S1: Welcome in San Diego , it's Jade Hindman. On today's show , a conversation about how a culturally competent therapist can help you navigate racial trauma. This is KPBS Midday Edition. Connecting our communities through conversation. About racial bias in American healthcare surrounds us every day , from misdiagnosis and pain , mismanagement to pediatric care. That bias is also embedded in our mental health care system , leaving black patients without essential resources. Ashley McGirt. Adair is a licensed therapist who co-founded the Therapy Fund Foundation , a group dedicated to mental health equity. Her book is called The Cost of Healing in Silence Navigating racial trauma and the call for culturally responsive care. Ashley's here in town for a book talk tomorrow evening at the University of San Diego. She joins me now. Welcome to midday Edition , Ashley.
S2: Thank you for having me.
S1: So glad to have you here. So I want to begin with the epigraph of your book. It reads , when care ignores culture , silence becomes survival.
S2: So it's a very real reality that I've experienced as a black woman in America , and both as a health care provider. So when you are not looking at an individual's cultural responses , it can impact how you diagnose over , diagnose , misdiagnosed them. And so it's really important that we're practicing care from a culturally responsive lens , and that we don't actually ignore the individual's culture. and we have a clear conversation with them and not just assume based on what we think about the person.
S1: You use the term racial trauma in your book.
S2: And it's more than just repeated exposure to harm. It's those direct experiences , indirect , whether it's real or perceived. And I always like to say whether it's real or perceived , because even just second guessing yourself. Did this happen to me because I had a hoodie on ? Did this happen to me because the color of my skin has a visceral impact on our body , and it really impacts our , um , lifespans. And we see this in mortality rates that differ between black , brown and our white counterparts.
S1: Tell me a bit more about that. How does this impact the life expectancy and the health of black people and black women.
S2: In a dramatic way. So I served as a hospice therapist for a number of years , and I served two very distinct communities in Washington state. One was Vashon Island , which is predominantly white , and one was Skyway , a suburb of South Seattle , which was predominantly black and brown. And my black and brown patients would be coming to me on hospice in their 50s , their 60s. My very last hospice patient was a 23 year old black woman. Meanwhile , my white hospice patients would be living well into their hundreds , and they also experienced trauma. But they didn't experience the impact of systemic oppression and racism. That literally takes years off of our life , and especially when we're looking at things like adverse childhood experiences. Your a score. And we know that if you have an A score six or higher , your mortality rate is decreased by 20 years. And add on to that racism , which was not actually acknowledged by the A score. Hmm.
S1: Hmm. I want to talk about the way that you you tell this story in your book because you tell it through the lens of your grandmother's lived experience.
S2: And when I look at her life and death and the things that are still happening to this day , my grandmother was sent home with a brain bleed with no support. Her family wasn't contacted. The same thing actually just happened to Jamie Foxx not too long ago , and he details it in his Netflix stand up. What had happened was so the same things happening to a celebrity multimillionaire black man. But of course , he had the celebrity to be able to advocate and all of the news sites that spoke out about what had happened to him. And fortunately for my grandmother , she would not survive that. And then I also think about the community she lived in up until her death , where there were liquor stores on every corner. And I often wonder how the trajectory of her life would have changed if there were community centers , sound , culturally responsive clinicians available to her , as opposed to liquor stores on every corner , and a public health crisis being the crack epidemic that was not recognized as such. And if we put in the same amount of resources that we do today with the opioid and fentanyl crisis , as opposed to the criminalization that occurred with the crack epidemic , how differently would her life and others impacted by that have turned out ? So that's why it was really important for me to tell the story through the lens of her life.
S1: You know , when I hear you talking about resources , um , one thing that I cannot ignore is the fact that we just had a conversation about the Supreme Court's recent decision , which impacts the Voting Rights Act. For for many of your patients , do you see this moment being , um , something that causes trauma ? Absolutely.
S2: And so many of my sessions , when that decision came out were filled with just immense stress , hypervigilance that was impacted from the clients that I was seeing who were exposed to that and even myself. Because I remember , you know , my grandmother speaking to me about the importance of voting and how some of these things that were meant to improve life for the well-being of communities of color are being taken away. And how that disenfranchising individuals and , you know , they're no longer being seen or heard in just visceral ways that impact them.
S1: And in getting deeper into , um , mental health here. I mean , you also trace the history of black mental health and racial bias in America. You point to the example of Drape Tasmania , uh , introduced in 1851. What is that ? Tell me about that.
S2: So drape to mania was once a diagnosis in the DSM , the Diagnostic Statistical Manual basically our Bible for how we diagnose individuals. And they said that individuals who wanted to be free were mentally ill. So enslaved individuals who were seeking freedom and wanted to leave the plantation , it was labeled a mental illness by Samuel Cartwright. And it was really just horrific that we pathologies something like freedom as a disorder. Hmm.
S1: Hmm. How else is racial bias embedded in psychiatric Practices.
S2: It shows up in a plethora of ways when we look at the medical apartheid , one of my very first jobs , Western State Psychiatric Hospital , they perfected lobotomies on Native Americans. And so when we look at the historical implications of things like that with Native Americans , indigenous communities , or even over diagnosing black men with schizophrenia , there's a phenomenal book by Doctor Metzl called How Schizophrenia Became a Black Disease. And we still see this today in modern times , in the ways in which individuals will see and label black or brown people who are presenting with the same signs and symptoms as maybe their white counterparts , but they get the diagnosis of bipolar or something that's more acceptable than like that of schizophrenia , and how society views that type of diagnosis. Hmm.
S1: Hmm. Um , you know , one of the things that I think about is we have this conversation is a conversation I actually had with Doctor Rodney Hood here in San Diego. He's the president of the Multicultural Health Foundation , and he talked about his theory of post-traumatic slavery , stress disorder , and the psychological response of the chronic stress of systemic anti-Black racism. I'm curious to hear your thoughts on that.
S2: It's actually the premise of my work. And doctor Joy DeGroot. She coined the term post-traumatic slave syndrome , which I actually detail in my book as well. And really looking at the intergenerational impacts of trauma that's been passed down within black communities and overall , and how it impacts our family systems , our cultural conditioning , and our exposure to chronic stress and inequities.
S1: I want to talk about this group that you founded because it could be a solution here. And you founded the Group Therapy Fund Foundation , which is all about removing financial , Cultural and systemic barriers to mental health access. What are some of those barriers and how does your your group remove those ? Yeah.
S2: So our mission is literally to eliminate any and every barrier when it comes to accessing wellness. And one of the biggest barriers is being able to access clinicians of color. There's only 4% black therapists throughout the entire United States also cost. So we eliminate that barrier by providing free therapy and also paying our therapists a market level rate who are doing that work. We also have tuition assistance to increase the number of clinicians of color in the field because as I shared , that number is extremely low. In addition to therapy access , we also invest in community based healing things like peer support services , education , culturally grounded wellness practices. And we host the only Bipoc led behavioral health conference on the entire West Coast every July during Bipoc Mental Health Awareness Month.
S1:
S2: And while I'm a big proponent of hope , I. I'm big on moving from hope to commitment. When when we look at hope , oftentimes we're hoping someone else will come in and do the thing that needs to be done. And so we remove ourselves from that. And so I like to say that we should all be committed to improving our mental health. And when we heal ourselves , we heal a generation. And so definitely have hope , but also see yourself within that hope. Maybe , um , also what's labeled as radical hope. So you're not just looking for someone else , a therapist , a pastor. You're seeing yourself in what you can do to actually heal better yourself , better your community , and you can act on this every single day as long as you're committed. And so really being truly committed to acting. Yeah.
S1: Yeah. Well , you know , in your private practice , um , a priority of yours is to destigmatize mental illness.
S2: It starts with having these conversations , not shaming or guilting people for their struggles with mental health , and also understanding the difference between mental health and mental illness. Because every single one of us has mental health and 1 in 5 of us suffers from a mental illness , and I think we're moving where we're having more broader conversations about mental health , but we're still stigmatizing those who are actually speaking up or acting and behaving in ways where you see their mental health in the forefront. So it starts by just changing how you talk about the individuals in your life , and even maybe celebrities and people that you don't know because your family and your peers , they see how you respond to the things that are happening in the public.
S1: You know , you really talk about the need for culturally responsive therapists.
S2: So in school , we're taught from a Eurocentric , westernized lens. We're taught from the Freuds , the Piaget's , the Watson. It's really important that we also know the Kenneth and Mamie Clark's , the Doctor , Joy DeGroot , who I labeled earlier , and that we're exposing ourselves to readings , experiences in people outside of ourselves so that we can really learn and not put that on our clients to educate us. But we're educating ourselves.
S1: You know , when you reflect on your grandmother and her story.
S2: And this , my grandmother was a person who believed that service was the rent we pay to live on this earth , and the way in which I give back , and all of the things that I do literally center around her life and death and the things that she taught. Being a product of the civil rights movement and really stressing that you be a voice for the voiceless , if you can open a door , you open a door for others. If you are an able bodied person , you do something to help improve the disabled community , ensuring there's ramps , ensuring there's access even if it doesn't impact you directly. And based on my work and the things that I've done , I think she would say job well done.
S1: All right , well done. I've been speaking with licensed therapist and author Ashley McGirt Adair. Her book is called The Cost of Healing in Silence Navigating Racial Trauma and the call for Culturally Responsive Care. Earlier , we said that the talk will be at the University of San Diego. The event will actually be taking place at the San Diego Central Library in downtown tomorrow evening. And of course , you'll be in conversation with local author Joy Jackson. More details will be on our website at KPBS. Ashley , thank you so much , and thanks for your insight.
S2: Thank you.
S1: That's our show for today. I'm your host , Jade Hindman. Thanks for tuning in to Midday Edition. Be sure to have a great day on purpose , everyone.
