- Just ahead on "American Black Journal," it is Mental Health Awareness Month, and we're gonna talk about the importance of access to care and reducing the stigma that surrounds mental illness in the African American community.

Plus, we'll get the latest on the COVID-19 pandemic from Michigan's top doctor.

You don't wanna miss these conversations.

"American Black Journal" starts right now.

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(upbeat music) - Welcome to "American Black Journal."

I'm Stephen Henderson.

May is National Mental Health Awareness Month, and the latest data from the US Office of Minority Health show that African Americans are 20% more likely to experience serious mental health problems than the general population.

Now, there are several factors that impact education and awareness, and they include racial discrimination in healthcare, a lack of equitable access to services, and the stigma that is still associated with mental illness.

I spoke with Eric Doeh, who is CEO of the Detroit Wayne Integrated Health Network about mental health in the African American community.

I wanna start with what I think is the crux of this issue, especially in a city like Detroit, and it is this stigma that continues to kind of follow the issue of mental illness, especially in the Black community.

Of course, there is a stigma in our society in general around the idea of mental illness, and I think there are lots of things we don't understand about it or really understand how to treat, but this is a particular issue with African Americans.

And so with May being Mental Health Awareness Month, I wanna give you a chance to talk about how hard that stigma makes it to make progress.

- Absolutely, you know, when you talk about trauma, in particular trauma amongst our youth and children, you know, when you hear a gunshot and you talk to kids, and that seems to be the norm, it's not the norm.

And you know, for a long time, and even today, mental health, sometimes it's considered a weakness within the African American community.

And I find that so strange, you know, because everyone has an uncle or an aunt who, from your time growing up, what you were told by the folks were that, "Oh, that's just, James is going through it" or whatever it was, and it creates such a challenge for us within the profession, because we wanna be accessible.

We wanna reach young people.

We wanna reach our seniors and our adults as well.

But when you have that stigma there, you first have to overcome that.

And some of the ways in which you do that is simply by communicating and recognizing to that, mental health is no different from physical health.

There's a reason why, Stephen, within our communities, we have urgent care centers there, because we know that one day you and myself will be cooking and we'll cut ourselves, and we'll need someplace to go to to receive services.

Within the behavioral health world, you come upon those challenges in life, you know, something happens that just completely change things for you, and you need someone to talk to, and there's nothing wrong with that.

- Yeah, so let's talk about how you approach then Mental Health Awareness Month here in Wayne County, where, you know, the city of Detroit is the largest jurisdiction, and it's the largest majority Black city in the country.

There's gotta be an effect of those factors on the way that we even start to talk about mental health.

- Absolutely, you know, at Detroit Wayne, we serve well over 75,000 folks.

Last year, even in the midst of COVID, we served over 200,000 folks within Detroit.

40,000 of our core members are in the city, and so whether we're talking about our 1-800 number, you know, 1-800-241-4949, that's a number that folks can use to access our services.

Regarding our young folks, we also realized that, you know, Stephen, unlike you and myself back in the day, we'll pick up the phone and have phone conversations.

Now young people text, you know?

So we came up with reachusdetroit.org is, you know, you can use that for text messaging, you know, receiving well up to 12 counseling sessions.

The same is true with our 313-488-HOPE, another source that folks can call to receive services.

What we find, or what we are finding, though, is that you first have to start with access.

Folks have to know who you are and what it is that you provide in terms of resources.

The next step is then how do you make those resources so that folks can come and receive those services, or you go to them?

I mean, sometimes the mountain has to come to Moses, and within the mental health space, transportation, you know, something to eat, a roof above your heads.

Those are all social determinant factors that we have to be concerned with that's in the physical health world.

Your doc and my doc are not concerned as to how we're making that appointment, but within the behavioral world, that matters, you know?

So we have made those things as part of our way of making sure that people have access to care and improving the quality of health for them as well.

- Hmm, the access barriers also play a role here and of course play an outsized role in the African American community.

I feel like that has gotten a bit better.

There is more access now, thanks to the health care reform passed now almost a decade ago, enacted almost a decade ago, but we still have hurdles there and barriers to people being able to access mental health, which is still treated differently from an access standpoint than other health issues.

- You know, and this is why when I have an opportunity to speak with folks such as Herman Moore, you know, he and I were on a program not too long ago, and we talked about, you know, and here is a prominent athlete who was able to share his challenges growing up.

And I think when young folks, older folks recognize that you are not alone in this at all, you know, when you have athletes who have gone through this, Naomi Osaka, for example, you know, here is a tennis phenom who challenges were mental health was brought on the stage, you know, to have those types of discussions.

I think when people see those things happening, there is an identification process there that says that you are not alone in this.

And I think the more opportunities that people get to see and hear this being discussed, it lessens the stigma.

Stigma will always be out there, let me make that very clear.

You know, Stephen, I don't think if we were to do an incredible job today or tomorrow, it would necessarily solve it.

But I think some of the little things that we can do is to listen to, we have to listen and understand what folks are going through.

COVID exacerbated a lot of health challenges that were always there, but they were just brought to light in all of its prominence because of that.

- Yeah, so let's talk more about the pandemic and the effect it has on the work to address mental health in particular.

I've kinda identified a couple of different challenges there.

One is of course the loss and the grief that so many people, especially in our community, experienced because of COVID.

There's the isolation that COVID forced on all of us in the disconnection from our families and our friends.

And then there is the economic insecurity that it absolutely inflicted on people, which is sometimes a trigger for mental health.

It seems like you've got a lot on your plate there.

- Absolutely, you know, and look, you have health disparity, and so starting with that, and then you put the economic challenges and barriers that are also part of that, you know?

So these are things that have always existed, and there are times that we try to solve them as best as we can, but can you imagine those things haven't always been there.

Now you put COVID as part of that as well.

And then there's also the sense of, you know, we are a community folks.

African Americans, we love to be around each other.

And I tell you, those were some difficult days and months to go through when you couldn't go and see grandma or you just couldn't get into those communal settings that we've been so used to.

But at the same time, though, organizations such as ours, we were going out in the community with mobile health services because we realized that folks weren't coming to buildings, so we needed to go to those spaces that they were in, whether they were their community centers, parking lots that we find folks in, barbershops that we find folks in, you know?

We needed to make sure that we kept connected with folks.

And then when you talk about technology, you know, folks often say, "Well, there's always telehealth."

Well, in some of our communities, access to the web isn't something that is as ready as our telephones, you know?

So we had those challenges, and so we invested in those communities by actually buying laptops and telephones, and now that you bought the laptops and telephones, you need to have the internet sources that folks can use in order to access those services.

So we invested in those things, Stephen, because there was a recognition that we wanted to keep folks in contact with services, and we wanted those services to continue.

- Yeah, so I also wanna ask you about the way we should approach not the people who are suffering from mental health challenges, but their families and the people closest to them and what they can do to make this whole process easier.

I think one of the things that we don't talk enough about is the struggle of living with someone who has a mental health issue or challenge and making sure that that person is ready to get the help that they need and knows how to do it.

What about the, I guess, caregiving aspect of this?

- I tell you, what a wonderful question.

You know, people are not independent of others.

They are connected to others, and this is why when we provide services, you know, to whether it is an adult or a child, we wanna connect with the families.

You know, when we talk about crisis services, for example, we don't have a crisis center, a true crisis center here in Wayne County.

We do in Oakland County in terms of Common Ground.

At Detroit Wayne, we are building one.

By the end of this month, we will have one built here.

What that does, though, now you're talking about someone in terms of a family member who realizes that, "Gosh, I have a loved one here who's struggling, but I have nowhere to turn.

I either call the police, okay, or I take them down to the emergency room."

The emergency room is not a place for folks who are experiencing mental health challenges to be treated.

I mean, it's just not, and docs will tell you that any day.

The jail setting, it's also not a place for folks to receive services when they're going through those challenges.

So we wanna be able to connect with families to let them know that we are a resource.

It starts with educating them first.

But in educating, you also have to have the resources that are connected to that.

And Stephen, this is why I tell people all the time, these are services that are free.

They are free, you know, free because your tax dollars are working for you.

And I think when people know that, there is that sense of you're not alone in this, in providing that cure for your loved one.

We are here to listen.

We are also here to help as well.

- Sadly, we're starting to see COVID cases rise again here in Michigan and across the country, fueled by the highly contagious subvariants.

However, the number of deaths has decreased, and there's better access to treatments and testing.

So what lies ahead in this third year of the COVID-19 pandemic?

"One Detroit's" Bill Kubota sat down for a wide-ranging conversation with Michigan's chief medical executive, Dr. Natasha Bagdasarian.

- When we think about where we're heading in the pandemic, we do expect to see future surges of cases.

We do expect cases and hospitalizations even to go up at times in the future.

And when we think ahead, what does that look like?

That could be the emergence of a new variant.

It could be schools reopening in the fall.

We have seen surges of cases around school reopening in the past.

It could be around colder weather in the winter.

So we're looking at this as really being a phased approach to the pandemic, because as you know, we have the BA.2 subvariant that we are closely monitoring.

- Well, talk a little bit more about BA.2.

- So what we're seeing overall is that it does appear to be more transmissible.

So it appears to be about 30% more transmissible than the original strain of Omicron, which as you know, was more transmissible than Delta, which was more transmissible than Alpha.

So these variants have become more transmissible as time has gone on, which is concerning.

However, there is some good news, and that is that BA.2 does not appear to cause more severe cases.

So cases are not more severe than what we saw with Omicron, and there does appear to be some cross-protection in terms of immunity.

So people who very recently had Omicron infections, they may be protected from some of those severe outcomes.

And then of course the vaccines still work, meaning that the vaccines are still protective against severe outcomes and death, which I think is really, really important.

- Well, you talk about transmissibility.

We've seen the governor's husband tested positive, the lieutenant governor earlier this year, and then the mayor of Detroit, Mayor Duggan said he tested positive.

It seems, is that what, everybody's gonna get this.

How 'bout you?

How are you doing?

You know, what are we doing with all of this?

Is it our turn, everybody's gonna catch this thing at some point?

- When we look at this pandemic and at the virus, the virus is not going away.

I think that there was some early hope and some early speculation that maybe this is something that could be eradicated.

We would be done with the pandemic, and we could go on with our normal lives.

And this has become apparent that this is not true, that COVID-19 and that the SARS-CoV-2 virus is not going anywhere.

It's going to remain with us, and that means we have to find ways to live with it.

And what that really means is that every one of us is at risk for contracting COVID-19 at some point.

Now, what we want to prevent are the severe outcomes.

We wanna prevent severe cases.

We don't want people to end up in the hospital, in the ICU, on ventilators, and we don't want people to die.

And so the best way to make sure those things don't happen are to use the tools that we have, and the best tool are vaccines.

So if you're vaccinated, your risk of having a severe outcome, your risk of ending up on a ventilator or dying from COVID are significantly reduced.

Then we've got tools like therapeutics.

We've got oral antivirals.

We've got monoclonal antibodies that can also be used to reduce the risk of severe outcomes.

And we also wanna prevent as a society these big surges of cases where everyone's getting sick at the same time and where our health systems and our infrastructure are getting overwhelmed.

- And we're also looking at that push for that second booster.

How does that fit into all of this?

- Well, again, vaccines are one of the most important tools that we have.

We really have to use all of these tools in a very holistic approach and use them together.

So you are safest if you are using our, what we call non-pharmaceutical interventions, meaning, you know, you're avoiding very large, very crowded gatherings.

You're doing what you can to prevent getting exposed to the disease as much as you can, and then also you are making sure you're vaccinated and boosted, so up to date with vaccinations, that you've spoken to your doctor, that you have a plan for whether or not you'd be eligible for one of these COVID therapeutics, and then making sure that you've got some of these tools at home, so making sure that you've got masks and hand sanitizer on hand for future surges, making sure that you've got over-the-counter tests on hand so that you can use those over-the-counter tests if you become symptomatic, if you've been exposed to someone with COVID, or before attending a large gathering.

So making sure that people have all of these tools at their disposal is really one of the keys to moving forward.

- Well, with the testing, I fear some people that they'll have false negatives.

They think they don't have it, and it turns out they do.

How is testing now?

Is it getting better?

Where are we with all of that?

- Well, in terms of testing, there are two main types of tests.

There are PCR tests, and that's looking for the genetic material in the virus at very, very small amounts.

And those are incredibly sensitive tests, and they can pick up illness early on, but they can actually remain positive for some time.

And then we've got antigen tests, which are like those home tests, and those are not as sensitive.

It is possible early in the disease to get a false negative, but there are some strategies that we can use to make those tests more effective.

So number one, you can repeat a test.

So if you have an antigen test at home, an over-the-counter antigen test, if you take a test and you are negative, you can repeat that test the next day, and that increases the sensitivity of the test.

We also advise if you are symptomatic, if you are unwell, regardless of your test result, that's not really a good time to be going out into public.

So if you're unwell, if you have a fever and you're sneezing and coughing, stay home.

Stay home and avoid exposing others to whatever it is you have, whether it's COVID-19 or influenza or anything else.

- You know, a federal judge just recently, very recently kinda lifted this mask mandate on airplanes and transportation.

What about that?

What do you think?

Will you still be wearing your mask on a plane now?

- You know, we have been saying for some time now that we're in a phase of the pandemic where making these sorts of decisions are really up to individuals.

So we now have access to well-fitting, high-quality masks that can protect the wearer.

In the beginning, when we were talking about cloth masks and masks that were not well fitting, really everyone had to wear a mask in order to prevent spread from happening.

But now, if you are wearing a really high-quality, well-fitting, multi-layered mask, you can provide protection to yourself.

And so people need to make decisions that work for them.

So we still recommend wearing a mask if you are unwell, if you've tested positive, if you are quarantining, for example.

So there are still some times where we would recommend masking.

If you're in a high-risk congregate setting, so if you're in a health care setting or a long-term care facility, that's another time to mask up.

And then we also want people to comply with local and federal rules.

So if there are any laws, mandates, rules around masking in the place you're going to, it's important to comply with those rules.

But overall, people can now make decisions that work for them, and there are lots of different reasons why people may want to continue wearing a mask.

So number one, you may have young children who aren't eligible for the vaccine yet.

You may be immunocompromised yourself.

Someone in your family may be immunocompromised.

You may be wearing a mask for them.

And then there's also just wearing a mask to be considerate to others.

You don't know who's around you.

You don't know if there are people who are very vulnerable who are sitting next to you, and so you may wear a mask for them and for their comfort.

And so when you ask if I will continue wearing a mask, I do generally wear masks when I'm in public, when I'm in, especially indoor public settings.

But again, it's a personal decision that I make with my family and do what's best in, for us, and people have to make those decisions for themselves as well.

- Yeah, you mention your family, children.

How are schools doing in dealing with all of this these days?

- I think it has been a very hard two years for schools.

I think schools have been put at the front line of this pandemic, and really they wanna get back to the business of educating our kids, which is their primary goal, but they also need to be able to stay open and make sure that kids are healthy enough to be able to stay in school, and that does mean preventing outbreaks.

And when I talk about those tools, and I mentioned that vaccines are one of the most important tools that we have, we see that vaccines have not been utilized to the degree we would want them to be in our younger age groups.

So when we look at overall vaccination, we're at above 60% for vaccine uptake across the state.

But when we look at our younger age groups, when we look at our pediatric population, the five to 11 population, that's lower.

That's at about 28% statewide.

And then when we look at certain communities, that rate, especially in children, drops even lower.

And when we look at communities of color, again, we're seeing lower vaccine uptake, and that matters because we are expecting future surges of cases, and we need to make sure that everyone and all communities across the state are protected.

So if we don't have vaccine uptake in that younger age group, we could be seeing school closures again in the fall, school closures into next year and even beyond.

We could be seeing outbreaks in schools.

And then of course we know that children who are exposed and transmitting in school settings, for example, can bring those infections back to their family members, into, you know, vulnerable grandparents or younger siblings.

So we really need to make sure that vaccine rates are up across the board, because if we are not all protected, if we have vulnerable individuals, vulnerable communities among us, then as a state, we're not gonna be able to move out of this pandemic.

- It always seems like when we look forward, we're looking back, and we've done a story or two about the long COVID, the long-haulers, you know?

And I'm wondering how you as a health professional are thinking we're accommodating that problem with so many people.

- Well, there's a lot more study and a lot more information that we still need on the long-term effects of COVID.

When we think about the virus, the virus has only been known to us for two years, and so we don't really know what the long-term consequences of COVID-19 are.

You know, how does this affect people five years after infection or 10 years after infection?

And we don't really have the answers to those questions.

So we'll learn more as time goes on, but really making sure that as many people as possible are vaccinated and have that level of protection I think minimizes some of those problems and risks that we're concerned about from things like long COVID.

- That is gonna do it for us this week, thanks for watching.

You can find out more about our guests at americanblackjournal.org, and you can can always connect with us on Facebook and on Twitter.

Take care, and we'll see you next time.

(upbeat music) - [Announcer] From Delta Faucets to Behr paint, Masco Corporation is proud to deliver products that enhance the way consumers all over the world experience and enjoy their living spaces.

Masco, serving Michigan communities since 1929.

Support also provided by the Cynthia & Edsel Ford Fund for Journalism at Detroit Public TV.

- [Announcer] The DTE Foundation proudly supports 50 years of "American Black Journal" in covering African American history, culture, and politics.

The DTE Foundation and "American Black Journal," partners in presenting African American perspectives about our communities and in our world.

- [Announcer] Also brought to you by Nissan Foundation and viewers like you, thank you.

(calm music)