Black, Indigenous and People of Color (BIPOC) are at risk of experiencing trauma due to mental and emotional injury from a variety of causes.

If you have experienced such trauma, you may find that your relationships are impacted. Consider these strategies to protect and manage your closest relationships and all that are important to you.

Recognize triggers

We can be triggered by and experience racism.

The impacts can go beyond our own emotional pain and psychological distress to affect our relationships. When we feel triggered, it’s important to:

• Identify your emotions—Are we feeling surprise, fear, sadness, disgust, anger? It can be helpful to name to our emotions so we can use our knowledge about how to deal with them and seek help if necessary.
• Recognize the validity of your emotions—We are right to feel the way we do, and we don’t need to waste our energy questioning that. It’s important to take the time to understand how we are feeling.
• Manage your emotions—When we know what we are feeling, we are in a better place to be in control of how to approach and react to people and situations. This can have beneficial impacts for our relationships.

Set boundaries

With family members and friends, co-workers and even strangers, we must feel safe to be ourselves and feel respected. Setting and sticking to personal boundaries can help. Here’s how you can do it:

• Prioritize needs—Take the time to think through where you stand, what you can and cannot tolerate, and what makes you feel happy or uncomfortable.
• Anticipate resistance—Expect that others may not easily understand your boundaries, especially if they have different backgrounds or personalities.
• Communicate boundaries—Clearly and directly let others know of your boundaries and reiterate them if you feel they are being overstepped.
• Distance yourself if necessary—If you feel disrespected or have your boundaries crossed repeatedly, it may be time to cut off further interactions to protect your emotional wellbeing.

Practice self-care

We are our own best advocates. It is vitally important that we take time to do the things that make us happy, keep us healthy and give us an outlet from negativity. Not only will our wellbeing improve, but our relationships will also benefit. Try these:

• Try a delicious new recipe—Taking time to enjoy cooking or baking can be relaxing and fruitful when it’s time to eat!
• Enjoy quiet time to rest or nap—Sometimes it can be hard to take a break. Take the opportunities as they arise and enjoy every moment!
• Catch up for a visit or phone call with a loved one—Connecting with others can increase your sense of safety, belonging and security.
• Read a book or start a hobby—Keep your mind active and engaged in activities that bring you joy.
• Volunteer—Giving of yourself to help others can improve your confidence, self-esteem and life satisfaction.
• Get outside for fresh air and exercise—Sunshine and nature have been proven to boost mood.

Additional emotional support resources

For more on BIPOC mental health, visit our website for July BIPOC Mental Health Awareness Month, MagellanHealthcare.com/BIPOC-MH, and be sure to check out the BIPOC mental health tip sheets and awareness campaign toolkit.

You can also check out a recording from our webinar, “BIPOC mental health and relationships.”

To lead differently requires grit. In a time where “difference” is still feared and excluded, today’s executive and government leaders must harness grit—which is unwavering courage and tenacity—to model and embrace differences in leadership. Government and industry senior leaders are positioned to continue disrupting the status quo among leadership ranks by creating and cultivating space for Black, Indigenous, People of Color (BIPOC) and Asian American Pacific Islander (AAPI) individuals to lead at all levels in organizations. As a diversity, equity, and inclusion (DEI) leader at Magellan Federal, I will share why BIPOC and AAPI leaders are critical to business success and offer ways to help senior leaders diversify those who occupy leadership positions.

Why BIPOC/AAPI Leadership is Business Critical

We all can agree that our world is constantly changing. As a nation, we are more diverse than ever. Still, the group of individuals who occupy leadership positions in many industries is quite homogenous, and the absence of adequate representation across leadership tiers in industries is, unfortunately, not new. Nevertheless, in the wake of a global pandemic, political and social upheaval, and a period that is being called “the great resignation,” the call for representation among leadership has increased and intensified.

Senior leaders are having to re-examine how they perceive and practice leadership to secure the long-term success and health of their organization as employees place greater demands on them to be more diverse and inclusive among leadership ranks. While many senior leaders embrace the idea of diversity, they sometimes grapple with understanding and articulating the nuanced need for and importance of diverse leadership.

One reason more leaders from BIPOC and AAPI communities are critical to the health of organizations is because BIPOC and AAPI leaders—like other people groups—approach leadership from their own diasporic lens. Historically, mainstream leadership in our nation has been largely shaped by Eurocentric ideals, views, and experiences. However, as organizations and businesses become more and more of a microcosm of the diverse world around us, our view and expression of leadership must evolve to reflect the diverse environment in which people work.

Additionally, BIPOC and AAPI leaders are critical to long-term business health because BIPOC and AAPI communities have unique lived experiences that inform how they show up in the workplace. When people come to work, they tend to bring their values, lived experiences, and cultural roots with them to varying degrees. In organizations where difference is embraced and celebrated, individuals are more likely to share their authentic selves, which has the capacity to enrich collaboration and team environments. Moreover, when BIPOC and AAPI leaders have the freedom to lead authentically by leveraging their lived experiences, they can positively contribute to organizational outcomes by modeling and establishing the possibilities of an inclusive culture.

While there are many more reasons BIPOC and AAPI leaders are critical to the health of organizations, it is not enough to simply recognize their importance. Senior leaders must take steps to create and cultivate space for diversified leadership.

How to Diversify Organizational Leadership

For senior leaders, creating space for diverse forms and expressions of leadership will require a great deal of personal introspection along with a commitment to examine the way business is done in one’s organization. The following list is only a handful of actions senior leaders can begin to take to diversify their leadership.

1. Confront Your Embedded View of Leadership. If we are honest, many of us are still discovering and shaping our personal commitment to diversity, equity, and inclusion. Contrary to popular belief, this is good because it takes time. However, senior leaders should proactively and diligently confront their personal views, thoughts, assumptions, and ideologies regarding leadership. We all have embedded cognitive scaffolding that creates mental shortcuts to aid in quick decisions. The consistent mental effort required to work against this scaffolding is admittedly rigorous but is critical to identifying biases and errors in our thinking about leadership.
2. Examine What Behaviors and Attributes are Rewarded. When building culture, it is important to know that in many cases, what leaders reward—consciously and unconsciously—influences what is repeated in the organization. Observe how (or if) divergent, yet productive forms of leadership are positively highlighted. Take note of how the word “leader” is ascribed to behaviors. When someone offers a contrasting view, do you or other leaders verbalize their thought leadership to signal that this is a welcomed form of leadership?
3. Adopt a Positive Psychology (Asset-focus) Lens. Historically, psychology has taken a deficit or pathological view when examining and seeking to understand human thought, effect, and behavior. Such a view is also prevalent in our day-to-day endeavors. We tend to gravitate to what is deemed “normal” and reject what is “different,” leading to the tendency to want to put everyone in a familiar group to reduce their degree of difference. Senior leaders can adopt a positive psychology lens and decide to elevate and affirm differences as strengths or assets instead of requiring individuals to conform to normative or traditional forms of leading that can exclude and disenfranchise entire groups.
4. Examine Who is in Your Proximity. By nature, we tend to interact most with those who are in proximity to us. When we diversify leadership at all tiers in an organization, we diversify who is in proximity to employees. Similarly, as a senior leader, diversifying who is in proximity to you can help broaden your worldview, allow you to see and hear new perspectives, and learn about existing realities among your employees that may not have been previously apparent.

 Conclusion

Since the mid-1800s there have been major advances and iterations of leadership theory. Individuals have made it their life’s work to understand and improve how we lead, and we are making progress, but there is still much more work to do, and it requires conscious effort.

What is abundantly clear is that senior leaders who dare to lead differently are always learning how to lead more inclusively and equitably. To make strides in our diversity among leaders across government and industry, we need to remember that all people groups bring distinction to leadership that is informed by their diasporic lens and current lived experiences. Bringing the collective experiences of all people to the forefront and allowing others to lead who have historically been regulated to only the opportunity of followership, will help engage your employees, and ultimately strengthen your relationships as well as your business. It’s a win-win for everyone.

Q: What is the cumulative effect on mental health of COVID-19, social distancing and now the protests/riots on African-American and other BIPOC adults, both immediately and in the long term?

A: The COVID-19 pandemic has worsened longstanding ethnicity-based healthcare disparities that have resulted in disproportionate infection, morbidity and mortality rates for BIPOC adults, specifically Black Americans. Black Americans represent approximately 11.9% of the workforce, however they make up 17% of the front-line, essential workforce that is at higher risk for contracting and transmitting the virus[1]. At a time when the pandemic has resulted in an employment loss of 17.8% among Black workers compared to 15.5% among White workers, the risk to individual health safety is compounded by the risk of occupational hazards, job loss and financial insecurity[2]. As such, the compounded crisis of police brutality and increased social awareness of protest movements and civil unrest adds an additional layer of uncertainty, worry, fear, anger and sadness. Studies show that Black Americans are more likely to develop both physical and mental consequences to prolonged exposure to the chronic stress associated with discrimination and socioeconomic status, particularly high blood pressure, asthma, diabetes, depression and anxiety[3] [4]. In the week following the release of the George Floyd police brutality video, the rate of Black Americans experiencing depressive or anxiety symptoms increased from 36% to 41%, and among Asian Americans, the rate jumped from 28% to 34%[5].

Q: Are there unique signs of mental distress in African-American and other BIPOC adults that differ from those presented by Caucasians?

A: Though various forms of mental distress are characterized and diagnosed by commonly reported symptoms and behaviors, it is not unusual for individuals to have unique experiences that don’t look or sound the same, depending on who’s experiencing them. Additionally, cultural and spiritual norms specific to certain ethnic populations can influence the ways in which we communicate our pain, worry, sadness, anger and fear to healthcare providers, which often leads to misdiagnosis and/or ineffective treatment planning for ethnic minorities. Moreover, a 2019 study conducted by Rutgers University, indicates that Black Americans with severe depression are more likely to be misdiagnosed with Schizophrenia, which reveals significant provider bias in overemphasizing psychotic symptoms compared to mood symptoms[6] . In these instances, it appears that Black respondents’ endorsement of mistrust, hopelessness and paranoia due to extenuating sociocultural and political circumstances can result in unique clinical presentations that pose significant obstacles to understanding and healing, and that this effect is heavily influenced by the identity and implicit bias of both the patient and the provider. Ethnic minorities are also more likely to somaticize mental health symptoms, meaning they often report physical complaints like pain, fatigue or headaches, as well as sleeping difficulties as their chief complaints, rather than attributing the combination of symptoms to a mental health condition like depression or anxiety. This dichotomy often leads to further limitations in access to care, weakening of trust in the healthcare system, and escalating feelings of traumatization, oppression and isolation for marginalized demographics.

Q: How can African-American and other BIPOC adults help each other process their thoughts and emotions about the general unrest in our country?

A: It’s often said that there’s strength in numbers, and this is equally true as it relates to emotional support for marginalized communities in times of social unrest and collective trauma. Generational exposure to workplace and community discrimination is a shared experience for many ethnic minorities, and this commonality may make it easier for individuals who are feeling distress to share their thoughts with friends, family and providers who have a firsthand experience with the same issues in our society and across the world. This familiarity may also reduce mistrust within the healthcare system, if BIPOC patients feel they have an opportunity to share their feelings without judgment, misdiagnosis or repetitive traumatization and discrimination. Likewise, ethnic minorities are more likely to rely on spiritual or other cultural leaders for support and guidance in times of stress or civil unrest and are more likely to benefit from clinical behavioral health services when these alternative modalities are considered and integrated as fluidly as possible.

Q: Are there unique barriers to mental health treatment for African-American and other BIPOC adults?

A: Apart from generalized limitations in access to healthcare that have been noted for Americans across the spectrum, behavioral healthcare remains out of reach for millions of people, including those who actually have healthcare coverage. Shortages in available providers, clinics and hospitals means that there are longer wait times for appointments, and fewer resources available for maintenance of chronic mental conditions. Many mental health providers have moved to cash pay only practices, and this may serve as an obstacle for people who don’t have the disposable income available to pay out of pocket for psychotherapy or medication management. Inpatient bed shortages and the lack of long-term behavioral healthcare facilities are also shown to contribute to chronic homelessness, frequent ER visits and more interactions with the criminal justice system, which has become the largest provider of mental healthcare and boarding for chronically mentally ill patients over the last few decades[7]. Finally, stigma remains a very prominent barrier to seeking care for many ethnic minorities. In some cases individuals may fear judgment, mockery, maltreatment or discrimination due to their mental illness, while others may simply lack adequate information about the mental health field due to relatively less cultural reliance on these modalities within certain ethnic groups.

Q: What would you recommend to Caucasian individuals who want to reach out to their BIPOC friends and acquaintances and show their support, but don’t know what to say or are afraid it would not be received well?

A: In times of social division, strife and unrest, marginalized groups who are experiencing emotional distress and traumatization are likely to be concerned about safety, survival and stability. Allies and systems of support outside of ethnic peer groups can be helpful in building trust and solidarity across demographics, and this may aid in the development of healthier coping and conflict resolution strategies. It’s important that friends, family and coworkers be mindful that not every BIPOC person experiences distress or social events the same way and be open to simply listening to how the person feels first, before rushing to offer apologies or solutions that may not be indicated or helpful. MLK said that riots are the language of the unheard, and it is indeed the case that marginalized identities continue to live social and emotional experiences that so often go unnoticed, misunderstood and unaddressed by the ethnic majority. An expression of willingness to hear, care and help despite not knowing all the answers or solutions is sometimes all that’s necessary to convey empathy, sympathy and solidarity.

[1] https://www.epi.org/publication/black-workers-covid/

[2] https://www.epi.org/publication/black-workers-covid/

[3] https://www.ajmc.com/focus-of-the-week/high-levels-of-chronic-stress-high-blood-pressure-linked-in-african-americans#:~:text=African%20Americans%20who%20report%20high%20levels%20of%20chronic,serving%20as%20possible%20catalysts%2C%20according%20to%20study%20findings.

[4] https://www.washingtonpost.com/health/2020/06/12/mental-health-george-floyd-census/?arc404=true

[5] https://www.washingtonpost.com/health/2020/06/12/mental-health-george-floyd-census/?arc404=true

[6] https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800223

[7] https://www.theatlantic.com/politics/archive/2015/06/americas-largest-mental-hospital-is-a-jail/395012/#:~:text=As%20sheriff%2C%20Dart%20is%20also%20responsible%20for%20Cook,considered%20the%20largest%20mental-health%20facility%20in%20the%20nation