Make Your Mood Bloom: Mental Health Benefits of Gardening

Since the days of the visionary nurse Florence Nightingale (1820-1910), people have used gardens to promote healing and reduce stress. What is it about a garden that lifts our spirits, and how can gardening improve our mental health?

Studies show that observing nature or even images of natural scenes have positive effects on our mood and mental health. Patients who can see plants from their hospital rooms need less pain medication and have fewer surgical complications. Hospital courtyard gardens lift the spirits of patients, visitors, and staff.

Gardening is great for your mind and your body. Activities like digging and weeding build strength and dexterity. They can also increase focus and decrease anxiety and depression. Outdoor gardening exposes you to sunlight, which increases vitamin D levels. This can help lower your blood pressure and heart rate.

Even Better with Others

While gardening offers a lot of personal benefits, it doesn’t need to be a solitary activity.

Working with neighbors to beautify a park, school, or other outdoor space can increase community pride. It can also restore social connections that may have been lost during the pandemic.

Community vegetable gardens are growing in popularity. They provide nutritious food for people who live in food deserts or are struggling with food insecurity. And growing food is good for you, too. Studies show people who grow food tend to make healthier food choices.

“Gardening is an all-ages activity, but it’s a great activity for seniors,” says geriatrician and Independence Blue Cross Medical Director for Government Markets Heidi J. Syropoulos, M.D. “Most people think of gardening as an outdoor activity. But gardening is also watering houseplants, growing fresh microgreens on a kitchen windowsill, or tending strawberry bushes on your porch. You get physical and mental health benefits from plants, regardless of whether they are indoors or outside.”

No Green Thumb Necessary

Some people have a talent for growing plants. If that’s not you, don’t worry. Gardening websites and home and garden centers can help you find your inner green thumb.

Seed mats make it easy to grow flowers or veggies. These thin sheets have seeds woven into them. You put the sheet in dirt, cover it with soil, and water as directed. In a few weeks, you have a beautiful garden. If you need something easier, mini-cactus blooms can brighten your space and your mood.

A Local Tradition

In our region, the Pennsylvania Horticultural Society (PHS) promotes horticulture – the science and art of growing fruits, vegetables, flowers, and plants – to advance the health and well-being of the people of Philadelphia. The PHS plans and oversees the Philadelphia Flower Show, which is the largest, longest-running horticultural event in the country. In addition to working throughout the year to maintain free public gardens in more than 250 neighborhoods, PHS offers educational activities for gardeners of all levels.

Gardening improves your mental and physical health. Whether it provides a creative outlet, a chance to strengthen community ties, or a way to brighten your home and mood, the benefits of gardening keep blossoming.

For more information about mental health, self-care strategies, and where to find help, visit ibx.com/knowyourmind.

Making Sure the Kids Are Alright

It’s a question parents, teachers, and researchers alike are asking. The COVID-19 pandemic robbed many teens and young adults of precious learning and socializing time. Add to that the challenge of not having enough mental health providers to meet the demand for counseling, and you’ve got a serious problem.

According to the Harvard T.H. Chan School of Public Health, the pandemic led to a decline in kids’ overall mental health. But that impact varies, depending on factors including age, family circumstances, and preexisting conditions.

Results from a 2021 National Survey on Drug Use and Health showed that nearly half of kids ages 12 to 17 who had a major depressive episode (MDE) in the past year said the pandemic negatively impacted their mental health either “quite a bit or a lot.” That’s concerning because only 12.4 percent of their peers without an MDE reported similar levels of impact.

Not a New Problem

Although the pandemic may have put a spotlight on teen mental health, rates of depression and anxiety in children have risen steadily in the last ten years. Many experts think this trend is unlikely to improve without rethinking how we approach teen mental health care. As a result, the U.S. Preventive Services Task Force now recommends regular anxiety screenings for children ages 8 to 18 and regular depression screenings for adolescents ages 12 to 18.

The Power of School Connection

According to the Centers for Disease Control and Prevention, one of the most important factors in boosting students’ emotional resilience is “school connectedness.” This is the feeling of being supported and belonging at school. Students who felt connected to adults and peers at school were significantly less likely to report feelings of sadness or hopelessness.

Experts believe that students can benefit from multiple support systems in school. But given the shortage of available counselors, only about half of U.S. public schools offer mental health assessments, and even fewer offer treatment services.

In Philadelphia’s public schools, the STEP Program provides mental and behavioral health and social services to students and families. The school district works with the Mayor’s Office of Education, Community Behavioral Health, Drexel Community Partners, and the Department of Human Services to provide this support.

At the state level, Pennsylvania recently made $190 million available for school mental health and safety programs for the 2022‒23 school year. Districts that applied by August could receive a base grant of $100,000 for safety and security improvements, with another $100,000 for mental health programs and training. Additional funding may be available based on population.

“What we need is to build capacity through all of the systems that are part of children’s lives — in families, in schools, in the education of everybody who interacts with children,” says psychologist Ann Masten, Ph.D., a professor of child development at the University of Minnesota.

Focusing on Student Mental Health at Girard College

Youth from underserved communities are less likely to receive mental health care services. To address this disparity, the Independence Blue Cross Foundation is funding a multi-year pilot initiative to provide access to mental health care for every student at Girard College. Girard College is an independent, five-day boarding school in Philadelphia. It serves approximately 300 students in first through twelfth grades from families with limited financial resources. More than 80 percent of the student population identifies as African-American.

This innovative care model integrates school support with telehealth services provided by Children’s Hospital of Philadelphia. “The pandemic amplified the urgent need for access to mental health care as young people were faced with additional difficulties such as school closures, family stress, social isolation, and economic challenges,” said Foundation Executive Director Heather Major. “A key goal of this collaboration is to create a replicable model for bringing mental health services into schools in a sustainable way.”

The pandemic showed us students of all ages need greater access to mental health care. “The focus needs to shift up toward preventive care and secondary and early intervention,” says Archana Basu, research scientist and clinical psychologist at Massachusetts General Hospital. Independence Blue Cross will continue to support efforts to improve access to mental health care for youth in the community.

If you or someone you know may be experiencing anxiety or depression, please seek help. If you don’t know where to begin, visit ibx.com/knowyourmind. If you are having suicidal thoughts, please call the National Suicide Prevention Lifeline by dialing 988.

Eating Disorders: Advice for Parents and Caregivers

Aside from opioid use disorder, do you know what the second deadliest kind of mental health problem in the United States is?

Eating disorders.

Tragically, eating disorders are very common in children and adolescents.

  • Nearly a third of children aged five – six have a body size ideal that’s thinner than their current perceived size.
  • By age seven, one in four children has engaged in some kind of dieting behavior.
  • 93 percent of young women engage in “fat talk” (criticizing each other’s appearance and weight) in everyday life.
  • 53 percent of American girls report being unhappy with their bodies at age thirteen, 78 percent at age seventeen.
  • 95 percent of people with eating disorders are between the ages of 12 and 25.

If anything, the COVID-19 pandemic has increased the prevalence of child and adolescent eating disorders by compounding the stress that young people experience daily. If you’re a parent or caregiver, it’s vitally important for you to be aware of these disorders and know what to do if you notice any troubling eating behaviors in your home.

Types of Eating Disorders

There are many kinds of eating disorders. The most common ones include:

Anorexia Nervosa

People with anorexia severely restrict how much food they eat. They may also exercise compulsively and/or purge (see Bulimia Nervosa, below). They usually see themselves as overweight, regardless of their body size. This can cause thinning of the bones and infertility, and can ultimately result in heart, brain, or multi-organ failure and death.

Bulimia Nervosa

Bulimia is characterized by binge eating (devouring large amounts of food uncontrollably) and then purging (trying to undo these binges through vomiting, fasting, laxatives, compulsive exercise, and other methods). Purging can cause an inflamed or sore throat, tooth decay, acid reflux, and severe dehydration. Ultimately, bulimia may create electrolyte imbalances that can lead to stroke or a heart attack.

Binge Eating Disorder

As with bulimia, people with this disorder will eat large amounts of food at one sitting. They may feel shame, disgust, or guilt about this. But, unlike people with bulimia, they don’t purge. They face an increased risk of complications like heart disease, stroke, and type 2 diabetes.

Avoidant Restrictive Food Intake Disorder (ARFID)

People with this fairly newly recognized disorder only eat a very limited number of foods. This is easily dismissed as just “picky eating,” especially in children. But individuals with ARFID don’t ingest enough calories to develop properly, or even maintain basic body functions. This can create dangerous electrolyte imbalances.

The Role of Body Image

Many kids and teenagers (and grownups) have body image issues, and this can play a big role in anorexia and bulimia. There’s so much pressure in our society to look a certain way — coming not just from in-person peer interactions, but also social media, TV, and other sources.

Kids and teenagers may compare themselves to unrealistic ideals and try doing something drastic to look the way they think they’re supposed to. Or to fit into a particular weight class for their favorite sport.

One thing you can do to help keep your child healthy is to encourage them to accept themselves the way they are and recognize that they’re attractive and worthy. Bodies come in all sizes and shapes. We can’t all look like [insert your child’s celebrity role model here].

Eating Disorders Aren’t Just for Girls

It’s commonly believed that only girls get eating disorders. However, the truth is much more complex. People of all genders and sexualities experience eating disorders. So it is important to tune in and recognize the signs of an eating disorder in all persons.

If You Think Your Child May Have an Eating Disorder

As a parent or guardian, you’re better positioned than anyone else to notice changes in your child’s eating patterns or an ongoing obsession with food or their weight. With that said, don’t try to diagnose or manage your child’s eating issues yourself. You and your child may not be the best judges of whether their weight or eating habits are healthy, or what to do if they’re not.

If you think your child may have an eating disorder, talk to their pediatrician or family doctor. They’ll also be screened for eating disorders at every well visit. If a health care provider believes your child has an eating disorder, they will probably be able to recommend where to take them for treatment.

There are many strategies for treating eating disorders. Treatment usually begins with some form of psychotherapy as well as nutrition education. More advanced cases may require hospitalization, a day treatment program, or a residential treatment program.

Independence Blue Cross members can find all these resources on our Provider Finder. All our health plans cover nutrition counseling and behavioral health treatment. And Registered Nurse Health Coaches are available to our members 24/7; call 1-800-ASK-BLUE (1-800-275-2583) (TTY/TDD: 711). You can also call the National Eating Disorders Helpline at 1-888-375-7767.

If your child has an eating disorder, they will have to learn to change their relationship with food. And you’ll need to learn how to support them along the road to wellness.

It probably won’t be a “quick fix.” It could be a long, tough journey. But it’s a necessary one, for your child’s immediate and long-term health. And the sooner it begins, the better.

Loneliness is a Serious Condition Among Seniors

In Japan, 65 percent of seniors live with their children, and in Italy, about 39 percent do. But in the United States, the figure is only about 20 percent, despite a rise in multi-generational households in recent years.

It’s just one of many factors that cause approximately one-quarter of Americans aged 65 and older to be socially isolated. People over age 50 are more likely to experience the risk factors for social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and reduced vision and hearing abilities.

It’s not surprising that being lonely is associated with higher rates of anxiety, depression, and suicide. However, a substantial body of evidence shows that social isolation also poses a major risk for physical problems including premature death — a risk level that’s comparable to having high blood pressure, smoking, or being obese.

Social isolation — a lack of social connections — is associated with a 50 percent increased risk for dementia. And loneliness among heart failure patients was associated with higher risks of death, hospitalization, and emergency department visits.

Pandemic Fallout

“Senior isolation was a tremendous problem during the pandemic,” notes geriatrician Heidi J. Syropoulos, MD, medical director of Government Markets at Independence Blue Cross (Independence). “It affected people who would never have considered themselves socially isolated before — whose children visited them all the time, or who perhaps had a caregiver that took care of their finances, or brought them a meal once a week, or went grocery shopping for them.”

“During the pandemic, some of those things still happened, but the affected individuals did not see those caregivers. They just dropped off the groceries or a meal at the front door and then left. So social isolation definitely increased during the pandemic. I think it’s gone back down a little bit now, but not to where it was before.”

Technology has helped bridge the loneliness gap to some degree, as seniors have become accustomed to using computers and other devices to keep in touch with family, friends, and health care providers. However, there’s no substitute for face-to-face social contact. For this reason, many local houses of worship and community service organizations are working to fill the gap to help seniors build relationships and maintain their quality of life.

Local Supports Deliver Connection

If you’re feeling socially isolated, the World Health Organization offers three key pieces of advice:

  1. Get in touch with friends by either meeting them in person or contacting them by phone or through social media.
  2. Do the things you enjoy, like engaging in a hobby or spending time outdoors.
  3. Reach out to local services that can connect you to new people, communities, or professional help.

The Philadelphia Corporation for Aging, for one, provides Community & Connection programs at 28 PCA-supported senior centers in the City of Philadelphia. They also offer health and wellness programs, volunteer support, and job training services that keep seniors active and engaged. To learn more, call the PCA Helpline at 215-765-9040 Monday through Friday, 8:30 a.m. to 5 p.m., except for major holidays.

In Montgomery County, the Senior Adult Activities Center helps seniors continue to be active, creative, healthy, and engaged in the community. Other resources include three Meals on Wheels programs, two senior centers, and an inter-generational art center — the Ambler Senior Adult Activity Center.

Similar organizations and services exist in Bucks, Chester, and Delaware counties.

Isolation can take a devastating emotional, cognitive, and physical toll over time. If you are an older adult, any steps you can take to maximize your social interactions will have a huge benefit.

If you or someone you know may be experiencing anxiety or depression, depression, please seek help. If you don’t know where to begin, visit ibx.com/knowyourmind. If you are having suicidal thoughts, please call the National Suicide Prevention Lifeline by dialing 988.

You’ve Got This: Five Tips for Setting Achievable Resolutions

It’s a good idea to set goals at the beginning of the year. In fact, research shows that people are more motivated to make changes at the start of a year, a month or a week. Beginnings encourage us to muster our focus and resolve.

But research also shows that we’re unlikely to persevere unless we anticipate and plan for obstacles ahead of time, says Benjamin Converse of the University of Virginia. If the goal is to lose weight, for example, we might need to carve out the time and money to plan meals and grocery shop for healthy ingredients in order to maintain a home cooking routine.

How can we keep our good intentions alive, without quitting our goals and feeling worse about ourselves than before we started? Success is not necessarily a reflection on who you are as a person, says Ayelet Fishbach, professor at the University of Chicago’s Booth School of Business. Success can depend on being at the right place and time with the right people.

To help you along, we offer some advice from Independence Blue Cross Medical Directors Reetika Kumar, MD, FACP and Ryan Connolly, MD, MS; as well as academics who have researched the science of motivation.

1. Set positive and realistic goals.

It’s actually very hard to just stop doing something, particularly when it has become a habit,” says Dr. Connolly. A key approach is to commit to a positive habit that’s incompatible with the one you’re trying to get rid of. So, instead of deciding to “stop lazing in bed every morning,” it is much better to decide to exercise every morning at 7am. “It’s very hard to lie in bed while exercising!” he adds.

In addition, it’s important to set realistic goals, says Dr. Kumar. “Don’t set yourself up for failure. Losing the 20 pounds you’ve gained in the past year can’t be done in a month, but maybe a 1-2 pound a week goal will keep you going.”

2. Monitor your progress and see where you are at the midpoint.

If you need to adjust your goals, have the flexibility to do so. To-do lists can be helpful when one item motivates you to do the next one but keep sight of your priorities. University of Virginia professor Leidy Klotz has found that it’s often more important to remove items from your list than to add new ones.

3. Don’t work at cross purposes.

Make sure your rewards don’t sabotage your goals, Dr. Kumar says. “If you’re trying to lose weight, have your reward be a new pair of jeans rather than an all-you-can -eat buffet at your favorite restaurant.”

4. Seek social support.

Surround yourself with people who can help you succeed. Find a buddy who shares your goals and can keep you motivated, Dr. Kumar says. An accountability partner can help you stick to your goals.

5. Pair the hard work with something you like to do.

Based on the work of behavioral scientists Katy Milkman, Julia Minson, and Kevin Volpp, the technique of bundling temptations recognizes that we struggle to do what’s distasteful in the moment, but we can reach our goals by relying on short-term gratification rather than willpower.

If you find it hard to exercise, for example, pair it with listening to your favorite music or podcast. Need to stop putting off studying? Reward yourself with a favorite TV show if you finish by 9:00 pm. Don’t feel like raking leaves? Challenge a family member to a competition and the winner gets to pick the evening movie.

The goal is to “take the fun that might typically distract us from our goals and use it to transform an obstacle into an enticement,” Milkman says.

For more information about mental health, self-care strategies, and where to find help, visit ibx.com/knowyourmind.

The Power of Talk: Erasing the Stigma of Suicide

Jason was happily married and a proud father of three who seemed to have everything to live for. So, his family was shocked when he died by suicide. They had no idea he had been struggling with depression.

Because admitting mental illness still carries a stigma in many circles, Jason’s story is not unique. The highest proportion of suicides in America is among middle-aged white men. They die by suicide almost four times more often than women, accounting for 69 percent of U.S. suicide deaths in 2020. But the number of Black teens of both sexes who have attempted suicide rose 73 percent between 1991 and 2017, and suicide is the second leading cause of death for youth between ages 12 and 18.

“Generally, when people don’t talk about depression or suicidal feelings, it’s because they don’t feel safe,” says H. Jean Wright II, PsyD, Deputy Commissioner of Philadelphia’s Behavioral Health and Justice Division and Department of Behavioral Health and Intellectual disAbility Services.

“Often people say there were no signs,” Dr. Wright says. “That’s an indication we may be having conversations, but it isn’t specific, so we don’t always realize the person is reaching out or feeling out whether this a safe person. They might be talking about challenges, but not saying, ‘I’m feeling depressed.’ They may not name it, and most of us are not looking to hear it, so we don’t pick up on hints. So, a lot of times, paying attention to changes in behavior is more of a red flag.”

Of course, being able to detect changes in someone’s personality or other common symptoms of depression, such as changes to their sleeping or eating habits, requires a close relationship.

Learn to Recognize the Signs

Mental Health First Aid can help teach us what to look for and what to say. Philadelphia was the first big city to bring the program to scale by offering it widely, with the goal being to teach people the signs and symptoms of behavioral health challenges, including mental illness and substance use disorder, so that people in need can be referred for professional help. The class is both online and in person, with versions tailored to people who work with veterans, children and youth, public safety, colleges/universities, and faith-based organizations.

When talking with someone about suicide, be genuine and lead with concern, Dr. Wright says. “Use ‘I’ statements – ‘I’m concerned’ and back it up with examples: ‘Normally, we have coffee together, and I haven’t seen you coming in. Is there something you’d like to share with me? I just want you to know I care about you, and I’m here to talk.’ They might be testing the waters to see who is willing to go down the road with them. Then you have to be there when they need you.”

Bringing up the topic of suicide isn’t likely to introduce the idea to a person in pain. “They’re actually relieved that people bring it up,” Dr. Wright says. “I wouldn’t go there immediately. Start with concern, and the next questions might lead up to it. Ask, ‘Have you thought about suicide? If they respond with a ‘yes,’ then ask, do you have a plan? Do you have the means to carry it out?’” You’re assessing how serious the plan is and whether they have the means to carry out a plan. If so, then you know it’s an emergency.

Public Discussion Helps Erase Stigma

Public conversations are also important because they can encourage and give strength to people who might not have close personal relationships. One study of the effectiveness of an anti-stigma social marketing campaign in California found that social media posts led more individuals to interpret their symptoms of distress as requiring treatment.

Fortunately, stigma around seeking help for mental illness is lower among younger people. A 2020 national survey found that 90 percent of teens and young adults experiencing symptoms of depression are researching mental health issues online, and most are seeking out other people’s health stories through blogs, podcasts, and videos.

Numerous celebrities, from Michael Phelps and Demi Lovato to Dwayne “The Rock” Johnson and Lady Gaga, are sharing their struggles with depression, highlighting the issue and helping to spread the message that depression can affect anyone — even those who seem to have it all.

“Suicide is not a respecter of a person’s age, race, or religion — it impacts all of humanity,” Dr. Wright says. Families, organizations, and faith communities can all be safe spaces to talk. “People need to know it’s okay to not be okay.”

If You Need Help

If you or someone you know is in immediate distress or is thinking about hurting themselves, call the National Suicide and Crisis Lifeline toll-free at 1-800-273-TALK, (8255) or call or text the new 988.

For more information about self-care strategies for mental health and where to find help, visit ibx.com/knowyourmind.

Finding the Right Type of Mental Health Provider

The demand for mental health services has skyrocketed since the start of the COVID-19 pandemic. At the same time, the U.S. faces a chronic shortage of psychiatrists and other mental health professionals. As a result, 65 percent of mental health organizations reported having to cancel, reschedule, or turn away patients in 2020.

In order to fill the gap, some primary care offices have developed collaborative care models. With these models an affiliated psychologist or social worker provides therapy and patient management and consults with a psychiatrist on medications. Other health care providers are undertaking additional mental health training to meet patient needs.

Psychiatrist, Psychologist, Therapist: Which Do You Need?

Determining the right mental health provider can be confusing. Should you see a psychiatrist, a psychologist, or a therapist? What exactly is the difference? The first difference is whether a professional specializes in prescribing medication, providing therapy, or both.

Prescribers and therapists are both mental health professionals whose expertise is the mind and the way it affects behavior and well-being. They often work together to diagnose and treat a patient. For example, a patient might see a psychiatrist who prescribes medication for depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), or bipolar disorder, and also work with another mental health professional for psychotherapy, also known as talk therapy or counseling.

Prescribers

Psychiatrists are physicians (M.D. or D.O.) who specialize in the assessment and treatment of the biological, psychological, and social factors that lead to behavioral health conditions. A psychiatrist may prescribe medication and may provide therapy as well. Often, the psychiatrist prescribes medication and acts as the leader of a treatment team that may include other professionals who provide therapy.

Psychiatric mental health nurse practitioners are another kind of professional that can prescribe medication for behavioral health conditions. They have a master’s of science in nursing or doctor of nursing practice degree with specialized focus on psychiatry. They provide diagnosis and therapy for mental health conditions and can prescribe medications independently or under the supervision of a medical doctor, depending on the state.

Therapists

Psychotherapy (also known as talk therapy, or just “therapy”) helps people deal with various mental illnesses and emotional difficulties. Therapy can help eliminate or control troubling symptoms so a person can function better. Depending on the issue, therapy can be short-term (a few sessions), or long-term (months or years). Psychotherapy is often used in combination with medication to treat mental health conditions. Therapy can be provided by several different kinds of professionals:

Psychologists have a doctoral degree in psychology and know how to evaluate and treat behavioral health disorders, but generally are not licensed to prescribe medication. In order to receive their license, psychologists also complete an internship with specific training in behavioral therapy and other methods of treatment. Once licensed, a psychologist is qualified to provide psychotherapy, counseling, psychological testing, and mental health disorder treatment.

Master’s level professionals

Licensed clinical social workers have a master’s or doctoral degree in social work and also complete two years of postgraduate supervised clinical work to become licensed. They are trained to evaluate and treat mental health issues, provide individual and group counseling, and like other therapists have varied specializations.

Licensed professional counselors and licensed marriage and family therapists are qualified to provide counseling or psychotherapy for mental health treatment. They have a master’s degree in psychology, counseling, or a related field, plus at least two years of postgraduate training working alongside a qualified mental health professional.

This list is not exhaustive and requirements often vary by state. It’s also important to note that your behavioral health is often best managed by a team that communicates well and uses each area of expertise to take care of you as a whole.

Getting Started

Your primary care provider is a great place to start discussing your mental health concerns. They are well-equipped to assess mental health needs and prescribe necessary medications, or to refer you to an appropriate specialist for counseling or psychotherapy.

In addition, many Employee Assistance Programs can be a source of mental health services to help employees with emotional and substance use issues, interpersonal relationships, legal problems, or financial difficulties. These services might be delivered in person, by telephone, or via online platforms.

There are also companies available, like Quartet*, that use specialized technology to help people more easily find and access care that’s right for them. Quartet does not provide direct mental health care. It works with health plans, like Independence Blue Cross, to match members with licensed mental health providers and programs that meet their needs and preferences, and accept their health insurance.

In summary, there are different types of support available to people seeking mental and behavioral support, and there are professionals skilled in getting you to the right provider. It all begins with that first call.

For more information about mental health, self-care strategies, and where to find help, visit ibx.com/knowyourmind.*Quartet is an independent company.

The Black Paradise Project: Countering the Mental Health Impact of Racism with Black Joy

As Philadelphia comes to grips with the mental health impacts of racism, how can we create a productive path forward?

One unique initiative, the Porchlight Program of Mural Arts Philadelphia, put out a call for a psychologist and visual artist to develop a project to address mental health issues within the Black community. In response, counseling psychologist Kimberly Marie Ashby, PhD, and visual artist Yannick Lowery created the Black Paradise Project. The project aims to reduce the mental health burden of exposure to racism by providing opportunities for Black people to share their experiences and engage in joy.

“Anti-Blackness is a serious problem,” says Dr. Ashby, whose research focuses on racial trauma and its effects on mental health. “A lot of the literature demonstrates that engagement in joyful activities — specifically activities that allow you to feel connected to others and put you in a state of flow and mindfulness — allow people to create a life worth living, despite the fact that they are negatively impacted by racism.”

Providing Relief During a Time of Turmoil

With input from Philadelphia’s Department of Behavioral Health and Intellectual Disabilities Services, the Black Paradise Project organizes a variety of events, from dance and yoga to nature hikes and reflective writing workshops. People of all ages and communities throughout Philadelphia attend these activities. “Our events have the goal to help people find peace and relief, especially during a time of racial turmoil,” artist Lowery says.

Lowery is incorporating images from the organization’s events during the past year into a mural that will be installed in West Philadelphia. The mural’s composition will demonstrate the methods that members of the Black community have used to “find paradise.”

The adult Black community is 20 percent more likely to experience serious mental health problems such as major depressive disorder or generalized anxiety disorder, according to Thomas A. Vance, PhD, of Columbia University’s Department of Psychiatry. The increased incidence of psychological difficulties, Vance says, is related to the lack of access to culturally responsive mental health care and prejudice inherent in the daily environment, as well as issues related to economic insecurity and the associated experiences, such as violence and criminal injustice.

Racial trauma is a form of post-traumatic stress disorder, but it’s never-ending,” Dr. Ashby notes. In a culture that often demands a show of strength and resilience, “There’s never any room for softness or vulnerability,” she says. “True freedom is being able to be fully human.”

The Black Mental Health Anthology Project

To reduce the stigma of seeking care and to help people cope, the Black Paradise Project launched the Finding Paradise: A Black Mental Health Anthology project this spring. From 30 submissions of visual art, essays, and poetry, Lowery and Ashby chose 19 to appear in a digital and printed anthology known as Finding Paradise: A Black Mental Health Anthology.

.The work is powerful. In “I’ll Show You the Way,” award-winning artist Afi Ese, of Houston, Texas, holder of a master of science degree in forensic psychology, depicts a dark bird covering a man’s head like a headdress. The image invites viewers to decide if the figure is wearing the animal or perhaps directing him.

In the 2018 poem, “You have that Depression thing, right?” Ailisha Sher of Philadelphia writes, “When sadness walks in/Grey is the only color I can wear without fear of a witch-hunt, and/Trees become helpless victims to intense bear hugs because at least trees can’t run away from me.”

“I was blown away” by the submissions, Lowery says. “I didn’t expect people to be so vulnerable. I think people can benefit from these and realize that they’re not alone.”

“I’ll Show You the Way,” Afi Ese
Source: Finding Paradise: A Black Mental Health Anthology. © The Black Paradise Project. blackparadiseproject.com/anthology

For more information about mental health self-care strategies and where to find help, visit ibx.com/knowyourmind or mindphltogether.com.

For Black Women Who Say They’re Okay When They’re Not

How are you feeling? 

As leaders in our communities, workplaces, families, and homes, Black women are often carrying a physical and emotional load for themselves and those around them.

Earlier this year we got a sobering reminder of the invisible baggage we carry when we learned about the death of Cheslie Kryst, former Miss USA and entertainment news correspondent at Extra

From the outside, the 30-year-old appeared to have it all. With a pageant crown, multiple degrees, talent, and charisma, she exuded what some would describe as “Black Girl Magic.” But in a social media post confirming her suicide, Kryst’s mother, April Simpkins, revealed Cheslie was dealing with high functioning depression.  

What is high functioning depression? The clinical term is dysthymia. According to Psychology Today, three causes of high functioning depression are trauma, intergenerational depression, and unresolved frustration, something many Black women know about.

In 2007 the Journal of Multicultural Counseling and Development published the report “Cultural dysthymia: An unrecognized disorder among African Americans?” The report states, “After more than 250 years of enslavement, prejudice, and discrimination, dysthymia is reflected in chronic low-grade sadness, anger, hostility, aggression, self-hatred, hopelessness, and self-destructive behaviors.”

As we’re starting to emerge from the pandemic and the stress of the past two years, it’s OK to not be OK. But if you’re not, it’s important to get help.

Here are six ways to mind your mental health:

  1. Make a to-do list and a to-don’t list. Too often we try to take on everything and consequently suffer from burnout. Try this Trash, Transfer, Trim, Treasure exercise we use at The Ladipo Group to help you recognize responsibilities and activities you should stop doing, delegate, spend less time on, or continue doing because it brings you joy.
  2. Ask for help. There’s no shame in admitting your emotions might be too much to process on your own. Use resources like TherapyForBlackGirls.com to find a therapist in your area.
  3. Rest, rest, rest. Whether it’s getting the amount of sleep you need each night or taking small rest breaks throughout the day, allow time for your body and mind to stop moving, shut down, and rest.
  4. Move your body. Dance, exercise or do anything that gets your body moving daily. Movement boosts your mood by releasing endorphins which make us feel good.
  5. Curate your social media. Oftentimes we scroll through our phones and feel lousy. Review the people you follow and content you absorb, and delete those that don’t add joy.
  6. Intentionally cultivate and connect with your tribe. Our tribes of sister-friends get us through the darkest times and celebrate the joyful times as well. Don’t wait until you’re in the depths of despair to reach out. Sometimes a text or funny meme is all that’s needed.

If you struggle to take time out to care for your mental health, remember that you’ll be better able to care for others when you’re filled and refreshed from first caring for you!

Tonya Ladipo is the Founder and CEO of The Ladipo Group, the region’s only therapy, counseling, and Diversity, Equity, and Inclusion consulting practice specializing in serving Black and African-American communities.

The Search for Culturally Competent Care

Fans of the award-winning TV series ‘This is Us’ may remember the episode where Randall decides to switch therapists. The character—a successful commodities trader turned Philadelphia City Councilman—is African American, was raised by a white family, and struggles with anxiety and PTSD. He admits that he isn’t comfortable sharing many of his feelings with his current therapist. His new doctor is “cool, smart, funny, Black, young father… we got a lot in common,” Randall explains.

Does your therapist ‘get’ you? The answer to this question is a key factor in mental health recovery. 

Finding a provider you trust, who you connect with and who has experience working with people like you, isn’t always easy. Yet it is especially important for members of minority groups—many of whom suffer generational trauma from systemic racism, yet don’t receive the treatment they need. 

The numbers are telling. Forty-five percent of U.S. adults with mental illness receive help, but just 23 percent of Asian Americans and Pacific Islanders (AAPI) adults, 33 percent of Black adults, 34 percent of Hispanic/Latinx adults, and very few Native people with mental illness get treatment. 

This is National Minority Mental Health Awareness Month—a time to focus on the unique struggles around mental illness that minority communities in the United States face, along with the solutions. Finding culturally competent providers is one of them. 

What is cultural competence in mental health? 

Cultural competence is understanding that a person’s values, experiences, and personal beliefs are shaped by their ethnic and community identities and the influences that come with it. These factors can also explain why a patient avoids treatment and how they perceive and express symptoms, cope, adhere to treatment, and attach stigma to mental illness.

Exploring a patient’s cultural identity may help providers tailor mental health treatment. On the flip side, cultural incompetence likely contributes to underdiagnosis and/or misdiagnosis in Black, Indigenous, and people of color (BIPOC) communities, writes Mental Health America. “Language differences between patient and provider, stigma of mental illness among BIPOC, and cultural presentation of symptoms are some of the many barriers to care that explain these errors in the diagnostic process.”

Assessing a provider’s level of cultural sensitivity 

It starts with asking the right questions. The National Alliance on Mental Illness advises that you ask:

  • Have you treated other people with my cultural background?
  • Have you received training in culturally competent care for members of my community?
  • How do you see our cultural backgrounds influencing our communication and my treatment?
  • Do you have training in trauma-informed care?

Here are a few places to start your search for a culturally-competent mental health provider:

Psychology Today – Search for a therapist by zip code, ethnicity served, type of therapy and more.

Inclusive Therapists – Search by insurance, specialty, therapist identity, language, cultural knowledge, therapeutic approach, and location.

Open Path – A nonprofit serving clients who cannot afford current market rates for therapy through a network of affordable mental health professionals. Search by specialty, language, therapist ethnicity, age specialty, treatment orientation, and location.

You might also try:

Asian Mental Health Collective

The Association of Black Psychologists Therapist Resource Directory

Therapy for Latinx

Centers for Medicaid and Medicare American Indian/Native Behavioral Health Service Locator