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    Advancing Mental Health Equity

    Jul 27 2022

    July is National Minority Mental Health Awareness Month, named after the great author, journalist, teacher, and mental health advocate, Bebe Moore Campbell. One of the goals of this month is to bring additional awareness to the inequities in our mental health systems. These systems have faced appropriate scrutiny from minoritized communities due to limited access to mental health care, a lack of cultural representation among mental health providers, and issues of inequitable treatment. Today, we're joined by Dr. Napoleon Higgins, Executive Director of the Black Psychiatrists of America, to discuss what's being done to address mental health equity and how we can get involved.

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    Christopher Chun-Seeley: Hello, welcome to Mentally Healthy Nation, a podcast of the American Psychiatric Association Foundation. I'm today's host, Christopher Chun-Seeley. Today, we brought in Dr. Napoleon Higgins, the Executive Director of the Black Psychiatrists of America, for a crucial conversation about what's being done to address mental health equity and how we can get involved to support creating a mentally healthy nation for all. Thank you, Dr. Higgins, for joining us today. And before we dive into this larger topic of advancing equity and what listeners can do, could you share some background information with us about the Black Psychiatrists of America, why it started, and what brought you to your current role?

    Dr. Napoleon Higgins: Well, Chris, I want to thank you so much for having me here for Minority Mental Health Month and the work that the American Psychiatric Association is doing as well as the Foundation in bringing awareness to the mental health Minority Mental Health Month. The Black Psychiatrists of America has been here since 1969 and basically was birthed out of the APA and the concerns that Black psychiatrists had regarding the APA and the lack of attention and concern towards Black psychiatrists and the mental health of Black patients. So the issue was the lack of concern, the lack of attention. A lot of bad information was out there regarding Black mental health.

    Dr. Napoleon Higgins: And so, the point was we needed our own organization where we were in control of what we were going to do and what we were going to say. Too often, when you're a minority inside of a majority group, the majority group may not see the issues and the needs of the minority. And the decisions that are being made are made outside of what the minority feels like is important to their particular group, realizing that African-Americans being about 13% of the entire country, but only 2% of all psychiatrists, it's quick to drown out the voice of millions of people, especially when they're not allowed even at the table. So even as members, we still weren't at the table. So therefore, we birthed the Black Psychiatrists of America to be able to address those specific issues without an overseeing body who was controlling the decision of the minority group.

    Dr. Napoleon Higgins: And when I was a medical student, I joined the organization and I've been actively involved since 1997, even as a medical student through residency. And oddly enough, I became president of the organization right after residency, which I would've been the youngest president. And it was odd to be president of an organization where you have such esteem for the members and mentors of the organization. And what I really do look back at that time of presidency is I feel more as if I was more of the insurance check so far as, let's invest in young people, let's invest in youth because these are our leaders of tomorrow, but honestly they need to be our leaders of today. And that's how I became involved.

    Dr. Napoleon Higgins: And then over time, I stayed involved. We did lose our executive director, Dr. Patricia Newton, who had been a long-term dedicated member to the organization and really carried the organization on her back. And we had lost her in 2020 during this COVID season, even though we don't believe it was COVID, she just had a sudden passing. And I just remember my phone blowing up early in the morning saying, "Hey, what's going on?" And we suddenly lost her. And at that time, I did not have a desire to be the executive director of the organization, but when I thought about what could I do best for my people, what could I do best for psychiatry, what could I do best for Black psychiatry is realize that Dr. Patricia Newton had invested a lot in me and a lot in other individuals. And so, it's time to step up and it's my turn to give back.

    Christopher Chun-Seeley: Well, I think we have to be so thankful for the large footsteps that Dr. Newton has left for so many others to follow and fill up. And I think that that statement that you made, Dr. Higgins, about the investment in the future, I think that's so important recognizing that there is this great potential within inside of you and that investment that they made is paying dividends now, I think. And I think that's not necessarily something that a lot of organizations look at. It's the time served and we don't necessarily challenge ourselves to put our younger career individuals in those leadership positions when they might be exactly what we need to push us in the right direction as well.

    Christopher Chun-Seeley: And Black Psychiatrists of America, right? It's a very specialized focus in on the needs of Black psychiatrists and the Black patients. But we know that minority mental health is a very broad term, and it really encompasses many communities across the country that have historically faced systematic oppression, from Black to Latinx to Appalachian to the LGBTQIA community. And we understand the implications of what that systematic oppression can have on your mental health. So what are those implications though of mental health across generations of living in these systems?

    Dr. Napoleon Higgins: Well, you always see another movement afoot in that the battle continues on, the continual push that you see throughout multiple generations. And understanding that, I like to look at generations through handshakes. Like when I say handshake, a handshake of a generation is about 40 to 50 years. And that at 50, I'm nearly 50 now. I shook the hand of people 40, 50 years ago, so that would say be my grandfather. But my grandfather would've shaken the hand of 40, 50 years before that, realizing that I am one handshake away from slavery and about three to four handshakes away from Africa, all right? So when we look at actual timelines, we make it look as if these things are in a distant past, but no, past history is not past history. Past history is current history because it impacts where we are right now.

    Dr. Napoleon Higgins: So if you look at me, and I know I was having a conversation with my father who turns 84 years old today. He said that when it comes to racism and how people deal with each other, honestly, he says it's as bad now as it was back when he was a child growing up in rural Texas in the '30s and '40s. And that the rhetoric, the amount of anger, the amount of angst, the amount of tension that you feel in the country, he was like, "This is worse than it was before civil rights movement." And that you have openly racist individuals, but you knew who they were and they let themselves be known. But now we have this constant undercurrent where you can't seem to miss it. It's always on television, it's always on social media, it's always in your life, and there's an issue of escaping.

    Dr. Napoleon Higgins: But another issue that I find that's going on within minority communities is that we've got to make sure that people are educated about the past history and the past work that people have done, so that they can take their work and continue to grow. Well, too often I'm hearing people say things that they think are new or new thoughts that actually somebody's already said that. Frederick Douglass said that, Malcolm X said that, and Martin Luther King said that, all right, but we need to continue to build. So we got to make sure this education is part of everyone's knowledge and information, all right? We need to know more than neurotransmitters. We need to know more than just different type of new types of therapies. We need to understand the timeline, the history that people have gone through of Black people, Latinx people, white people, all of these things. Realizing not all white people have the same history.

    Dr. Napoleon Higgins: We think that Western Europe is all of Europe, and then when something pops off in Ukraine, we don't understand what the issue is going over there or why people are trying to take other people's land. And some of them feel as if those lands are different ethnic lands that don't belong to the other group. But our lack of history, our lack of knowledge is causing individuals to fall back and to fall backwards. And we've got to do a better job of educating this generation because they're dealing with new challenges that were not seen before. So they need to know what were the old solutions and how to continue to grow, realizing that this fight is a continual fight of equality and the impact of the inequality on the mental health and the overall health of our nation, especially the young people who are coming through right now.

    Christopher Chun-Seeley: Thank you so much for that answer, Dr. Higgins. You offered a lot of historical context, and I think a lot of challenges to the current generation to look back at how successes were had, what failures happened, and what to learn from that. And your point is really well heard on some of these organizing ideas or even the pushes for some of these things are not new. Or these are well thought out and well conceptualized and at points in times, especially in the near past where they like to put it in Black and white, but color photos were available. Some of that stuff allows us, even from a social construct to be very separated. The current generation has a different social construct of what they can be and how much more powerful that could be if they understood the historical context of what it took to get there. And how much more of a rolling stone it could be in the right direction. So what are organizations like the Black Psychiatrists of America and the American Psychiatric Association doing to advance mental health equity?

    Dr. Napoleon Higgins: Well, I would say the fight is continual. When we look at this historical context, I would say if you look back at what Chester Pierce wrote and the conversations he was having in the amount of writing that he did, some of that you would swear was written last week. If you just switched out the names of individuals and you would see where the issues have been. And you see the advances, the steps that were taken to try to advance the movements that were created. And you saw where some got through, and other ones stalled and failed. So you did see the creation of the Black Psychiatrists of America. And you did see some creations of other groups inside of APA itself, the cox of Black psychiatrists, the committee that's later been sunsetted. So we find ourselves in this perpetual cycles of continuing to push for equity amongst multiple groups in organizations.

    Dr. Napoleon Higgins: And there is a need for the APA and there's a need for Blacks to be involved in APA. APA has the loudest sounding voice of anybody in mental health and especially in psychiatry. So you got to be at the table and make sure that you're heard because if you're not at the table, people don't recognize what the issues that are going on within your group. Especially within your minority group that is represented by so many, that's why it's important for these minority groups to be involved. But then also, you need your independent organizations where it's not under the thumb of a larger group telling you what you can and cannot do, what's appropriate or what's not. Because realize, the APA has all other kind of things that it needs to deal with.

    Dr. Napoleon Higgins: But Black Psychiatrists of America specifically for Black psychiatrists and the patients that we represent. So we have to make sure that we've got to understand the background, but then the continual fight to push forward so far as equity, knowledge, information, making sure that you're being heard. Giving those different perspectives so that we can be a better group as a whole. Because if you're not giving that perspective, how do you get equity if you're not pushing to get that information out?

    Christopher Chun-Seeley: A lot of times too, some people get disenfranchised by larger organizations, and I think back to Audre Lorde and the master's tools will never dismantle the master's house. And in thinking about how some of these organizations and the structures they're created to make change very slow and the progress very slow as well. So what can individual members do to advocate not only within their organization but within their local communities and within their local practices to really make an impact on mental health equity?

    Dr. Napoleon Higgins: Well, as stated, it's very difficult to get large organizations to move differently than what they've been doing before. And too often, one complaint that I would have that I see about individuals, minority groups and large organizations is that they see their only place in the large organization to make change. And that is completely false, all right? It's like they say all government is local, all right, you can vote for president, but the President of the United States, but the president does not fill potholes on your local street. They don't put up streetlights and things of that sort. So too often, we'll run to the large organization. And honestly, I think some of that running to the large organization is based upon, I want to be seen, respected, and elevated so I can be close to the large organization. But there's so much work to do all over the place when it comes to advancing minority mental health and health equity.

    Dr. Napoleon Higgins: So my thought is, if I only see you in this place, but you're not involved in your local places. I got invited to do a talk at a small church. Rumors only have about 20 people at the whole church. Who is talking to that group? Because the fact is that when I talk to other Black psychiatrists who come to APA, who come to BPA every once in a while, we'll say something that I haven't heard before, that I haven't heard you say before. And I appreciate the knowledge and information. But there are so many other people who need the knowledge and information and so many other places that we don't go. So I tell individuals, you got to advocate within obviously, in the larger organization because you got to move the needle forward.

    Dr. Napoleon Higgins: But also, if you're advocating over here, and you can only speak to the 200 or the 2000, but you're not willing to speak to the 20 who actually need it, who are hanging on every word, who are waiting for the answer. If you're not willing to speak to the 20, well, why are you speaking to the 2000 or to the 20,000 who may hear this podcast? So we've got to make sure that there is work to be done everywhere and well too often, I believe that we want to be on the main stage, sadly, so that we can be seen and respected by the majority versus actually putting in the true work that needs to be done in our own individual communities.

    Christopher Chun-Seeley: That's personally a great call to action for all mental health professionals to think about. Especially if you're a psychiatrist, thinking about the American Psychiatric Association, what is your district branch doing, and how are they working to advance mental health equity in your state? And then dive even deeper with the Foundation because I think there's such an opportunity as a Foundation. I'm the program director for school and justice initiatives. There are people waiting in the justice system to learn more about mental health and what the impacts are and why do the most seriously mentally ill end up in the justice system. And there's individuals at school that are wondering why do we send kids with disruptive behaviors that are most likely Black and Brown and Latinx into the criminal justice system instead of to the supportive systems that might be available. And we need the advocates and the individuals who are educated, like psychiatrists, to be the people who are using that knowledge base and, I think, that expertise to really push communities in the right direction as well.

    Christopher Chun-Seeley: So if I can just ditto, strike asterisk super highlight that call to action Dr. Higgins, I would love to do that. And I think when we neglect to create systems of care that adequately support the mental health of minoritized communities, we miss the chance to create a universal standard of care that would benefit everyone. And I think that goes back to even your initial statement about why the Black Psychiatrists of America was started. If we would've seen that as an opportunity, as just as a mental health professional, as an organization, as a way to create a universal standard of care, seeing that Black Americans at that time maybe had the least access to mental health, had the least access to culturally appropriate care. If we would've looked at that as an opportunity to create a true system that was universally beneficial, where we could have been, I think is always my thought process. But what can we do, and why do you think there are such resistance to creating universal standards of care based off of the people and the communities that are most in need?

    Dr. Napoleon Higgins: That's a very tricky and difficult answer to give on why are we not creating the systems, and why are we not incorporating? And honestly, it's it to me, it is hard to look past the past. It's hard to look past it. When the country is founded on the issue of exploitation, it is founded on ignoring the pains and the problems of other individuals. Then you see it grow and continue to grow to where it's not focusing on those things. And we've got to be in a situation where we want to know what's going on, that we have a love for all people, that if there's something concerning you or bothering you and we're not paying attention, no, we want to pay attention to that particular problem because it's not only affecting you, but it's also affecting other individuals.

    Dr. Napoleon Higgins: And when you look at the issue of the decision-making that we do, say for example, in the state of Texas, we refuse our own Medicaid monies that we pay into the United States government and we refuse to take that money back because it has a stamp of Obamacare or something else or some other issue that's going on. Well, understanding that that's a race issue, but that's also a class issue. And as a class issue, that type of decision-making not only affects more Blacks and people of color, the Latinx or even your Native American, but it affects white people. It affects a lot more white people than anyone else. And so we often think of it as a minority issue, but it becomes more of a class issue. And I'll say this, a forgotten population in America is the white poor.

    Dr. Napoleon Higgins: There are more poor white people in America that these policies impact than there are Black people total in the entire country. So there's a group of individuals who, when we make these poor decisions that we based on race of the past, but really anything that we do in America that's based on race also is based upon class. It impacts a whole lot of folk. So not paying attention to this small group, realizing this small group that's a minority, that's only 2% in APA or 2% in the country of psychiatrists represents 13% of the country. But when you extrapolate that towards the issue of class, that's probably about 100 million people in America that those policies impact.

    Dr. Napoleon Higgins: So we've got to make sure that we create systems and break systems down if the system is not working. It's like trying to drive a car on one flat tire. Even though you're trying to prop it up and I don't know, a spare on, it's still not going to function at its best. So the thought is, well, it's only one flat tire. It's only a minority of the tires. Well, the whole car does not drive correctly because you've got a flat tire. So we need to make sure that we create a system where everybody's included, where we pay attention to everything that is going on, and we want to know what we can do to make a more functional system. Because the fact is that if it helps that one tire, it actually improves the entire car.

    Christopher Chun-Seeley: You bring up such a salient point in the conversations around the divisiveness of what's happening around a lot of these conversations. And if we focused on who is impacted the most, which is just poor people, if we grouped poor people in general together and said what would make a universal standard of mental healthcare. Or a universal standard of education that benefited everyone who is not benefited from the current system that we have? I think that would allow us to maybe be a little more open to some of these changes that need to happen. And I wonder, thinking about the role of mental health professionals and how they can be influential, we touched on this a little bit in educating others in their profession, but also in the community about mental health equity. What are a few things that every mental health professional should have in their back pocket when it comes to these conversations about mental health equity?

    Dr. Napoleon Higgins: Especially when you're looking at the issue of community and as you asked, because it's very common to us as psychiatrists, we assume that everyone else knows. And really just regular mental health facts are things that the community so often doesn't know, especially minority communities and in poor communities. A lot of times people don't even know what depression is. I've heard people say, "Well, I thought everybody felt like that." And I'm like, "No, not everybody's depressed." You've been depressed your whole life. So you've always felt like that. But not everybody has that. Not everybody has anxiety. Not everybody's hearing voices, not everybody's having erratic behavior that throws off the whole functioning of the family. So having just regular facts helps individuals, but facts that are pertaining to them. So the fact is that I can go, I just did a talk yesterday at a small church out in the country where my people are from.

    Dr. Napoleon Higgins: So some people actually knew my family there. And you see light bulbs going off like, oh, that's what that is, that's going on. Oh, I can go get help for that. Well, what is your phone number? I've got a friend, I got a family member, I've got myself. How do I make an appointment to get in? So it doesn't have to be a lot of information, just regular stuff that people are dealing with. And normally when I'm going to speak somewhere or talk to a group of individuals, I'll just look up the area, just Google. Google is a very powerful medical tool, especially for our patients who want to tell doctors what to do. But the fact is that you can use Google on your side as well to find out what's going on with individuals. And we've got to make sure that we're doing that when we go out to speak to our people.

    Christopher Chun-Seeley: You've mentioned the church community. I think that's a community that is probably widely mis-utilized, I think by mental health professionals as far as an education point and a place where a lot of community members are probably looking for support. I'm thinking back to my own personal upbringing and how supportive my church community was and probably just how thirsty they are nowadays for mental health knowledge and how they support people with not just mental illness, but dis-continuum of wellness that we find ourselves on as human beings. Are there other places that you can suggest psychiatrists, other mental health professionals to look at utilizing their education towards?

    Dr. Napoleon Higgins: Oddly enough, I received a text the other day. Someone wanted me to speak to mental health to a group of 9 to 11-year-olds who are going to be a part of a golf learning exercise, and they wanted a psychiatrist to come out to speak to them. I'm speaking to a group of boy scouts that are doing a family merit badge. So there are those places. Schools, recently, Global Health Psychiatry, we've been doing some talks in schools about trauma and loss. And honestly, the hair stands up on your back when you see a group of young folks, 9, 10, 11 years old, 12 years old, 14 years old, who are having a mental health awakening because somebody told them that this is your brain, this is how it works, this is what's normal, this is what's abnormal. And all sadness is not depression. And depression doesn't necessarily feel like sadness.

    Dr. Napoleon Higgins: There's another type of pain that goes along with that and being seen their minds open up and like "Oh, that's going on with me." So we really need to get this information out to kids. You can teach a kid how the brain works, you can teach them about neuroanatomy and how the amygdala works and the nucleus accumbens and the frontal lobe. And this is where we think depression is, and these are neurotransmitters. This is therapy, and these are things that impact how your mood is, your family, your sleep, how you eat. All of those things can be taught at a very early age.

    Dr. Napoleon Higgins: You don't have to wait until you're 30 something years of age, been depressed for 20 years and been having panic attacks, and nonfunctional and not able to take care of yourself and your family before you find out about your mental health. If we could push it back earlier to make it a part of just regular learning, I think that a lot of individuals will be a lot better, and we have a lot better healthy nation throughout all communities, and that's something that we really need to start doing better.

    Christopher Chun-Seeley: I cannot agree more. Those who are listening, psychiatrists, mental health professionals, that's something that psych, the A Foundation is really interested. We currently just look at educating kind of the adults in the community about how do they respond. But we want to continue to look at what is an appropriate curriculum, what makes sense to teach kids that is easily and acceptable and that our psychiatrist members can kind of take out to their community. So I think that Dr. Higgins, that's something that is sorely needed. One of the biggest things having worked at a college counseling center is the percentage of students who showed up in a crisis mode because they've had therapy in the past, but it wasn't the right fit. Whatever they were looking for, it wasn't culturally aware, it wasn't culturally competent and they had a bad experience. So now they're not willing to engage and support services until it's literally a crisis moment.

    Christopher Chun-Seeley: I think some of just mental health literacy is so important. I wish I could just give you the microphone more often, Dr. Higgins at this point. We know that it's important for all of us to understand the way in which we view the world is not the only way people view and experience the world. Dr. Higgins, your viewpoint, your life experience is very different as a Black psychiatrist man from a white social worker as myself. And so, caring for diverse populations may mean that we need to unlearn some old habits and relearn some new ones to prevent causing harm. Why should every person self screen for their own biases and preconceived notions when engaging with people who are different from them?

    Dr. Napoleon Higgins: It's important. And I tell folks that I've been a psychiatrist for almost 20 years, but I've been Black my whole life. And so, my perspective is shaped by my environment, realizing that my experience as a Black person may not be the same experience as somebody else's. So we, as mental health clinicians need to be interested in people and we need to love people and love their history, love their past, love their culture. My thought is I don't know everything, but it is my responsibility to know more about my patients. And so, I tell individuals, if there's something you don't understand about the patient, ask the question. Because the question shows interest. The question does not show ignorance, it shows interest. So asking how that made you feel as a Black person, and I want you to be honest with me and trust me, I can take it. I'm a professional.

    Dr. Napoleon Higgins: So let me know how it makes you feel as a woman for them to tell you that you cannot control your body and pro-life, pro-choice. Let me know what are your thoughts about that. And then I've got to be in the mindset of receiving that, even if I may disagree or have a different life experience or a different background or a different gender or a different sexual orientation. So my point is to receive it as a professional and then have a pure interest in wanting to understand different people, different communities that are very much different from our own. So we can all have these blind spots because your brain makes multiple calculations all the time, and it makes inference based upon what it has seen and perceived in the past. So for example, I'm assuming that you can hear me speak right now through this medium, all right?

    Dr. Napoleon Higgins: Not until you show me something on your face or you give me the little ear motion that you can't hear me, my brain is automatically making these calculations. So with our brain making these calculations based upon past experience, we've now been on Zoom and Microsoft Teams and all these different platforms. I'm assuming that this still works. Now, when I see someone that I don't know from a different community that may be influenced by the things that I was taught as a child, that may be influenced by the television, the radio, social media, and I start making all these hundreds of thousands of calculations per second. And based upon my past history, I may have missed something or don't know something, and I have a huge blind spot. So the point is, we all have our blind spots like driving in the car. The reason that you actually have to turn your head to the left and to the right is because you need to take a look at where your blind spot is.

    Dr. Napoleon Higgins: So you do not want to go into a position of I don't have blind spots. I understand people, I understand all communities. All communities think the same way that I do. Or there's no need to think differently because all these things are obvious. Well, unless you're looking to your left and looking to your right, you cannot see the dangers that are hidden within the therapeutic situation or the doctor-patient relationship or the doctor professional relationship. As physicians, we're all team leaders. One doctor requires about five people around them to actually get the job done. So we have to look for these blind spots throughout what we're doing and be sincerely interested in people and culture. Sometimes I will read books that I would not necessarily normally read or I'll watch a movie I wouldn't normally watch just so I can understand a little bit better about the culture of individuals in the population that I'm working with.

    Christopher Chun-Seeley: I love that analogy of the driving and looking into your blind spot, especially as you explained it earlier about you're gathering information and that's what looking into your blind spot is it's allowing your brain to actually download the information that's missing and you're turning and looking, you're downloading that information, and then you're making an informed decision. And I think it's also such a powerful tool as far as a relationship building thing. As far as I'm concerned, and what I've used it for as well is when someone in front of you is different than you and they present something and you're asking questions, you provide them an opportunity for them to teach you. And that's a very powerful tool in I think the therapeutic relationship even sometimes, because I've worked with kids in the past.

    Christopher Chun-Seeley: And if I can invest in something that they're really interested in and they can tell me about it, man, when I'm going to tell them how to use these therapeutic skills to help them not get in trouble anymore, there's a different way that they approach that. And I think that your point about the professional conversations. And I think sometimes we have to challenge our own professional relationships and have some difficult conversations.

    Christopher Chun-Seeley: And I'm just wondering, we've talked a lot about mental health professionals and psychiatrists and kind of their role and responsibility, but what are some things that the average person can do to support minority mental health, someone who's just kind of passionate in making changes in their community to benefit all?

    Dr. Napoleon Higgins: Well, I would say that we're all a mental health advocate. Mental health is so big, so important. We all see mental health issues going on, and letting people know that you're an ally, that you want to know, that you want to understand. I love communities, I love people. I think every psychiatrist should love people and be genuinely interested. So if you tell me where you're from, if I've never heard of that, I will look it up. Even if there's a game a kid is playing, I've never heard of that game. I'll look the game up. If this is a big part of your life, I want to understand it. So when we're looking as individuals, if we see something wrong, say something. Or if you see somebody in pain or hurting, say something. For example, on a job, somebody may say something to offend you and a colleague or a coworker, just somebody just giving you a pat on the back say, that was wrong.

    Dr. Napoleon Higgins: Or even better stepping up and saying like, "Hey, let's redo that, let's relook at how we're seeing this." That goes a long ways to acknowledge the minority individual in the room when something like that is going on. I was listening to a recent experience with someone who was giving a presentation on minority mental health and the impact of racism on the overall health of people of color. And in that room, multiple individuals shot down the idea that there was an issue of racism and its impact on Black health, especially when it comes to Blacks who make good money or are professionals. And she was saying how no one defended or validated her in the room. And then one of her mentors heard about it and he understood, and he was an older white male, and he understood what was going on and he actually stuck up for her in that particular place.

    Dr. Napoleon Higgins: And that meant a lot to be acknowledged by someone else who's a professional, who had something to say, not only by yourself. So trying to be that advocate, the person that speaks up, and even if realizing that not everybody can speak up. There are some dynamics that go on where a person can put their own selves at risk. But the factors that just letting the person know we're acknowledging what's going on is at least a step in a start. But we all want to be advocates so that we're making sure that we're protecting other individuals around us.

    Christopher Chun-Seeley: You kind of answered the next question about how we make this work and everyday effort, understanding that July is Minority Mental Health Awareness Month, but just like Black history, women's history, we should be talking about these topics for longer than just their designated month in our 12-month American calendar here. But anything else that you'd like to offer as far as how to make this work every day and not just a monthly hashtag?

    Dr. Napoleon Higgins: Well, it is very important that we understand that Black history is American history, Asian American history is American history. Obviously, we hear of Western European history and how that made American history, but all continents contributed to where we are right now, even though we've left those out. Obviously women's history, I mean, all of us have a mom. How can that not be a part of our history? That is who we are. I'm at least half female, all right? There is no YY chromosome individual walking around anywhere. So this is a part of who we are and we don't want to offend or not acknowledge or not understand. Now, we may not always agree, but we do want to understand the perspective that other individuals are coming from. We do want to understand the history. And to me, what drives much of the issues that we have is a lack of understanding history.

    Dr. Napoleon Higgins: And sometimes we've got to understand that we've been taught the wrong history. We've got to sometimes understand that we've been lied to and that the people who educated us were lied to. In Texas, we have a continual issue of pushing back against people trying to change history. That was a recent push by the Texas Education Board to change the term slavery to forced immigration. And I'm like, what? So obviously you got to push back against that. Somebody came up that with a room somewhere, and then you have that once they brought it to the bigger body, it got voted down. But people are continually trying to change the history. The majority makes the past history, which causes individuals to be more ignorant, to have more blind spots because they truly just don't know. So we've got to make sure that we're educating individuals, understanding that I want to know how Pacific Islanders contributed to the culture of California, that's left out.

    Dr. Napoleon Higgins: I want to know how Africa contributed to realizing that slavery was over 250 years. Africans here were here before then, middle of it and afterwards. Obviously, there's a lot of European history that we don't understand. Why are they fighting in Ukraine right now? Most of us have no idea of the ethnic issues or the war's fault or how people delineate, who is Ukrainian versus who is Russian. So knowing people's history makes us a better country, makes us better understand, and it takes away much of the blind spots of where we are right now because we continue to have to go over these same things over and over because it's a lack of knowledge and understanding of other individuals and other people that cause you not to be concerned about them because you don't know where they're coming from.

    Christopher Chun-Seeley: Taking from what you've said today, Dr. Higgins about the driving, don't forget about the rear view mirror that shows you that past, that shows you what's behind you, that work that's been laid before you. Where the mistakes have been made that the successes are at, so that you have the full picture. I guess, I'll steal a little bit from your analogy and add just that piece of rear view because I agree with you that we have to continue to look to the past and learn from it so that we can evolve this conversation of equity towards what will be the true state of equality. Which we're still obtaining to and is still a really tough and long road.

    Christopher Chun-Seeley: Dr. Higgins, I just want to thank you so much for this conversation. It's been absolutely wonderful. I'm excited to continue these conversations with you. I hope this is the start of actual work together because I think it's important not just to talk about it as we said, besides the conversations that are important to engage in. But it's the actual work that has to be done so that we can make the changes that are possible. So I want to leave you with our last words as we typically do with our guests. So if you could, just one thing for listeners to walk away with today as it relates to this topic or any kind of last things you'd like us to take away with from this conversation.

    Dr. Napoleon Higgins: Well, the fact is that as you stated, we've got to continue to build the car. We've got to make sure we put all four tires down. We got to look for the blind spots, look in the rear view mirror and look for the path forward of what direction do we need to go in. And I think this conversation with us today, hopefully it helps somebody to become more interested. It's Minority Mental Health Month. There are a lot of things impacting us. There's health issues, there's issues of racism, continual disparities, those populations that we often forget about as we've spoken of, the poor white population that's in America. Poverty in general, class issues that are combined with race issues that keep these disparities in care, in afoot. It will be great that where we can get to the point where we don't have to track these things, where it is not necessary and not needed, but we are far from there. We sadly, we may be a few 100 years away from being there, but the fact is that we can get it done and each one of us needs to do our part.

    Christopher Chun-Seeley: Dr. Napoleon Higgins is not only the Executive Director of the Black Psychiatrists of America, but also the President of the Black Psychiatrists of Greater Houston, the past President of the Caucus of Black Psychiatrists of the American Psychiatric Association, President and CEO of Bay Pointe Behavioral Health, CEO of Global Health Psychiatry, and a past Minority Fellow. Thank you for joining us today on Mentally Healthy Nation. For more information about the work being done at the APA Foundation, we encourage you to go to If you enjoyed what you heard today, please share this episode or any of our other episodes with a friend, family member or colleague. And remember, take care of yourselves and take care of your communities as we're all in this journey of wellness together.

    Christopher Chun-Seeley: The views and opinions expressed in this podcast are those of the individual speakers in their personal capacity only, and do not necessarily represent the views of the American Psychiatric Association Foundation or the views, official policy or position of the institutions and organizations with which the speakers are affiliated. The content of this podcast is provided for general information purposes only and does not offer medical or any other type of professional advice. If you are having a medical emergency, please contact your local emergency response number.