Tag Archives: Black History Month

Black History Month, Heroes in Psychology

Olivia Hooker, PhD (1915-2018)
As a child, Dr. Hooker survived the Tulsa race massacre of 1921. She and her siblings hid behind a kitchen table while watching the destruction. She described the trauma as life-long, but it didn’t hold her back. Dr. Hooker was the first Black woman to enlist for active duty (Coast Guard) and the only Black woman in her Ph.D. class at the University of Rochester, graduating with honors.  She previously attended TC at Columbia University, where she obtained her master’s in psychology. She was told she was ‘not intelligent enough’ to proceed to the doctoral program, and subsequently transferred to the University of Rochester for her doctorate.

She began her mental health career at a prison in New York, counseling and supporting women with learning disabilities. For decades, she continued to work with neurodivergent people who had intellectual and developmental disabilities and established Division 33 of the American Psychological Association, which focuses on neurodiversity. She was also a distinguished professor of psychology at Fordham University, where she was a mentor to both students and faculty. She was a tireless voice for justice and equality, especially for neurodivergent individuals. Dr. Hooker died in 2018 at the age of 103.

A Tribute to Psychologist Dr. Mamie Phipps Clark

Dr. Mamie Phipps Clark was born in Arkansas to a physician father and a homemaker mother who also ran the office practice. She was an exemplary student, and graduated with honors, winning scholarships to Howard University and Fisk University. She attended Howard University in Washington DC, where she majored in math and physics, before she fell in love with psychology.

Primarily, Dr. Clark investigated and analyzed the development of racial identification in black children and how that relates to self-esteem. After completing her undergraduate studies, and influenced by her work with children in an all-Black nursery school, Clark completed her master’s thesis, “The Development of Consciousness of Self in Negro Pre-School Children.”

Essentially, she wondered when and how children develop the idea that they are Black, and what that means to them on a personal level and social level.

She moved to New York with her husband, the psychologist Dr. Kenneth Clark, where she started her doctoral studies at Columbia University. Their combined research resulted in the famous “doll experiments.”

The Doll Experiments and Black Psychology
Dr. Clark completed the doll experiments with her husband, research which played a key role in the Brown v. Board of Education Supreme Court decision.  It was also the first psychology research to be submitted as hard evidence in the Supreme Court’s history.

The study used four dolls identical in all ways except skin color and asked 260 Black children, ages 3 to 7, to rate them for liking and overall attractiveness. Over two thirds of the participants indicated a preference for the white doll, saying it was the ‘best’.  Further, 60 % of the participants indicated that the brown doll “looks bad.” The tendency to believe that the brown dolls were inferior was consistent, even in three-year old children. The study showed that segregation had significant negative mental health effects on the self-esteem and self-perception of black children.

She gave back to her community
Inspired by her volunteer work at the Riverdale Home for Children, where she conducted psychological testing with homeless Black girls, Dr. Phipps Clark founded the Northside Center for Child Development, in NYC, in February 1946. Launched with a $946 personal loan by her father, the Center was housed in the basement of the Paul Lawrence Dunbar apartments, where her family lived. The first of its kind, the Center provided therapy for children in Harlem, parent training and consultation, and provided support to families needing housing assistance. Dr. Phipps Clark remained active as the director of the Center until she retired in 1979. Today, it continues to support the community with remedial reading and math tutoring services, nutritional workshops, and psycho educational programs. The Clarks also collaborated on various other community projects, including the Harlem Youth Opportunities Unlimited project (HARYOU), to provide job training and employment opportunities for Black youth.

She faced racism head-on
Dr. Phipps Clark earned her Ph.D. in psychology in 1943 from Columbia University. Her doctoral dissertation advisor was Dr. Henry Garrett, an openly racist professor and social scientist, outspoken in his writing and lectures. Dr. Clark later testified against him in a prominent Virginia desegregation case, rebutting his support of inherent racial differences in the ability and cognition of Blacks. Dr. Clark wrote extensively about experiencing pervasive frustration in her career. She attributed this to the “unwanted anomaly” of a Black female presence in a field dominated by White males.

Also see The Pioneers and Black History Month.

The Pioneers: Psychology and Black History Month

FRANCIS CECIL SUMNER (1895-1954)
Dr. Sumner was the first African American to receive his Ph.D. in Psychology. He was a founder of the psychology department at Howard University,  the first renowned department at a historically black college. Dr. Sumner completed a vast amount of research which delineated racism and bias in psychological studies of African Americans, including in research, testing, and clinical work. Some of his students went on to becoming leading psychologists in their own right, including Dr. Kenneth Clark (below).

INEZ BEVERLY PROSSER (1891-1934)
Dr. Prosser was the first African American woman to receive her Ph.D. Her dissertation examined the academic development of African American children in mixed and segregated schools. Her findings showed that African American children fared better socially and academically in segregated schools. Specifically, she found that African American children from integrated schools experienced more social maladjustment and more bullying, and felt less secure, a barrier to their learning.  Her research findings were used in the Brown versus Board of Education Supreme Court ruling, in 1954. She spent the last seven years of her life teaching at historical Black colleges, before she was killed in a car accident in Louisiana, in 1934.

KENNETH BANCROFT CLARK (1914-2005)
Supremely gifted psychologist, Department of Psychology, at Howard University in Washington DC. In the famous “Bobo Doll Study” he studied the responses of Black children who were given a choice of white or brown dolls. His findings illustrated that children showed preference for white dolls from as early as three years old. He concluded segregation was psychologically damaging, which played a role in the Supreme Court decision in outlawing segregation. He was also the first black president of the American Psychological Association (APA).

MAMIE PHIPPS CLARK (1917-1983)
Dr. Clark graduated from her segregated high school in Arkansas, at age 17, with honors. She subsequently attended Howard University in Washington DC, where she originally intended to major in math. It was at Howard that Mamie Phipps would meet her future husband, Kenneth Clark, in 1934 (they married four years later).  After struggling with misogyny in the math department, she was persuaded by Kenneth Clark to join the psychology department.

After completing undergraduate and Master’s studies at Howard University, the couple enrolled in the psychology doctorate program at Columbia University, where Clark challenged herself by studying under Henry E. Garrett, a prominent statistician, and unabashed racist and eugenicist. Despite his discouragement, she completed her doctoral thesis work on intellectual development in children. She and her husband became the first black recipients of psychology doctorates at Columbia University, in 1943.

Her work with children showed that African American children became aware of their racial identity as early as three years old. Many of the children she studied began to reflect and internalize the views that society held about them. These findings lead to the later Bobo doll studies conducted with Dr. Kenneth Clark, where both black and white children significantly preferred white dolls over dolls of color, rating them as more attractive and intelligent.

Mental Health and Black Patients: Survival and Stigma

The Black community suffers from a high rate of mental health concerns, including anxiety, PTSD, and depression. Black people experience direct traumatic stressors (including being heavily policed or being the victims of physical and verbal attacks), indirect stressors (such as the effects of viewing the video of the killing of George Floyd and others), and intergeneration-ally transmitted stressors (from traumatic stress passed from one generation to the next).

Access and availability of mental health care
Despite these challenges, however, Black people are far less likely to seek care. Statistics show us that about 25% of African Americans seek mental health care, compared to 40% of white Americans. Unequal access to health care is one major contributor to this disparity. The lack of cultural sensitivity by health care professionals, feeling marginalized, and the reliance on family, community, and spiritual support instead of medical or psychiatric treatment are others.

The incidence of psychological difficulties in the Black community is related to the lack of availability and access to appropriate and culturally responsive mental health care, prejudice and racism inherent in the daily environment of Black individuals, and historical trauma enacted on the Black community by the medical field. Moreover, given that the Black community exists at the intersection of racism, classism, and health inequity, mental health needs are often exacerbated and mostly unaddressed and unfulfilled.

History of exploitation and stigma
In Black communities, reluctance to seek both physical and mental health care can often be attributed to a general distrust of the medical establishment. This distrust is not without merit: historically, African Americans have been misdiagnosed at higher rates than white patients, and black communities have been exploited by the U.S. government and medical community in the name of medical research. Seeking mental health care is often viewed as a weakness, running counter to possibly a survivalist mentality born from systemic oppression and chronic racism.

Dr. Martin Luther King, Jr. suffered from bouts of severe depression from his teenage years throughout adulthood. He attempted suicide three times, but refused to go into long-term treatment, even though urged to do so by his inner circle of friends and advisers. He stated that he did not want the Civil Rights movement and his work to be tainted by the stigma of mental health problems. Today, the mental health stigma remains.
Culturally responsive mental health treatment

Culturally responsive mental health treatment is one way of addressing the disparities in psychological wellbeing in the Black community. Culture, a person’s belief, norms, values, and language, plays a vital role in every aspect of our lives, including mental health. Being culturally responsive is a mental health provider’s ability to recognize and understand the role of culture, both the client and clinician’s and the ability to adapt the treatment to meet the client’s needs within their cultural framework.

When meeting with mental and medical health providers, it is essential for clients to ask questions to gain a sense of their level of cultural sensitivity. Many people often feel nervous or guilty about asking these hard questions, but providers usually expect and welcome questions as this helps them better understand the patient and what’s important to them. If they become defensive, that provides important information as well. 

Here are tips Black clients could do to seek out culturally responsive providers:
Experience and training
Ask the provider questions about their treatment approach and if they provide care that is culturally sensitive.

Awareness of intersections
Seek attention from someone who is aware and affirming of your intersecting identities (social categorizations such as race, class, and gender, that are overlapping and interdependent systems of discrimination or disadvantage) and your cultural background.

Ability of the provider to ask questions and be mindful of their own gaps in knowledge and experience

Sidebar: I have to note another statistic that I frequently discuss when I am teaching seminars on this topic. The stats are that Black clients enter therapy with a sense of optimism. Microaggressions can occur in the very context of the therapeutic space. If they remain unaddressed, most often clients will just go away rather than complain. Research also shows that people who drop out of therapy are much less likely to go back.

Additional information on research on developmental psychology and microaggressions can be found here.

(Stats included are from Department of HHS 2017; APA 2019; Mental Health America).

Black Mental Health

Black history month and psychology:

A quick look at research into disparities in need for services and access to mental health treatment.

1946
In the 1940s, psychologists Kenneth and Mamie Clark designed and conducted a series of experiments known colloquially as “the doll tests” to study the psychological effects of segregation on African-American children. Drs. Clark used four dolls, identical except for color, to test children’s racial perceptions. Their subjects, children between the ages of three to seven, were asked to identify both the race of the dolls and which color doll they prefer. A majority of the children, BOTH black and white, preferred the white doll and assigned positive characteristics to it. The Clarks concluded that “prejudice, discrimination, and segregation” created a feeling of inferiority among African-American children and damaged their self-esteem.  The findings were presented to the American Psychological Association about the crisis in mental health for Black children.

2016
In a study published in June 2016, in the Journal of Health and Social Behavior, Princeton doctoral graduate student Heather Kugelmass used voice actors to record phone messages for 320 New York City-based psychotherapists, each asking for a new patient appointment. The psychotherapists, all of whom had doctoral degrees and were selected from the directory of a large HMO, each received calls from one black middle-class and one white middle-class caller, or from one black working-class and one white working-class caller. Each caller mentioned symptoms of depression, mentioned that they were covered by the HMO health insurance plan, requested a weekday evening appointment, and asked the therapist to call back with possible appointment times. Kugelmass varied the names, wording and accents of the callers to suggest race and class. Overall, she found that 44 percent of the voice messages were returned, and that 15 percent elicited a clear appointment offer from the therapist.  Importantly, offer rates varied by race and class—the therapists offered appointments to 28 percent of white middle-class callers but only 17 percent of black middle-class ones. Among working-class callers, only 8 percent of both black and white appointment-seekers received offers.

Current status
According to the federal Health and Human Services Office of Minority Health, African Americans are 10% more likely to experience serious psychological distress.

However, only 30% of Black Americans are likely to seek any form of treatment, when experiencing significant psychiatric symptoms, compared to 45% of white Americans.  In 2017, suicide was the second leading cause of death for African Americans, ages 15 to 24.

Making treatment more affordable
The cost of treatment may be prohibitive for many, especially among those without insurance coverage. Many low-income individuals can find help in the community health system, but such systems may suffer from a lack of clinicians able to treat complex and less common conditions. It can be especially difficult to find care for those who lack any sort of insurance, have an unstable living situation, or who must contend with the inability to make appointments due to overcrowding.  Individual practices and treatment centers can help by publicizing effective low-cost treatment options (i.e., practicum students/interns, sliding-scale slots, etc.)

Increasing awareness of mental disorders and treatment options
Education about mental disorders and the treatment process is critical to reducing barriers to treatment among the African American community. Suggestions for overcoming this barrier include public education campaigns (e.g., mass media), educational presentations at community venues (e.g., black churches), and open information sessions at local mental health clinics. In fact, many black churches are taking the treatment to where the people are and hiring licensed therapists to work with their flock.

Transparency
For those who do start treatment, the first clinical encounter presents an important opportunity to address skepticism about the usefulness of mental health treatment. It’s the clinician’s responsibility to demystify the process and explain the benefits of staying the course. Without this knowledge, the participant may only assume what he or she may encounter and base their decision to follow through on incorrect assumptions. If the expected outcomes, number of sessions, and potential goals are clearly outlined in advance, there is lesser chances of feeling misled or not in control.

Making mental health a priority
Treatment has the potential to conflict with many daily activities or commitments for busy people. Many individuals take second and third jobs to make ends meet. Whether the individual feels treatment is a necessary priority despite prior engagements, transportation, or scheduling issues is an important positive step.

Including the family
Actively incorporating the family is another crucial measure in overcoming barriers to treatment. By gaining familial support, the client may start to lose the fear of being outcast or stigmatized. In addition, with the family’s acceptance, making time for treatment becomes easier and priorities may be put into perspective. Utilizing the family to emphasize the importance of good mental health creates more allies to emphasize the relationship between improved functioning and greater success at home, community, and work.

Reducing fears about therapy and stigma
Making psychotherapy less intimidating may be one of the most important ways of improving help-seeking. Careful use of language can help to reduce some discomfort surrounding mental health care. For example, many clients are more comfortable with the term “counseling” over “psychotherapy” (Thompson et al., 2004), and this should be considered in advertising and conversational exchanges. Another practical way to reduce fears is to offer free initial  assessments, screening/intakes, and phone consultations, which will help familiarize potential patients with the clinic, clinician, and treatment. Clinicians might use initial contacts to address fears of being involuntarily hospitalized by explaining the difference between typical mental health challenges and “being crazy,” which has often been brought up as a concern.

Provider Bias And Inequality Of Care
Conscious or unconscious bias from providers and lack of cultural competence result in misdiagnosis and poorer quality of care. Black Americans, especially women, are more likely to experience and mention physical symptoms related to mental health problems. For example, you may describe bodily aches and pains when talking about depression. A health care provider who is not culturally competent might not recognize these as symptoms of a mental health condition.

Statistics: NAMI (National Alliance on Mental Illness), 2017.

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