How does diversity impact mental health?

How does diversity impact and change the way we think about mental health care?

In this episode we are exploring what diversity means in the mental health space, specifically how the experiences we have in life change the way we approach that care. We are joined by guest Dr. Jurdene Coleman, Owner & LCMFT of Sage & Summit LLC, who explores the space where diversity and mental health meet. Today is an eye-opening conversation that covers stigma, creating connection, and the perspectives we can see around the world. 

Have questions, thoughts, or stories you want to share? We would love to hear from you! Shoot us an email at brightminds@pawnee.org

Your mental health matters. While this podcast is meant to foster connection, understanding, and hope, we know that some conversations may bring up difficult or emotional moments. If you need support, help is available and you don’t have to navigate it alone.

If you or someone you know is in crisis or experiencing emotional distress, call or text 988 to reach the Suicide & Crisis Lifeline. Free, confidential support is available at any time.

To learn more about Pawnee Mental Health, visit us at https://www.pawnee.org

Transcript

SPEAKER_00 0:03

Welcome back. I'm Jonathan Sapal.

SPEAKER_01 0:05

And I'm Michelle Malieu, and this is Bright Minds and Brighter Days Podcast.

SPEAKER_00 0:09

Where every episode, our goal is to bring you real conversations that meet real care. Today we have a great episode. But here at Bright Minds Better Days, we believe in uh talking about topics that are often uncomfortable to talk about. We have with us uh Jerdine. Uh if you could introduce yourself.

SPEAKER_02 0:41

Sure. Uh my name is uh Jerdine Coleman and I am a licensed marriage and family therapist and I've been practicing in this community for, gosh, about 12 years. Um I currently own a private practice here in town, Sage and Summit, where I do mental health uh therapy and leadership consulting.

SPEAKER_00 1:01

So when you talk about diversity, what does that actually include? And is there anything that people often overlook?

SPEAKER_02 1:08

Yeah, that's such a good question. People are often start with race and ethnicity when they think about diversity because it's something that's typically pretty visible. But really, diversity is such a broad category. Um, it includes things like um a person's age, their ability or disability status, um, what uh income level they are, uh includes their sexual orientation or their gender identity. Um so diversity covers such a broad um spectrum of things. And I think people often forget to think about some of those other categories of difference. Um when I think about like what is diversity, really it's just the things that make each person unique and individual. And um, we talk about mental health and diversity, we can think about how do those unique things impact people's mental health. So, how does diversity play a role in the mental health world? So each of those different aspects of um a person's identity or um so they're different, I guess, categories you might say that they belong to impact how they understand and how they relate to mental health. Um so when we think about, like for example, pawning covers a vast service area. And so people who maybe were born and raised in um, I would say, I would say Manhattan is a suburb. People might not agree with that, but it's suburban. Um so thinking about that perspective versus like folks that you all serve, like who are out in Beloit or Concordia that are in your more rural or farming communities, they have completely different understandings of mental health and even like openness to what mental health is. And so um you really have to to be thinking about what is this person's like background and experience with um how their family might have talked about mental health growing up or what they might come in contact with even in their day-to-day lives around um experiencing mental illness or knowing someone who talks about their mental illness, like that really varies um based on people's uh diversity and their background.

SPEAKER_01 3:14

When when we're talking about diversity, does this include, like, I remember when I used to do admissions a long time ago? People would often call and say, Well, I don't want to see anybody younger than me. I only want to see, you know, a female that's close to my age or somebody that's faith-based, or is that included in diversity because they're trying to stay within that own comfortability?

SPEAKER_02 3:34

Yeah, you know, I think there's there is a level of comfort with seeing someone, um, like for therapy or even from medication management who share some of those characteristics with you because um, which I'm sure we're gonna talk about today, um, those unique um perspectives really impact how, like I said, how you understand mental health and how your providers can connect with you around that unique understanding. Um so, yes, age and uh faith background, being from a rural or urban area, all those things are included in diversity.

SPEAKER_00 4:05

Just from your experience, I mean, do do you see a lot of uh a lot of mental health struggles that show up differently across things like culture?

SPEAKER_02 4:13

You know, in in some ways they're they're different, but in some ways they're they're similar. Um sometimes I I will say people from all different backgrounds have mental illness, right? They struggle with mental illness. So it's not unique to any one community. Um but maybe how people present with symptoms or how they describe their symptoms, that is where you see some difference in people. Um so there are some groups of folks who maybe will talk more about being stressed or overwhelmed versus like being sad and depressed. And so as a mental health provider, you have to be able to understand like those two things are kind of along the same spectrum and then be willing to ask more questions to try to see, like, okay, this is depression, even though they're saying I'm stressed and overwhelmed. Um, it's it's actually all the other parts of depression too.

SPEAKER_01 5:07

And I think I've mentioned this on a previous show that we've had, but you know, my mom being from Thailand, she struggled. I mean, I've been here almost 19 years, and she till this day still struggles as to where I work, why I work here, why there is such a place like this. Like she gets it more and more because yes, now there's TV shows or commercials about it, and it's more openly talked about. But yeah, so how does somebody's identity and or background shape the way that they're experiencing mental health and how we do those challenges?

SPEAKER_02 5:33

I want to touch on that piece about your mom though, because I I do think that there's there are some cultures, like um, I think about like Asian cultures, um, Latin American cultures, um even like African-based cultures, like African Americans and even African continent, um, Indian, Native American, like those are more collectivist cultures, meaning that they are more centered around community. And so they often go to that community for healing and support. And when you think about like typical therapy, it feels like a very individualized um experience that I'm gonna go and sit with someone and talk about my problems. More personal. Yeah. And so I think a lot of folks from those communities don't often think about therapy as the the first avenue to get help because they want to go to those community-based supports, which could be family, it could be friends, it could even be their like church or like religious um institution that if it feels more comforting because you're going to your own community. And I think that the work that you're doing, Michelle, with like helping communities understand mental health and be able to talk more about mental health will help those folks who are getting people coming to them be able to like recognize signs and symptoms and like recognize like this is beyond what I can help you with. Like then here are some other resources. Like I think the work you're doing is so valuable because I think people are going um to their communities a lot of times first.

SPEAKER_00 7:01

So have you seen like a big shift? Because I I know when I was younger, you know, I'm from Houston, Texas, and you know, I come from you know a Hispanic background and you know, things like um things like mental health was, you know, is often like uh even though I had my mental health struggles as a teen, they was it was largely discouraged for me telling people about it, you know, telling telling my aunts and uncles, you know, it was you know, that was kind of a no-go situation. But just in the last you know, decade or so, have have you seen a shift where people from different backgrounds and cultures are are a little more uh op are opening up or giving it some actual uh acceptance?

SPEAKER_02 7:38

Yes. Um and part of that I think has to do with the field of of mental health as a whole has become more diverse. I don't have any stats with me, but I did a presentation a while ago about this, like the the field, so I'm a marriage and family therapist, and like our field has grown exponentially in the diversity of the providers, and so having a therapist that comes from the same um race or ethnicity background as you increases the likelihood that you will go to therapy. And so I think that a big piece of of communities of color being willing to go to therapy is because it's so much easier to find a therapist um that can relate to you in that way. And a lot of work is being done around um training um therapists of all backgrounds to understand more of the cultural nuances that people experience. So um a lot of professional development is just available now. Whereas I would say even 10 years ago it wasn't as readily available. So there's more training, more people willing to be therapists who come from different backgrounds. So both of those things open up the door for different people to access therapy.

SPEAKER_01 8:48

Um, Jardine, can you share an example of where diversity may have impacted somebody's mental health for better or worse?

SPEAKER_02 8:54

I really was trying to think about a for better example, and the ones that came to mind are maybe ones that are more challenging. Um so what I think about people having a mental health crisis, for example, um, and then a lot of times when people don't understand a mental health crisis, they can view that as like threatening or aggressive behavior towards other people. And most of the time we know when people are having a crisis, they're more likely to hurt themselves than other people, right? So a lot of times we've seen in the news instances where uh people of color specifically are having a mental health crisis, and then law enforcement gets involved and they are taking their behavior as threatening to other people, and then it ends out poorly, whether that person loses their life or gets arrested or something like that. And it made me think about programs like mental health co-responders and why those are really important. Um, because those those programs allow therapists to be embedded into police departments and in like really embedded in their communities and really getting to not only to know the people who are having the biggest challenges so that it's almost like um if I know you, then I can at least um help people think about like, oh, okay, this is so-and-so, and we know that so-and-so has this challenge. So let's maybe assume that that's what's going on before we go in and assume it's an aggressive situation. Um and also I think having therapists embedded in those departments also just helps people um who are in law enforcement learn more about and understand more about mental illness. It bridges that gap, definitely, yes. Exactly. And so I, you know, I think that programs like mental health co-responders are really saving the lives of of people of color who are having some of those more significant mental health challenges like schizophrenia or bipolar disorder that if they're not treated can can really show some escalated behaviors. I think that those programs are are saving lives in lots of communities.

SPEAKER_00 10:57

I I know every time we talk about on the topic of uh you know mental health, um, you know, stigma seems to play a pretty big role in in this field. How would you say, I mean, is there a difference uh across cultural cultures or generations?

SPEAKER_02 11:13

Yeah, I I love that you included generations in this question. Um because like to your point earlier, I do think that there is a generational difference in openness and acceptance to talking about mental health and getting treatment for mental health. Um and I mentioned earlier about the differences around like individualist versus collectivist cultures, and so a lot a lot of those collectivist cultures are really wanting to use their own community for healing, and so um it's important that we demystify like what therapy could be and what um how it could be beneficial, and also thinking about um family therapy and like that therapy doesn't have to just be where I go and talk to someone and everyone in the family doesn't know what I'm talking about. Sometimes healing a relationship, the best way to do that is for me and the person I'm struggling with to go in together. And so I I do think that yes, there is stigma still, and yes, we are still doing a lot of work to help sort of destigmatize or demystify what is therapy, um, how could it help you and your family? How could it benefit you and your community to be a part of a process like that? Um, and I think even like openness to medication management, also I would say is another thing that has changed a lot. Um, I I can't think of a single person that I knew um, gosh, probably before I was 20 that would have openly said they were on medication. I can't think of a single person. Um I can think of like the person in my family who people maybe like said like like derogatory things about, and probably it was mental illness, but we didn't know that or we didn't talk about that at that time. But there was never talk about um, like, oh, like so-and-so has a psychiatrist or a so-and-so um has depression. Like that was never discussed growing up. And so now, I mean, that is something I feel like even like college age and high school age, kids are even open to talking more about and like um I gotta go see my therapist at three o'clock.

SPEAKER_01 13:21

Yes, like versus you know, growing up here in town, never heard of Pony Mental Health before I even started. I'm like, I don't even know what mental health is, but exactly. I'm gonna wing it until I figure this out. But yeah, everybody's just so open now. Oh, I'm getting my meds over at this place. You should try okay, okay, yes.

SPEAKER_02 13:35

Yeah, giving each other recommendations, and I think about like the impact of social media on that, even and like just the access to um like lots of therapists have social media accounts, and so they make therapy and therapy talk like accessible to people. Um so yeah, I think a lot of good work is being done to help reduce the stigma, although it it is certainly still there. Um, I think generationally speaking, there's that's just hard. Um but there's there's good stuff happening.

SPEAKER_01 14:02

I do like seeing that light bulb moment though. Like when I do trainings in larger communities, like at churches where there's a huge range of generations there or different agencies. I like we'll talk about a topic during a training and then like we'll break to do group activity. They don't really do the activity because they're so busy talking about I would have never thought about that because we didn't talk about this, you know, growing up. And so you kind of hear that side conversation, but then like as we come back together as a clash, you kind of see that light bulb of like, oh. So yeah, the stigma is breaking, we're all kind of making that shift. It's just how comfortable are we? And like, okay, I recognize what you're saying, but I'm not ready to put it into play yet, but at least they're aware of it. Yeah. But yeah, I I like seeing that, and then yes, the younger kids just openly talking about it, I think helps a lot too.

SPEAKER_00 14:46

Mm-hmm. You know, and I I know one thing that I have noticed over the last few years is um is it's becoming a little more open in the veteran community. You know, I I got out of the army in what, 2016, so now 10 years. Um man, time flies.

SPEAKER_01 14:59

Yeah, it doesn't seem like that long ago until you say that.

SPEAKER_00 15:02

But you know, um even even at the time that I got out, because it was it was a very culture thing in there that, you know, I mean, you you you just didn't want to let anybody know you were going to behave your health. And unfortunately you can't do a lot of things without letting your chain of command know and getting their approval. And so um uh so uh you know, when I got out, it you know, it wasn't my first step was to go seek out a counselor or or you know, any type of help, anybody to talk to. That that wasn't my first um my first goal because it was just kind of bred into me that we don't do that. And um, but I but I I am seeing a lot more um you know, a lot more promotions, a lot more activity, a lot more veterans even now uh seeking help early, uh like as soon as they get out, that it's a part of their it's a part of their exiting journey.

SPEAKER_02 15:50

That's amazing. Yeah, I know that there's a lot of work being done to to get veterans access to care. Um and I, if I remember right, there is like a like a liaison role within Pawnee still that like their their job is to sort of bridge that gap. And um I I also I think about like um gosh, years ago when I was a therapist and like full-time therapist seeing people 40 hours a week. I you know, there was maybe like one veteran that I maybe came across at that time. And I would say, gosh, in the last five years, like that has changed significantly. I mean, people like are just willing to talk more about it, they're willing to to access services. And I think we've become more trained as a society for like what veterans are experiencing because I think a big part of that too for for veterans is you have no idea what I've been through the last X number of years, so why would I come in here and try to talk to you about it? Right. And so again, we've done so much work as a mental health community with learning more about what veterans have experienced, what what have families of veterans experienced, um, so that we're better equipped to be helpful. Um, because it's it's one thing to get people in the door, it's another thing to actually like be able to relate and and help them. And so yeah, they need to know that even though every therapist maybe isn't a veteran, that they they can have some knowledge that can be helpful, and and they should be looking for that when they're looking for a therapist. Ask those questions.

SPEAKER_01 17:28

Can you touch on this? And I know you and I have talked about this a long time ago, but I think it kind of plays into the diversity. Oftentimes people will say, Oh, I used to see a therapist and it's just not for me. And I I tell my training classes that I do all the time, I always say, Show of hands, how many of you are still dating your grade school, high school, you know, your grade school boyfriend or girlfriend? Like from third grade. Nobody raises their hand. And I'm like, How many times have you dated since then? And I'm like, that's kind of like finding a therapist. It's not a one-size-fits-all. Just because you go one time doesn't mean that you're gonna connect with that person. Yeah. And I think that's also kind of where that stigma comes into play, is because you have to trial, it's just like your primary care. If you didn't like your primary care, you would probably find a different one because you still need to go. So why isn't mental health the same way? And I think it kind of ties into the generations, the diversity, and just okay, I'm done.

SPEAKER_02 18:18

Yeah, it really is important to, I mean, shop around in some ways. Lots of therapists offer like free consultations and and even if you go somewhere and have an intake appointment, it's that's not a commitment. Yeah. Right? That's that's just a initial conversation. Um, but yeah, you you want to find someone who can connect to your experiences, um, especially if you come from either a minoritized background or just a um you have some aspects of diversity that maybe are not as common in the community that you live in. Um, does the therapist that you're trying to see, do they have they worked with people who are like you before? Um what uh maybe have they found to be helpful um with the kind of problem that you're having? So I mean, yeah, I encourage people to shop around. Um it's it's important that you connect with the person. And it's also okay if you've been with someone for a while and it feels a little stale that you maybe about, yeah. Yeah, like maybe we even need to take a break, maybe you need a different therapist, like that's okay too. Um as a therapist who um you know makes money seeing people, that's hard to say. Sometimes it's hard to hear, and you and it you kind of can can get down on yourself about it. But the reality is that we all want people to get better. And if I'm not the person right now, I'm okay with that. I want you to go find whoever that person is gonna be. And and a and a good therapist is gonna give you some referrals anyway.

SPEAKER_01 19:41

Kind of like a put yourself in their shoes. Like if my mom were going and she came home and be like, you know what, I'm just not getting anything, I'm not connecting, I'm not gonna tell my mom, well, you just gotta stick it out. Like, you're gonna want her to find somebody that she connects with. And it's the same thing with every therapist. They're gonna, I mean, everybody's a human. We see people in that human capacity and we want them to get better regardless of who they're seeing. Exactly. Yeah. Yes.

SPEAKER_00 20:01

So if there was um if there was one takeaway you wish, you know, more people understood about diversity and mental health, what would that be?

SPEAKER_02 20:08

My takeaway would be that mental health is a part of everyone's life, regardless of your background or how you identify. Um, and that talking about how you feel and what stressors you experience and asking for help um is is a sign of strength and wisdom and courage and it's not um it's not a weakness and it's not going against the beliefs or principles that you have. Um, even if it feels different than maybe what other people in your life would do. Um, even if maybe your parents or your siblings or your loved ones don't don't understand therapy or mental health, it doesn't mean that you shouldn't try to explore that and help yourself to be better.

SPEAKER_01 21:03

I talk about changing culture. Mm-hmm. Like we go back to, and I we said this on I think episodes ago of it's just natural for people to greet people. Good morning, how are you? Yeah. Like when you're asking people, how are you, do you really want to know, or is that just a cultural thing? You grew up listening to people greet people that way, so naturally you want to do it. It's the same thing is we kind of slowly have to break that mold. If you don't want to know how somebody is, don't ask, right? So I think we need to break that mold of it goes back to therapy. Like in your culture, you know, if my mom wasn't comfortable going, doesn't mean that I don't have to. Like I slowly have to, you know, find that courage and be like, you know what? Might be in the best interest for me. Times have changed, and then slowly changed. Because then if I can make that change, then it's gonna follow suit with my son and my husband and everybody else. And then you can slowly make that change.

SPEAKER_02 21:53

Yeah, exactly that. Yes. I I would say, and I hope my husband appreciates me saying this uh on his. Here. But I would say that in the beginning of our relationship, he he knew what therapy was peripherally, but it was not something that he would be interested in or felt like it'd be helpful for him. And over the years, like that has changed significantly. And now he is a mental health first aid trainer. And he he goes around to communities and talks about mental health and encourages. He's a school resource officer. And he encourages kids and their families and teachers to openly talk about mental health and um recommends people to get therapy if it's something beyond what he can support them in as a resource officer. So absolutely, like change is completely possible. And part of that is just like being around it and being exposed to it. So yeah, so stuff like this podcast, for example, is like giving people exposure to talking about mental health in different ways, and hopefully they'll be more open to considering it for themselves or recommending it for someone that they know based on what they hear here.

SPEAKER_01 23:01

I tell people when I train all the time, I am not a bullet point reader. I said, that's not why I'm training. I said I train because I believe in this stuff. And I said, You better believe that my son, his friends, my husband, they get all the same train. They may not sit down for two and a half hours like you guys do and sit through a class, but they get all the same tidbits. Like they learn it all too, because who am I to go out in the community and train if I can't train my own family and friends? Right, right. Exactly. Yep.

SPEAKER_00 23:24

Oh man, this has been a great conversation. It has. I like to ask a last question. Um, you know, given your given your experience um of the decade plus that you've been doing this, you know, what gives you hope for the future?

SPEAKER_02 23:36

I mentioned this earlier, but the thing that gives me hope is that I continue to see uh an increase in the different kinds of people that are going into the mental health field. Um and that says a lot, I think. As as a kid who comes from a family who maybe was not open to mental health or discussions around mental health, for you to choose to go into a field to help people in that area is is an enormous thing. And so it it is remarkable when I think about like um the like the marriage and family therapy program here in town, like the the increase just in the different kinds of students and not even just from the US, they have students from all over the world who are coming to go into the mental health field. And so to me, that is so exciting, and I think that that is going to be a catalyst for decreasing the stigma around mental health and and mental illness. Um, I think that those kids becoming therapists and helping people from their communities, it's just gonna be that trickle-down effect that Michelle was talking about. Um, so I I certainly see a bright future for that because it's it's only continuing to grow.

SPEAKER_00 24:54

That's great.

SPEAKER_01 24:54

Change starts with us.

SPEAKER_02 24:56

That's right. Yeah.

SPEAKER_00 24:57

Thank you for being a part of our show.

SPEAKER_02 24:59

Thank you so much for having me.

SPEAKER_01 25:02

A new day at Pawnee is here. It's about building a mental health system that's easier to access, more flexible, and supportive of our communities. For more than 70 years, Pawnee has been standing with people through challenges and change. Now, therapy, recovery, crisis, and medication services are even more connected, accessible, and ready to meet people where they are. Find out more at Pawnee.org.

SPEAKER_00 25:29

Michelle and I would like you to know pain is temporary, but giving up is permanent, and you don't have to face it alone.

SPEAKER_01 25:36

If you or someone you know is in need of care, hope is available. For local listeners, you can call Pawnee's Crisis Hotline at 1-800-609-2002.

SPEAKER_00 25:48

For our national listeners, you can call or text the National Suicide and Crisis Lifeline at 988.

SPEAKER_01 25:54

Other mental health resources can also be located on our website, Pawnee.org.

SPEAKER_00 25:59

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