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Racial Inequalities in the Mental Health Field Throughout the United States

A video Op-Ed by Andrys Tavarez that explores the racial inequalities in the mental health field.

Racial minorities often suffer from poor mental health outcomes due to multiple factors including inaccessibility of high quality mental health care services, cultural stigma surrounding mental health care, discrimination, and overall lack of awareness about mental health. In this video, we explore the racial inequalities in the mental health field and how we can hopefully break the stigma.

Andrys’s Op-ed Draft…..

Racial inequalities in the mental health field throughout the United States

Hurricane Maria served as an example on how the American government failed and mishandled its citizens. Specifically, it highlighted racial disparities in the United States. Time and time again, history has shown that the American system was created to serve a very specific type of American: white Americans. Citizens of color do not have an equal voice to those privileged white citizens. With this Op-ed, I hope to explore racial inequalities in the mental health field throughout the United States. I plan to explore the increased incidence of psychological difficulties in the Black / Latino community as a result of lack of access to appropriate and culturally responsive mental health care, prejudice and racism inherent in the daily environment of Black / Latino individuals, and historical trauma enacted on the Black / Latino community by the medical field.

I am tossing around the idea of creating a video Op-ed for this final project. Personally, I would like to use this as an opportunity to explore a creative outlet and incorporate another art form.

Living with Fear – One Puerto Rican Woman’s Trauma as a result of Hurricane Maria

“I fear that a great storm is going to come and kill me,” says Silvia Ramos. The 47 year old Puerto Rican explains this to me via a WhatsApp call that is so low quality, we might as well have been talking with the world’s worst walkie talkies. 

Hurricane Maria tragically struck the island of Puerto Rico 2 years ago. Ramos explains how people of the island were unprepared and unexpecting of the damages brought along with this storm. Poor phone quality aside, Ramos very explicitly recalls her experience in the midst of the hurricane and how she had to be “muy fuerte para mi familia” (very strong for my family). 

Ramos was fortunate enough to live in an area where the storm didn’t have as much of a physical impact on her home. Because of this, she took in seven other family members, including her 89 year old aunt, and provided them with food and shelter. She recalls this as being one of the most stressful times of her life. 

“I remember always being a little hungry…if serving myself less food meant that someone else could eat, then that’s what I had to do. I had to do what was right for my family”

Ramos had to learn to handle her own fears during Maria. She felt forced to put on a brave face for the sake of her family. She still has many vivid memories that haunt her about the devastation and anxiety felt during Hurricane Maria. Like Ramos, many other Puerto Rican natives are still having a hard time coping with everyday life. Across the island, more than three million people saw their communities devastated — many lost their homes, jobs, family members, and friends.

After the storm hit on September 20, 2017, there was an increase in anxiety, depression, and post-traumatic stress disorder across the island. When people are more focused on their immediate needs like food and shelter, their mental health takes a backseat. Ramos explains how she refused to feel sorry for herself because she had to make sure her family survived. Silvia was working in a public school as a special education assistant at that time. The school was turned into a shelter to house hurricane survivors for 3 months. Having lost financial income was a great burden for Silvia because she was still responsible for seven other family members. Luckily, Silvia’s husband was able to bring in some income to the home, but it still wasn’t enough. Silvia’s family was very reliant on the help they received from their family members living on mainland USA. Without the help of her family in the mainland, Silvia doubted that she would be able to sustain her family in Puerto Rico. 

Natural disaster has significant mental health effects even for people who have more financial resources than many Puerto Ricans. A study conducted by the University of Albany after Hurricane Sandy hit New York in 2012 found “a significant increase in emergency room visits for substance abuse problems, psychosis, mood disorders and suicides throughout the city.”

In the aftermath of a climate disaster, survivors may recover physically but the mental health impacts can last for years to come. Psychiatrist Lise Van Susteren explains “solastalgia” and other aspects of climate anxiety.

The mental health toll of Maria on Puerto Ricans is still palpable to this day. A recent study came out that surveyed public school students about how Hurricane Maria impacted them. The study, conducted by the Puerto Rico Department of Education, the National Child Traumatic Stress Network Hurricane Assessment and Referral Tool, and the Medical University of South Carolina (MUSC), found that more than 7% of youths reported symptoms attributable to post-traumatic stress disorder after the storm.

As a result of the natural disaster, 83.9% of youths saw houses damaged, 57.8% had a friend or family member leave the island, 45.7% reported damage to their own homes, 32.3% experienced food shortages, and 16.7% still had no electricity five to nine months after the hurricane. In addition, 30% reported that they perceived their lives or the lives of people they loved to be at risk, which, according to The Guardian, is a strong predictor of post-traumatic stress disorder (PTSD). 

Two years later, Silvia still “holds fear in her heart”. A lot of her family members that were originally staying with her eventually moved to mainland USA. Silvia is back to work in the public school and back to her prior “normal routine”. Financially, she is in a much better place, but her mental health is something she still struggles with. Silvia also believes she has PTSD. She is in constant fear that another storm is going to hit the island, and leave her completely vulnerable. She states she is more anxious now than ever before, especially during hurricane season. “Last time I was lucky” she states, “but I may not be so lucky next time.” 

Who’s to blame for climate change?

Despite what Donald Trump may think, it should come as no surprise that climate change is a real phenomenon and is having a heavy environmental impact on the planet. But who is climate change really affecting? Scientists have long predicted that the environmental damage caused by climate change will have the biggest impact on the world’s poorest, most vulnerable people. In fact, it already has. 

Coming up on its two year anniversary, Hurricane Maria exposed Puerto Rico’s inherent vulnerability to climate change, and the further-widening gap in global economic inequality. Puerto Rico had already been facing a recession, with almost half of its residents living below the poverty line for over a decade before Maria hit. According to this article, “the storm disproportionately affected Puerto Rico’s poorest residents, who have fewer resources on hand to help them recover and rebuild. Many of these people live in more rural communities and the hard-to-reach areas of the mountains and were the last to regain access to water or see their electricity restored.”

Natural disasters caused by global warming, such as Hurricane Maria, displace people from their homes, and worsen the lives of those living in poverty. With the threat of increasing natural disasters looming over the face the planet, it’s the countries that are living below the poverty line that are more at risk. But why are underdeveloped countries more threatened by the damages of climate change than the countries of the Global North? Unlike the Global North, when having to recover from these disasters, underdeveloped countries are faced with more of a challenge since resources are thin. In the case of Puerto Rico, the island’s agriculture industry took a $780 million loss, family businesses were destroyed, 4 in 10 Puerto Ricans suffered a job loss, reduced hours, or lost wages, and hundreds of thousands migrated to mainland United States in search of a job.

The real question is, who is to blame? You guessed it: the richest, most developed countries. Temperatures are rising due to growing concentrations of greenhouse gasses, and the Global North produced significant carbon emissions during the process of industrialization. The United States and Europe, especially, are some of the largest emitters of greenhouse gases as they grew their economies by burning fossil fuels and spewing carbon from cars, homes, and factories. While rich, developed nations are ultimately the ones to blame for the catastrophe of global climate change, it’s the poor underdeveloped nations that are left to suffer the consequences. A new Stanford study found that  “in most poor countries, higher temperatures are more than 90% likely to have resulted in decreased economic output, compared to a world without global warming. Meanwhile, the effect has been less dramatic in wealthier nations—with some even potentially benefiting from higher temperatures.” The study also states that, “the gap between the group of nations with the highest and lowest economic output per person is now approximately 25 percent larger than it would have been without climate change.”

All that being said, you would think that these developed nations would take on some responsibility, and provide aid that is equally beneficial to all those affected by natural disasters. Well, think again! Two years later, those affected by Hurricane Maria are still trying to get their lives back to a sense of “normalcy”. 

While these circumstances are unfair to say the least, how can we expect these rich, developed nations to do better, and take accountability, when they have a strong colonial legacy of taking advantage of poor black and Latino countries?  How can we be surprised in the total lack of responsibility and effort being put into aiding underdeveloped nations in the fight against climate change when history has exposed time and time again the racist, capitalist nature of the developed nations? 

Colonizers have and will continue to profit off of the lives and the lands of the colonized. With climate change, widespread pollution, and ecological devastation, it’s always the colonized who will pay the price. In the case of Puerto Rico, it’s colonial history continues to deny Puerto Rico its autonomy and self-determination as they still do not have representation in American government. According to this article, “colonial policies in Puerto Rico also reduce access to necessary aid because of shipping restrictions due to legislation like the 1920 Merchant Marine or Jones Act, which limits shipping from non-US flagged ships between US territories. Thus Puerto Rico would have been forced to rely on fewer potential ships and more expensive shipping coming only from US ships instead of ships worldwide.”

Global economic inequality created by climate change is directly linked to a colonial history.  There is ongoing destruction of indigenous lands and loss of lives that only profit the rich, developed nations of the Global North. What is frustrating is the blatant ignorance demonstrated by these rich nations, and the narrative of providing aid as a “blessing”. When talking about Puerto Rico’s need for aid after Hurricane Maria, Trump stated that Puerto Ricans “want everything to be done for them,” and he continues to go about his day playing golf, while Puerto Rico is left without resources. 

If we really want to make an impact on climate change, we have to put the focus back in the hands of the Indigenous and colonized people. We must change the narrative to highlight that climate change is already an existing problem for impoverished people living in underdeveloped countries. Climate change is not that much of a problem for a little white American girl who’d get “stripped of her dreams” when the children of colonized lands had their dreams stripped away from them a long time ago. 

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