear a miniskirt to school, and my mom would actually hide my miniskirt, and I didn't understand it. You hear those stories of a young person changing what they wear when they get to school, but now that I'm older, I understand where my mom was coming from. She was worried about how people would respond to my body. She was worried about people seeing me as older than I was. That happened quite often, that people did see me when I was 11, 12 years old, and would ask me if I was 18 or 19 years old. These are the things that start to impact your mental health and well-being, but it also starts to impact your relationship with your parents and the way that your parents are parenting you and supporting you. We also see high rates of cyberbullying among Black girls. This is something that has started to significantly increase over the last five years and is contributing significantly to some of the increases that we see in the suicide completions for young Black women is around cyberbullying. Also mentioning before, trauma. Trauma is going to be one of the biggest predictors of experiencing mental health issues, being diagnosed with a mental illness. So the high rates that we see and the stress factors that we see around trauma for Black girls is really important to notice as well. And the last thing, the ACES score, the Adverse Childhood Experiences. On average, you are seeing higher rates among Black girls. We at times are so focused on how that can impact them academically and needing to get other authorities involved from an academic setting. But when we look at the ACES metrics that go into the scores, these are things that really impact mental health and well-being. And seeing these higher scores, this is definitely going to be a risk factor for Black girls. Lastly, with stress factors for Black girls, home and family responsibilities, having a high pressure in the home or family environment, academic pressures, again, speaking about media representations and suicidal ideation, suicidal behaviors. These are things that we're seeing increasingly impacting the mental health and well-being of Black girls. And so we're seeing a lot of stress factors in the mental health and well-being of Black girls. So what are some effective strategies? So I've thrown all this information at you, and you're probably like, this is great, Lauren, but what do we actually do about this? So let's look at some of the strategies. One is going to be incorporating critical race theory, principles, and social justice into therapy. This may seem controversial, and CRT has been under fire quite significantly across the country recently. And CRT originated from a law and system stamp. But if we look at some of the principles of CRT, if we look at some of the framework aspects to CRT, we see ways that providers can be more versed in a more holistic view of the things that their patients of color, specifically Black women experience, will give them a broader view for treatment and for intervention. And one of the aspects of that is narrative storytelling. You find quite often that Black women, it takes us a minute to feel comfortable in a therapeutic environment. You may see some initial aversion, not necessarily feeling comfortable opening up, but things like narrative storytelling are historic to us. These are things that we use all the time as telling stories. This is things that have been passed down. So finding ways to incorporate narrative storytelling, ways where you can kind of center the experiences of a patient, these are going to be effective strategies and interventions. And these are pulling again from critical race theory. I know it's controversial, not telling anyone to go out and to enforce it, but looking at what CRT really means and pulling what serves us, what could serve us in a therapeutic environment is really important. Also incorporating things like faith and community as a protective factor. It's a huge misconception. And this is one thing that I have to dispel all the time, that the faith-based community and the mental health community are at odds. And this is big when we're talking about Black women and the Black community overall. Faith is a huge aspect of our lives and of our identities and being a part of a community. And there's ways where faith and community are a protective factor and can be leaned into to bolster mental health and wellbeing. And these are things that a therapist, a counselor, a psychiatrist, whoever your profession is, working with Black women or girls that we can look to incorporate that are kind of unique aspects to effective strategies and interventions. Also identifying and addressing factors that may help seeking behaviors. So what we mean by that is, it's not abnormal for a Black woman to not want to seek treatment. They may know things are going on with our mental health and wellbeing, but we just don't do that. We don't go to therapy. What are ways that a therapist can start to break that conversation down? And honestly, it's as simple as that, to start the conversation, to talk about what are some of the unique aspects and experiences that would make someone, make an individual not want to seek help, especially when it comes to their mental health and wellbeing, and start to break those down. Start to use our usual, our age-old therapeutic tools, but focusing on what are some of the things that we can address first so that therapy can be successful and we can get a positive outcome if we address some of those issues up front. And I say help seeking behaviors because recent research has actually shown that Black women specifically, stigma is not always the biggest barrier to treatment. That could be, again, socioeconomic issues. It could be other stress factors that impact our ability to seek treatment, but that stigma is not always the biggest barrier to treatment and to help seeking behaviors, as has historically been thought. But we do still need to address maybe things around the strong Black woman syndrome, maybe things around the Cinderella syndrome. And I can speak to this personally. I recently started hosting social media chats to talk to women within my network about what are some of their biggest therapy lessons. And one of the questions I have asked each time is, what were some of the stigmas that you had to get over in seeking therapy? And each woman I have met with so far has said that there wasn't stigma. That goes against what some of the historical research has shown that that's the biggest barrier to treatment for the African-American community. We're seeing specifically among Black women that that may not be the biggest barrier, but we still need to address help seeking behaviors. Also, thinking about cultural considerations and trainings that you can potentially do, making sure that we're incorporating cultural sensitivity, and then also person-centered strategies. So making sure that this is one technique specifically that can allow us to make sure that we are centering all of our work on the individual. And what I mean by that is a therapist may have to take a little bit of a backseat and just let the woman speak. Thinking about Kamala Harris's line, like I'm speaking, but just creating space for the client, for the patient to be heard can be really impactful for Black women because too often we feel like we are silenced. We feel like our voices are not honored, are not respected. So to start out, to have space in therapy where your voice is honored, is listened to, and is centered around can be key to positive outcomes in a therapeutic environment. Now let's talk about some of the cultural considerations. I started to kind of delve into this, but we're gonna dive into it a little bit deeper. What are some of the things that providers can do to ensure that they're taking into account cultural considerations? First, creating a nonjudgmental, safe, culturally competent, and sensitive environment. Being aware of any barriers to treatment, again, being very client-centric. And that may mean opening up your view, looking at systems that inherently impact the mental health and well-being of Black women that may not be directly impacting your patient. Within the Black community, and specifically the Black female community, we feel it all. We feel the things that happen to our brothers, that happen to people we've never met. And those are things that are really important for a provider to be aware of, and to have that more holistic view about things that historically and currently may be going on that could be impacting the mental health and well-being of Black women. Also, delving a little bit deeper there, thinking about historical details. How historically have African Americans been regarded, been portrayed? How has the behavioral health community historically hypothesized things around Black women? Those are things that still impact our relationship with therapy, and are important for a provider to be aware of, and to, again, create space that is non-judgmental so that an individual can start to take down layers, that they can start to break down the wall and start to open up to a provider. I'll provide you one example. I recently was speaking with a provider on another panel, and the provider mentioned that she had a friend who was in therapy and was seeing a provider that was not a woman of color, and in her therapy sessions, she would do this. Well, if I have anyone on the call that also identifies as a Black woman, you know what this means. It means that your scalp is itching. As simple as that. But the provider didn't think about and didn't know about some of those cultural nuances and thought that the patient actually had a tip. Those little things can lead to misdiagnosis, and that happens significantly among Black women and girls, that we are misdiagnosed because cultural nuances, language is not picked up on, and providers don't have a wide enough view. For a Black woman to come into therapy and say something like all of their co-workers are talking about them, a provider may see that as someone is paranoid. But if that woman is the only woman of color in her office, it's possible that she doesn't feel comfortable in her workplace and doesn't necessarily mean that she's paranoid, but that she doesn't feel comfortable in her workplace. That's something else that needs to be explored. But again, these are things that can lead to a misdiagnosis and also poor treatment outcomes because we're not having a complete view of things that could be impacting mental health and well-being of Black women. And this goes very nicely into my next slide. Why is it important to have these cultural considerations? You guys are probably thinking, why would I need to know that someone like pats their head? That means that they're their stuff. That is just one example of just having a more holistic view of the African-American female experience. Our stress factors, our unique circumstances that impact our mental health and well-being because that's what makes up the mental health and well-being of anybody. But we each have unique experiences within various demographic groups. So why is this important? If we don't think about cultural consideration, if we don't invest in cultural competency training, we may have poor treatment outcomes. We may have an individual who goes to therapy and says, hey, this is just not for me. This environment is not for me and doesn't actually seek the help that they need. We're seeing then the longevity of symptoms and the severity of symptoms. I can't tell you how many Black women I have met over my years who told me I have been depressed for decades, decades, 20, 30, 40 years because they don't want to seek help. Also, with cultural considerations as a part of a therapeutic relationship, we see a decrease in mental health distress and overall positive and increased mental well-being. We also start to move from a place of generational trauma to a place of generational healing. That's why I have this picture here. It is so powerful when you have one individual within a community or within a family that starts to normalize going to therapy, starts to normalize healing, starts to normalize getting away from poor coping skills that we may have passed down, addressing mental health issues. These are things that don't necessarily just get passed down to children or to mentees, but these are things that start to radiate out within the community. I can speak of that personally. I have people every day within my network coming to me saying, hey, I finally want to start therapy. Can you help me find a therapist? Because I have been so vocal about how healing it is, how joyful it is to be in therapy, to focus on your mental health, to invest in making sure that you are mentally healthy and well, and that is something that radiates out. Black women are a part of so many different networks, play so many different roles in their personal life and their professional lives, whether it's at church, whether it's at home, whether it's volunteering, whether it's in a school environment, it runs the gamut, but that starts to radiate out. Perceptions of listening and understanding by mental health professionals and professionals overall starts to increase, and we start to see improved client and provider relations and relationships. We also start to see a decrease in misdiagnosis as well, which is, again, key and happens way too often within our community that we show warning signs and symptoms differently at times. We have unique experiences that providers are not always versed in that can impact our mental health and well-being. One second. I thought I saw a hand up. We'll have some time for questions at the end, guys. Let's see. Additional cultural consideration for providers. Being aware of social norms, traditions, language. Also, very big, is addressing confidentiality. It's very common for providers to have confidentiality within their agreements. People kind of quickly sign those, but confidentiality can be an extreme issue for Black women when seeking treatment or seeking any sort of recovery options. They may have questions around, will their insurance know? Will their job know? Who can you tell? Will you be talking to your friends about this? Will you be talking to your colleagues about the things that they're experiencing? Addressing those things up front can be really big for Black women. We are taught very much to keep things inside, to not share anything outside of yourself or your family or your community. So to start to share those things, there can be some fear around confidentiality. Also, attention to any historical details about ways that African-American community, again, is portrayed or is regarded are things that providers should take into account in regards to treatment with Black women. We're going to talk about some treatment alternatives. So I mentioned narrative storytelling earlier. This is really providing some parameters in which a patient can almost tell you things that are going on in a story-like fashion. This can be really helpful and can start to open up Black women who are seeking treatment and ensuring that you're starting to build that rapport. Also finding ways potentially to involve family or faith can be really important to the positive outcomes of Black women seeking treatment. And then there's a specific model that kind of encompasses all of this. And that's the HERS model. That's taking into account history, empowerment, rapport, and spirituality. And this model has shown extremely positive outcomes in treatment for Black women and has been extremely helpful with building a positive relationship with providers and patients as well. Also looking at various holistic approaches, potentially encouraging things like mindfulness or meditation or yoga. These are practices that haven't always felt inclusive, but it has been a very big movement over the last maybe three years to increase representation among holistic approaches. Also going with stress reduction techniques and anxiety reduction techniques. These are things that too often we have never heard of, that we don't even know that there's things that you can do. There's breathing techniques. There's meditations that you can do that can reduce stress and anxiety. Too often we fall back on the coping skills and the self-care methods that are depicted by our parents or our grandparents. And there's ways to honor the experiences of our ancestors, but also to start to build our own mental wellness toolkit. And stress reduction techniques can be really helpful. Anxiety reduction techniques. As I mentioned before, it's not uncommon for Black women to play multiple roles. They may be a youth leader at their church. They may be working 40, 50 hours a week, taking care of a young one, taking care of a family member, volunteering at a soup. It can be quite expansive. So helping Black women as clients or patients to have these things in their toolkit that they can utilize can be extremely helpful. Also research has shown offering alternative times and days can be really important to meeting the needs of Black women who are seeking treatment. And this can account for odd job hours, not necessarily, let's say someone works nine to five every day and providers work nine to five too. Then that's not going to really create space for someone to come in during work hours. They may not have days that they can take off. They may not be able to take off so that they can ensure that they have all the funds possible to take care of their family. We also see issues around child care as well. So offering alternative hours or days can be extremely helpful to making sure that Black women can get to treatment, can get to therapy, and reap all the benefits. Now let's briefly talk about some resources. And I put some good, hopefully some good resources together for you guys. So first resources that I think are extremely important to point out, this is a list of organizations or companies that work in this Black women and girls space. Few that I'll point out, Ayanna Therapy, they're a therapist of color. If you identify as a therapist of color, if you're looking for recommendations or things like that, Ayanna Therapy is a great resource there. BEAM, and I will talk about this again, because they offer some of the best cultural consideration trainings for providers. We also have things like the Black Women's Health Imperative. They have great resources overall that focus on the health and wellbeing of Black women. And a few other organizations on here that are just doing great work within the community, offering programs and resources and therapy. These are things that I would really encourage, providing to Black women and girls that you may work with in various capacities. These are great organizations to check out. So, a few other resources, Therapy for Black Girls, they have a podcast, they have a community. Great resource to feel like you can be in communion with others that are really looking to focus on their mental health and wellbeing, and honor the experiences of Black women. Also a few books that are really important here. A new book that has come out recently, My Grandmother's Hands, Racialized Trauma and the Pathway to Mending Our Hearts. This one has received phenomenal reviews. I'm actually in the middle of it right now, and it's such a great book. Also, Black Pain, this woman, Terry Williams, she has been working in this space for a very long time. This book is an awesome way to get good context on what is unique about the Black experience. This is a book, even being in this field for 10 plus years now, I was learning things from. And then the last one I wanna point out here is The Strong Black Woman, How the Myths Endanger the Physical and Mental Health of Black Women. This is a book that was actually edited by three professors at Emory University. This is a great book to learn so much about Black women's mental health, and to really break down that concept I mentioned earlier of the strong Black woman. And last thing I'll note is the therapy cards. I have these great product to help consumers. Just think about your mental health and wellbeing, and really focus on it outside of just the therapeutic environment. Then on the provider side, as I mentioned earlier, BEAM is a great resource for trainings for providers. Another one that I really like, I've taken it myself, is the DSM-5, The Black Way. Really talks about breaking down the DSM-5, which is the Holy Grail, and ways that we can look at the DSM-5, but relate that to the Black experience and the things that African American community experiences with their mental health and wellbeing. The Black Mental Health Alliance also does trainings and workshops. And another training that I've heard great things about, I have not had the pleasure of taking quite yet, is the Decolonizing Therapy. They have trainings and workshops on their website as well. And then resources for providers to delve a little bit deeper into some of the content that we discussed today. This is going to be Therapy for Black Girls, as I mentioned before. Podcasts, resources on their site. Black Women's Mental Health, mentioned that book earlier. And the Unapologetic Guide to Black Mental Health is a great book that really outlines so much about the Black experience, both historically and status quo, that impacts our mental health and wellbeing overall. And I always like to leave you guys with a little bit of my personal nuggets as well. Things that I have learned along my mental health journey. As I mentioned, I was diagnosed with clinical depression when I was 15 years old. I had the pleasure at the time, I lived in Atlanta to see a provider of color, and that was extremely helpful for me to get a handle on things that I was experiencing with my mental health and wellbeing. But I have to admit, there still was a lot of stigma, self stigma around the things that I was experiencing. I definitely felt like there was embarrassment and shame and it was a weakness. Now I see mental health issues very differently. I see it as we all experience mental health issues and the quicker we can get help, the better outcomes we have and the quicker we can get back to really enjoying our lives. But also some of the things that I've taken through my work is that race and gender are very closely linked to mental health seeking behaviors, attitudes, and outcomes. Being a Black woman greatly impacts the way that I view the world, the way that I show up in the world and the way that I feel about myself. And those are all things that are closely linked to mental health and mental health outcomes. It impacts me on a daily basis. When I hear or see things going on in society at which Black women are made to feel less or are not honored or respected, those are things that are closely linked to my mental health and wellbeing. So race and gender, those things, you can't unhook those when you're talking about mental health of Black women. Also that cultural and gender specific nuances can lead to misdiagnosis. As I mentioned before, I gave a very basic example of the head pat, but I also talked about psychosomatic symptoms. Black women, again, are the demographic group that experiences the highest levels of psychosomatic symptoms. So it's not uncommon for us to be diagnosed and treated for a physical ailment or a physical illness when in all actuality, we're experiencing a mental health issue or we're experiencing a mental health issue and our symptoms show a little bit different and those things are not picked up on. Also, lastly, I think it's really important to mention that body image and self image are two things that largely impact the mental health and wellbeing of Black women and girls. Our bodies, our self-worth is constantly threatened in various ways, whether physically, mentally, spiritually, and these things are closely tied to our mental health and wellbeing. These are things that are worth noting as a provider so that you can address it with anyone who comes into your office that may identify as a Black woman or girl and how these things can potentially impact the way that they are showing up and the way that they feel about themselves with some of the things that they may be experiencing. Also, it can be very hard for Black women to be vulnerable. It's not something that comes innately to us. It's definitely something that's a part of the unlearning process of being vulnerable, of opening up about the things that you experience. We are told very often, either implicitly or explicitly, that we should keep. So it can take us some time to open up and to feel vulnerable, and that's both in our personal lives, our professional lives, we are also gonna see that play out in therapy. Also, we are very much told to take care of ourselves. This, again, is something that's either explicit or implicit, that we are supposed to take care of everybody else, and then whatever is left, that is what you can give to yourself. We pour our cups empty before we give it to ourselves. And this is something that, again, is a part of the unlearning process. This is something that probably served our ancestors very well, but doesn't necessarily serve us well today, and contributes to lack of boundaries and how that can impact your mental health and wellbeing. But the positives, because I am big on positives when it comes to mental health. People too often think that mental health is all negative, all grim. There are so many positives to mental health. One, we all have mental health. But specifically looking at black women and girls, we are so resilient. Our resiliency rates, when you look at various surveys, research, we're really resilient people, and helping black women to tap into that, to remind them how they've gotten through various experiences in the past, whether it's trauma, anxiety, or stress, and helping them tap into those things that have worked for them before, or helping bolster some of those techniques is really important. And I'm sure you guys have all heard that black girls and women are magic. Black girl magic is very real. And these are things that really go into our mental health and wellbeing, when we believe that we are magic, when we believe that we're deserving, that we should be honored and respected. These are things that really help to bolster our mental health and wellbeing. So that is all that I have for you guys today. I really appreciate you creating this space with me to learn a little bit more about black women and girls, some of the things that uniquely impact our experiences and how we show up in a therapeutic environment. Lauren, thank you. I thought you were the truth when I met you those years ago. Only thing you did this evening was to confirm that many times over. So I wanna thank you for a brilliant presentation and scope and the thoroughness of it. That was amazing. We're gonna open the floor for questions now. I'm gonna invite people to submit their questions. If you have them, I wanna get us started in terms of hearing your thinking with respect to, you talked at the beginning of your presentation about the multiple traumas that black women and black girls have experienced. And I'm wondering, and then towards the end, you talked about the challenges of black women being vulnerable. And if I've been traumatized, I think that that would be a tough thing to kind of open up. How do we bridge? Because it also seems to me that as you're talking to, I know there are some providers in the audience that we have been part of the problem in terms of kind of creating spaces for black women and black girls to show up. And as I was listening to you talk about alternative therapies, I'm like, are those really alternative? Or are those some of the things that we have to do if we're to invite that vulnerability that we know important to the wellbeing of black women? And so how do we move? Because a lot of what you talked about without talking about it is systems change. Toss it back to you. Yeah, so I think one is the education piece. I think being here and starting to even learn that we have to move away from this one size fits all model and that this is how we treat one patient. So this is how we have to treat the next patient is a start. Being here, being in this space where we start to think about what are some of the unique experiences? What are some of the statistics? What are some of the things that I see on TV? What are some of the things that I hear on the news? How could that impact the mental health and wellbeing of my patients in general? I think is a starting point because this isn't something that just impacts black women. This is going to be any marginalized community is going to have unique stress factors. So, and what I mean by that is black men also have issues opening up with vulnerability but for different reasons at times. You also see issues among, again, the Latinx community, the Asian American community, the indigenous community. Overall, we need to start to move away from this one size fits all model and start to have a more global perspective on the things that can and do impact the mental health and wellbeing of our patients. And I also think it's important to know, as a black woman, I do not tell people you need to see a black woman provider. It is way more important, one, for you to see someone, if you need to see someone, but also that you see a provider that you feel comfortable opening up to, that has experience with specific issues and can help you come up with an appropriate treatment plan. That doesn't always have to be a black woman. I have seen providers before that were not black women who I got so much out of that experience because they created space for me to be a black woman. They didn't judge me for the experiences that I had. They didn't bat an eye when I'm telling them about something that they may not have known about. So really creating that space to honor, respect, and hear the experiences of black women, but I would say any kind of marginalized patient or client is key. And being invested in learning more about those experiences and just really being invested in the education piece. That's awesome, thank you. Related to black girls and black women, which is our focus this evening, but do you have thoughts about how black fathers, I kind of thought about this for myself because I'm the father of two black daughters, but how do black dads, black men, how do we show up? How can we show up in terms of promoting the resiliency that you talked about towards the end of your presentation? Yeah, one of the ways that I think has been most impactful in the last, let's say five to 10 years is really addressing things around adultification. And for me, that's from the parental side, starting to parent more from a place of liberation. It is completely normal and understandable for us to be worried about our black children when they go out into society, whether that's their physical safety, their mental safety, but at times we parent from that place of fear. We are not open with them about where, specifically black girls, where they will be sexualized, where people will think that they're older. How do they respond to those things? These are not conversations that I had with my parents. They knew, my mom knew that once I left the house that there was going to be an issue with me in a miniskirt. Did I know that? I just wanted to be cute like the rest of my friends, but that wasn't a conversation that a lot of parents feel comfortable having about, hey, look, this is what's going on in the world. I don't want to parent you from that place, but I want to make you aware of it. And then we're going to come up with ways that we can combat that together where we can have those open conversations is key. And to one of the other things that I mentioned earlier is starting to move from a place of generational trauma to a place of generational healing. There is a lot within the black community that we keep locked up, that we keep a secret that we don't want to address because it's painful and it's difficult. And there's ways that our grandparents failed our parents, our great grandparents failed our grandparents, but there's ways for us to honor that and to say, hey, this is what worked for them at the time, but I'm going to find different ways for it to work for me now. Those are kind of the biggest things that I have seen be impactful for parents being a part of the support and the resource aspect for black women, for young black women, for black girls, because the support aspect is key. If we have that support at home, that's going to make a huge difference. And being versed in already knowing, okay, if someone comes whistling at me, these are conversations I've already had with my dad. I know what's happening and I know how to work through that. And I also, now that I've had that conversation with my dad, I feel comfortable coming back to him and talking to him about my experiences as well. Awesome. So it sounds like one of the things that we can do is being engaging parents, because it may be the case that black adolescent, that young black woman may not find therapy, but that there are some things that parents can do and learn to do themselves. And trainings, workshops, such as these, provide a vehicle to kind of talk about those challenges. Definitely, definitely. We start to see these things passed down. Even mindfulness, breathing exercises. These are, too often we have seen our parents drink. We've seen our parents self-medicate when they are experiencing stress or anxiety. We've seen them not open up when they have macroaggressions or microaggressions at work. We've seen them not feel comfortable being vulnerable. The more we can see our parents model these positive behaviors, these are things that are gonna start to take shape and allow us to also be vulnerable, to seek help, to feel like we don't have to continue on this whole track of black people don't go to therapy, mental health isn't something that impacts us. We're just gonna get by. That's awesome. Thank you so much. If there are no other questions, one of the things that Lauren has agreed to do is to make their slides available. And the AP office can advise us how you would access those slides. Lauren, do you have a parting thought or comment that you wanna share with the group? I would say the biggest thing is we have to move away from a one size fits all. We all have unique experiences. We all have unique circumstances and finding ways where we can honor that in therapy and in a therapeutic environment is extremely powerful. That's on the client end, but it's also on the provider end as well. For sure. Well, I'm gonna do a better job of staying in touch. You're doing terrific work. This is exciting. And thank you for leading this discussion in your presentation today. Talk about first rates. I think I'll be one of the first persons to download those slides. For our attendees, we wanna thank you for your participation and showing up today. Dr. Reese, there's one more slide here that shows I think how they can get credit for this. Right, and they're clearly gonna put you on a pin. No, you're good. Cause I would have skipped over it too. So how to get your CME credit. We'll leave that up for folks to take down the information that they need to take down. I'll also let everyone know, there is a citation slide as well. I'm gonna go ahead and keep this one up so you guys know how to make sure you can get credit. In the followup, I will touch base with my contact, with the APA to ensure that you guys get my citations as well. So if you feel like it, you can dive into some of these studies and research a little bit more. And again, just thank you, Dr. Reese. Thank you to the APA, to Morehouse for having me here. I could talk about this stuff all day. So I really appreciate you guys lending me a little bit of time for your evening and just hope everyone has a good rest of their week and weekend. Take great care. You all be well. Thank you.

African American female mental health

mental health disparities

stress factors

racial trauma

domestic violence

sexual assault

academic pressures

strong Black woman syndrome

cultural considerations in therapy

holistic mental health care