Thursday, January 15, 2015

Racial Disparities? Of course there are.........

Here is the article I'm basing this on: http://huff.to/1zeIonG  As you can see when you read the article, it talks about disparities in dealing with mental illness due to race.  Based on personal and professional experience, I believe those disparities exist. The article is excellent, and I don't want to discuss what this woman talks about because I think she lays out her case.  However, as I was reading the article, a situation in my own professional life leapt into my mind.  It made me wonder.  What role did race play?  Here is a recap:  I had a client.  My client was black.  I'd spent time with her helping her to take care of situations and problems contributing to her depression/addiction.  Nothing surprising.  She was a client.  I was her case manager.  She called me one day after a domestic violence incident in her home.  When I arrived, the police had already been there.  There was a small amount of what looked like blood on the door, which confirmed for me that something had happened. Her mood was flat.  When I say flat, I mean that I saw no emotion on her face.  Except for a little panic and anger when we discussed the situation, she stayed flat.  That concerned me.  In addition, given that I had knowledge of domestic violence, I was concerned for her safety.  So, I brought her into the crisis center of the agency I was working for.

We spent what seemed like all day there.  She remained pretty flat in my estimation. You see, since I'd spent time with her...I knew she wasn't what she normally was. She was usually more animated. And since we spent that day together at the crisis center, I was able to observe her. At some point, I noticed that her speech was starting to become slurred.  I hadn't seen any of her medications do that to her, so that was another clue that something wasn't right.  The nurse who did evaluations saw her. A social worker was part of the evaluation.  And they both told me that she was fine and directed me to take her home.  The nurse and the social worker were both white.  I reported my concerns. They both discounted what I was saying.  And told me again to take her home.

To end the story, I put this client in my car and she promptly passed out.  She went in and out of consciousness.  I wasn't feeling all that confident that the nurse and social worker wouldn't send me on my way with her again, so I raced to the nearest trauma unit.  Turns out she had overdosed on medication.  She later told me that she had taken it before I came to the house. Whether she had taken it at the agency, or when she was home wasn't important.  We were dealing with a serious health crisis. I spoke about how unwise a choice to drive to the hospital was in my previous blog post.  But at the time, I was really scared. Something was wrong and I wasn't getting help from the people assigned to deal with it.  Frankly, that had happened before in my life.  Remember Maxine?  From my perch years later, I realize that something would have to have been done.  You can't ignore a woman losing consciousness.

But here is what I'm wondering at this moment.  My client was black.  The women doing the assessment were white.  What part did that play in their lack of willingness to take what I was reporting seriously?  I don't know. I worked with the agency and can't say that I ever saw any racism before that time. But was I looking for it?  What did I know about the nurse and social worker before I worked with them?  Would there have been a difference if the client had been white?  I don't know. But I can't believe that race didn't have some impact.  Were the nurse and the social worker operating on a belief system regarding race and mental illness?  There will never be a concrete and final answer to these questions, but given what I know about race and the treatment of mental illness, it does lead me to more questions.  And the recognition that these questions are even more important to raise today. Let me know what you think. If you feel comfortable, share YOUR experiences. Let's talk!

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