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Dimensions of Health Mental health disparities in Black communities

Black barbers train to cut through mental health stigma

As more studies show the connection between racism and mental health, new approaches to help Blacks, especially men, find advocates and get care are springing up in traditional community hubs like barbershops.

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Less than 50% of all Americans with a mental health disorder are able to get the treatment they need. Source: National Institute on Minority Health and Health Disparities

For a homeless man in Kentucky, the free haircuts might have been enough of a blessing, but one man lucked into something more valuable: A barber who connected him to mental healthcare that helped him turn around his life. 

“I grew up in my aunt’s beauty salon as a kid, and I went there every day and it was just a normal transaction as a young person — going there after school, doing my homework, waiting until she got off work to go home,” said Lorenzo Lewis, founder of The Confess Project, an organization that trains barbers as mental health advocates. “That led me to understand how powerful and transformational beauty and barbershops are.” 

The Confess Project, created in 2016, exploits the barbershop’s special role as hubs of conversation and engagement in the Black community, particularly among men. Thus far, the organization has trained over 251 barbers in 20 cities to serve as mental health advocates, reaching over 240,000 individuals, according to Lewis.

Styling itself as a movement as much as another approach to mental healthcare, the organization partnered with Gillette in 2020 for the 16-city “State of the Mind” tour.  Postponed in 2020 due to the pandemic, the tour resumed in March 2021.

Lewis’s organization resolves two aspects of reaching Black men: First, lecturing Black men on what they’re not doing is less effective than leveraging what they are doing. Second, the most impactful approaches connect individual mental health with existing traditions of mentorship and community action.

Lorenzo Lewis, founder of The Confess Project, an organization that trains barbers as mental health advocates. (Photo courtesy of Lewis)

“It’s not often you find guys who just want to be lectured to,” said Ryan Sutton, who holds a doctorate in counseling psychology and serves as director of the Herman Sweatt Center for Black Males at the University of Texas at Austin. “I think that the more that we’re able to put hands on guys and make it conversational, then you see guys really chomping at the bit to get into it.” 

The events of 2020 brought into sharp relief racism’s impact as a chronic stressor — but also signs of what a new healing discourse might look like. For Black men, there has been a decided shift toward acceptance of men’s need for mental health support in these turbulent times. 

Sutton said the past year as a potential turning point. “I think that since George Floyd, it’s different in the sense that I hear it talked about more often in terms of protecting our own mental health in a social and political landscape where we continuously find ourselves at the worst end of it,” he said. 

With the deaths of Breonna Taylor and Ahmaud Arbery having already opened gaping wounds, Sutton said, Floyd’s death may have been the “straw that broke the camel’s back.”

But Black people were under tremendous psychological strain long before Floyd’s video-captured murder in Minneapolis in May 2020. Eleven months later, Derek Chauvin was convicted of the murder, which he committed while a Minneapolis police officer. 

While Chauvin’s conviction might bring some respite from rage and grief, the continuous trauma is unquantifiable — its effects compounding across generations. Biopsychology even has a term, “allostatic load,” which captures the toll that chronic exposure to stressful experiences takes on the human body. 

“I think what hasn’t changed, though, is that a lot of our conversations are still very reactive,” Sutton said. All too often, he said, conversations about Black mental health erupt in moments of crisis or perceived threat, which overshadows more proactive approaches. 

Darnell Rice speaks to barbers at the Profile Institute of Barber Styling in Atlanta. (Photo courtesy of Max-El)

There is mounting medical evidence that allostatic load is elevated in historically marginalized groups. For Black people, racial trauma that accumulates throughout a person’s life leads to activation of stress responses and even hormonal adaptations, increasing the risk of chronic disease and earlier death. 

A U.S. Centers for Disease Control and Prevention study found that only 26.4% of Hispanic and non-Hispanic Black men (aged 18-44) went in for mental health treatments — a number significantly less than the 45.4% of non-Hispanic white men in that same age group who sought treatment.

The tendency of all men, regardless of racial and ethnicity, to shy away from help-seeking, combined with the unique stressors faced by nonwhite men and boys, lead to mental health challenges that show up in other ways —  such as, isolation, substance abuse, or acting out through violence and aggression — that can lead to more stigma and a continuation of the cycle.

But far from the news being all bleak for Black men, Sutton sees potential in efforts to meet Black men where they live and to flow mental health support through existing community institutions — such as barbershops.

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Imani Evans

Dimensions of Health

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Episode Mental health disparities in Black communities