Minority Women and Depression

​Musenge Lachembe Hayslett, a Nashville psychotherapist, shares her knowledge about how depression affects black women, along with some of the barriers for treatment.

Begin Transcript 

Rosemary Cope:  Welcome to this edition of the Vanderbilt University Health and Wellness Wellcast .  I am Rosemary Cope with Work/Life Connections.  Our guest today is Musenge Luchembe Hayslett.  She is originally from Los Angeles but lived in the African country of Botswana until she was 16.  She has studied at the University of California Berkeley and at John F. Kennedy University.  She is currently in private practice in Nashville.  Anyone can experience mental illness, but women are at least twice as likely to experience an episode of major depression as men, and compared to their Caucasian counterparts, African-American women are only half as likely to seek help.  Musenge, thank you for being with us today, and what are your thoughts on how mental health conditions affect African-American women?

Musenge Hayslett:  Thank you for having me on your podcast.  I am grateful for the opportunity to discuss a very important topic.  I'm a multicultural individual and I've always practiced with very diverse populations in my private practice and the agencies in Oakland and San Francisco.  So, I feel comfortable stating that African-American women are affected by mental health conditions in the same way as other racial groups.  The isolation, hopelessness, fatigue, sleep disturbances, strained relationships, weight changes are all present.  I think what differentiates our experience and makes us less likely to seek and receive the appropriate treatment is how our symptoms are perceived by health providers, our access to treatment, and stigma.

Rosemary Cope:  What are some of the barriers that you eluded to that women might have in asking for and receiving quality mental health?  And you mentioned there's a bias or there might be a stigma attached to receiving mental health.  Could you tell us a little bit more about that?

Musenge Hayslett:  Access to treatment is probably one of the biggest barriers.  Very few of us therapists take insurance because managed care tends to put a lot of restrictions on our ability to provide care, and there is a wage gap for African-American and women of color, and that is much lower than our white counterparts.  So, many African-American women cannot afford to pay $80-$120 a week for therapy out of pocket.  And then, as far as stigma, faith and religion can be a double-edged sword in our community.  The black church has been, and still is for many, the most powerful resources in the African-American community and probably one of the most welcoming and least oppressive institutions that African-Americans have access to in this country; however, some of the leaders spread a message that all you need is God when it comes to mental health conditions, and this is not true, because I have several deeply spiritual clients that are really suffering in silence, and as a wholistic therapist, I feel it is possible and necessary to incorporate spirituality into treatment.  And regarding provider bias, our country has a history of racial inequality, and that has had a big impact on how we perceive African-American women.  Stereotypes such as the "strong black women," "angry black women," "Jezebel," and "Mammy," and often being characterized as overly dramatic and antagonizing can result in misdiagnosis, and a lack of attunement between the client and the therapist.  And because of the media portrayal of African-Americans in the news and reality T.V., it is very easy to incorporate these depictions into our work.  And doctors and therapists are not exempt from taking these stereotypes into the exam room and the therapy room.  

Rosemary Cope:  How would a woman recognize those signs of depression (you mentioned some of them at the beginning of our talk) and understand how she needs help and actually going about the process of getting there?

Musenge Hayslett:  So, with the symptoms, there's hopelessness, lack of energy, lack of interest in doing the things that you once enjoyed, weight loss or weight gain, sleeping too much, or little, or just poor quality of sleep, and irritability and anger.  This also looks like very strained relationships, not really wanting to go into work, not performing as well.

Rosemary Cope:  Are there places that you might recommend for somebody who is listening who says, "Boy, this sounds like me, but where do I go?  If I can gather my courage, where do I go to get help?"

Musenge Hayslett:  There is actually a directory called "Therapy for Black Girls," and it links African-American black clients with African-American therapists in the different locations.  So, that's a really good place to start.  There's also organizations like "Open Paths Psychotherapy Network," which provides care for relatively lower ... about the price of a co-pay, so between $30-$50, and they are guaranteed to charge you no more than that.  Those are two organizations that I am fairly aware of that are helpful and a good place to start.

Rosemary Cope:  Can you also give us some information about how to deal with the barriers that women might face?

Musenge Hayslett:  Provider bias can be remedied by increasing access to culturally-competent care, so more African-American providers being available and also better training ... not necessarily just educating about specific ethnic groups but really teaching providers how to consistently examine and question their own biases and privileges.  There's also a Facebook group called "Therapy for Black Girls Thrive Tribe" and this is a place where black women can ask questions about mental health and receive responses (some of them are from therapists and the general community) without worrying about judgment.

Rosemary Cope:  I really appreciate, Musenge, you giving us at least some places to start to look that, if I am listening to this and I am a black woman and I am wondering where can I go to get help, along with going through your Vanderbilt EAP, there are places in the community who are open and welcome to you.

Thank you all for listening.  If you have a story or a suggestion, please email it to us at health.wellness@vanderbilt.edu or you can use the "Contact Us" link on our website at www.vumc.org/health-wellness.