My name is Christine, and I am mentally ill. I have depression, bipolar and alcoholism. I am also white (actually I am kind of a pasty beige with age spots freckles but race discussions - unlike the paint aisle at Home Depot - are limited to five colors - black, white, red, yellow or brown.)
Alcoholics and addicts come in all colors but you wouldn’t know it from walking into a 12-Step meeting. You would think that alcoholism and addiction are illnesses that overwhelmingly afflict white people (and pasty beige people with age spots freckles.) But we all know these illnesses are color blind. The truth is that there just are not many 12-step meetings in minority communities.
I do not know why this is and I do not want to ascribe any blame. But I do know that alcoholics/addicts walking into their first 12-step meeting are often at the lowest point of their lives. They feel as though someone has taken a potato peeler to their soul. They are vulnerable and frightened beyond words.
I ask myself, would I have walked into my first meeting - shaking, hung-over and emotionally raw - if it had been in a black or Hispanic neighborhood, in a black or Hispanic church and I was the only white face in the room? Honestly, I don’t know - and I am white and have never been the target of bigotry.
I can only imagine what it would feel like to be the only black or brown face in a room of 10, 25, 50 or 100 white faces. But I have had it explained to me by a dear friend, who - in her words - is the color of her beloved Dunkin’ Donuts coffee with three creams and two Splendas. She has many, many years of sobriety, which means she attended 12-step meetings back in the days when women were uncommon and blacks were a rare oddity.
She has told me stories of racial slurs, back-handed insults, crude sexual advances and flat-out bigotry aimed at her because of her color. But she kept coming back and speaking her mind - a testament to her determination to recover from her addiction. Today she is deeply respected and scares the hell out of a lot of old timers. I like her.
Why does any of this matter? Because many - perhaps most - alcoholics/addicts suffer from a companion mental illness: depression, bipolar, anxiety disorders, post-traumatic stress syndrome etc. This is called dual-diagnosis. Study after study has shown that minority communities are vastly under-served by mental health care programs. According to the U.S. Dept. of Health and Human Services Offices of Minority Health:
Couple these data with the lack of 12-step meetings in minority neighborhoods and we have a serious problem. I say “WE” because “WE” are all in this together - regardless of race, religion, age or any other excuse we use to segregate ourselves from each other.
12-Step programs are the most successful programs that have ever existed to treat addictions. These programs are free. There are no dues or membership. These are the same 12-Steps that are used in the chi-chi treatment facilities costing upwards of $1,000/day. Every week there are over 300 12-Step meetings in the county where I live. Yet only a handful are in minority churches and community centers.
As I see it, dual-diagnosis is the number one mental health problem in America. People with depression, bipolar, schizophrenia, post-traumatic stress disorder etc. who do not receive good, responsible, unbiased mental health care will very likely self-medicate with drugs, alcohol, food, sex, gambling and other addictions. When this happens many become homeless or commit crimes. Others clog our emergency rooms. Some beat their children and partners.
It does not matter how much pigment you have. If we do not provide treatment for every mental illnesses afflicting an alcoholic/addict, it is very likely that he or she will relapse or slip into a depression, mania, hallucinations or even suicide. We all pay the cost.
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I don’t know what city you live in, but here in Boston there are a ton of 12 step meetings in black and hispanic sections of the city. There are also a ton of 12 step meetings in mixed areas that are largely black and hispanic. Meetings do tend to be segregated, as is everything in Boston, but minority communities are not underserved by 12 step meetings. After all, anyone can start a 12 step meeting. All you have to do is find a space (usually a church basement) and call the main office to get it listed in the schedule. It doesn’t take any money to start a meeting.
Hi Christine,
thanks for this article which I find powerful and moving. I really get a lot from your articles so please keep on writing!
Your story about your black friend is powerful and inspiring. I really respect her for enduring all that racism and abuse for the sake of her recovery. She must set a really powerful example to others.
Also your point about dual diagnosis is powerful, scary, and important. I am currently studying for a Social Work degree and am trying to think what I can do for my final year dissertation. I am thinking a study of dual diagnosis might be a really good topic to cover.
I sent you an email but one of the thing you mention, racial disparity, is also explained by Subliminal Distraction exposure. The symptoms of exposure are fear, paranoia, panic attacks, depression, and thoughts of suicide.
Note that it’s low income living arrangements that make the likelihood of SD exposure probable. The race of those groups changes from country to country. The slums of Ireland are not populated by blacks but they have the same high incidence of mental illness not found in rural areas. That statistic has held true for more than a hundred years without explanation. Subliminal Distraction explains it.
Suicide rates for poor areas and third world countries do not take into account the fact that in such places or even in very rural areas regardless of income, one does not need an overt act of suicide, just do something stupid, or reckless.
There is also the matter of priorities, if you spend most of your time, surviving you do not have time or the energy to thrive.
There is another discrepancy in mental health related to culture and income. WASPs as opposed to others including generic whites get under diagnosed as we tend to repress our symptoms. We seem energetic or gregarious instead of hyper. Thoughtful instead of depressed.
Of course this also means that those who are more emotionally demonstrative seem off to us. To us being openly emotional to the extent that many others are is a sign of extreme mental illness as we only scream at family at the dinner table if we are completely bonkers. For many this is now they express themselves when they are relatively fine.
When we had been together a short while my wife watched my father and I discuss our lives and all the stuff that has happened. Afterwords she asked who we were talking about. She was confused as we had spoken in the third person and without emotional outbursts. She thought we were discussing a case study. I was confused, how can one discuss something with the intention of understanding if one is just reacting to it emotionally.
So don’t forget about us, we may seem fine, and well behaved, but underneath…
I read this article expecting to hear the opposite as well.
The services I was referred to while waiting for a referral were in a part of town that would be largely First Nations (indigenous), and in an area known for street prostitution and intravenous drug use. It’s not a place I would feel unsafe in other circumstances - but I would feel uncomfortable going there to seek help. I feared among other things that people there would find me ridiculous - coming from a stable family, with stable housing, with no dependents.
I don’t mean this as a complaint because the services are somewhere they are very much needed - but not necessarily somewhere I’d feel comfortable going for help. And my discomfort was less cultural/racial but more demographic I guess. I’m embarassed to admit it, to some extent, but I do think it’s important to have a place to go that feels comfortable- because seeking help is hard enough as it is. Also, if you’re dealing with a condition that makes you afraid of everything, or of the dark (which comes at 4pm in winter)it can be a pretty strong barrier.
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