The importance of inclusion – for everyone

I caught this article on Facebook the other day – it’s results caught me by surprise (to an extent) but it has a key finding that I really wanted to go over.

In 2014, the University of British Columbia examined the connection between suicide rates and having a Gay-Straight Alliance at High Schools in Canada. The results showed that students were less likely to feel discrimination, experienced lower suicidal thoughts, and have lower rates of suicide attempts.

Just gay students, right?

Wrong. All students.

This is a pretty striking finding. Not only are GSAs positively related to the mental health of gay students, but if the findings of this study are correct, they can also positively impact the mental health of students whose lives would (theoretically) not be impacted directly by the Gay-Straight Alliance.

This is great for many reasons. First, as I discussed last week, LGBT Americans sadly have significantly higher rates of a slew of negative mental illnesses, including suicide. Clubs like GSAs can provide safe places for LGBT teens to congregate, build vitally necessary social relationships and learn they aren’t alone. All of these are mitigating factors against mental illness and suicide.

Intuitively, this makes sense. But the finding that I think is more worth examining is why GSAs are potentially tied to lower suicide rates in heterosexuals. First, a disclaimer: It is worth noting that this study is correlational, not causational. In other words, while lower suicide rates and GSAs appear to be related, the lower suicide rates may not be a direct result of GSAs. Indeed, it is possible that there are more GSAs because of lower suicide rates, or that a third factor (such ass wealth of a school district, education attainment of parents, etc) is tied to both GSAs and lower suicide rates.

However, the fact that both of these items seem related (regardless of the relationship) begs the question: What is the relationship between a more tolerant society for everyone, not just the directly affected groups?

This is one worth thinking about, because it can help change the frame of how we view ideals like inclusion an tolerance. We often have conversations about how they can positively impact effected groups – how marriage equality leads to better lives for LGBT individuals, how a lack of racism can improve the lives of impacted groups, etc.

But I want to change that perspective for a second.

I certainly think I’m not a racist person, and I can’t imagine what it is like to be that way. Being racist means you walk around which large chunks of anger, bitterness and resentment inside you all the time. Doesn’t that lead to higher levels of depression, of anxiety, and self-destructive behaviors?

That’s what I want to know. And it makes me wonder if more studies like this aren’t available – ones which show that a more tolerant and more inclusive society is better for everyone, not just affected groups.

As always, I’d love to hear your thoughts, your experience and if more research is available which proves or disproves this theory. Please let us know what you think in the comments below!


Six Questions: An interview with Laura Silverman, Author of You Asked for Perfect

Today’s interview is with Laura Silverman, who wrote You Asked For Perfect, the story of a super smart, LGBT teenager who is trying to learn to navigate his life in a high pressure world. From the summary:

Senior Ariel Stone is the perfect college applicant: first chair violinist, dedicated volunteer, active synagogue congregant, and expected valedictorian. And he works hard―really hard―to make his success look effortless. A failed calculus quiz is not part of his plan. Not when he’s number one. Not when his peers can smell weakness like a freshman’s body spray.

Ariel throws himself into studying. His friends will understand if he skips a few plans, and he can sleep when he graduates. But as his grade continues to slide, Ariel realizes he needs help and reluctantly enlists a tutor, his classmate Amir. The two have never gotten along, but Ariel has no other options.

Ariel discovers he may not like calculus, but he does like Amir. Except adding a new relationship to his long list of commitments may just push him past his limit.

1) Do you think that experiencing mental illness is a requirement for any author who deals with this topic?
I don’t think it’s a requirement, but I do think if a writer is ever writing outside of their own personal experience, it should be done with a great amount of both research and empathy.
2) Your book obviously deals with a gay teenager, a group which faces enormous mental health pressures. Can you talk a little about writing a character with mental health challenges from that perspective?
Ariel is a bisexual teen, but his anxiety in the book is related to academic pressure not his sexuality. I wanted to write a book about the extreme academic pressure teens deal with today, as I believe it’s something so many teens experience but is rarely written about.
3) As I type this questions, your book is number one in “Teen & Young Adult Jewish Fiction.” What has your experience been like in terms of the interaction between religion and mental health?
I grew up in a very supportive Jewish community and wanted to reflect that in this novel. Ariel’s Jewish community is a place of comfort and warmth for him. Although services certainly take up more time in his busy schedule, adding additional stress, overall his Jewish community is an incredibly supportive aspect of his life. And his rabbi is actually one of the people who helps him the most throughout the book.
4) Your book addresses many of the societal pressures which teenagers face today. What do you think any of us can do to try to tamp down those pressures?
I think we need to send the message that grades do not define you. There’s so much pressure to excel in school and get into top universities, but while education is important, it should be about the learning experience not about top SAT scores and AP credits.
5) Many of the reviews of You Asked For Perfect note that you seem to perfectly capture what it’s like to be a teenager in a high pressure environment. How did you do that??
I went to one of those high schools! Although my experience wasn’t as intense as my protagonist Ariel, I experienced the exhaustion of taking multiple AP classes, taking extra electives, the pressure to excel, the fear of scoring a low grade. I also did a lot of research for the book. I talked to high achieving students about their experiences and watched documentaries and read books.
6) If you could do it again – anything you’d do differently?
With the book? I wouldn’t change a thing!

A shameful disparity: Minorities & Mental Illness

Earlier this week, I had the good fortune to attend Pride in the Park, the Lehigh Valley’s annual LGBT festival.  I always bring the family and it’s a blast; it’s interesting, has great vendors, good food and is a great time for the kids.

On our way out, I commented to my wife that everyone at the event always seemed so happy, and how relaxing it must be to attendees to be in a place where you know no one cares who you are.  My wife corrected me: Everyone cares.  Period.

This reminded me of a tragic reality about mental illness in America: If you are a minority, you are more likely to be mentally ill, and less likely to be treated.

Before I go into the statistics, one caviet: “Minorities” is a broader term than you think.

African-Americans make up 13.2% of the U.S. population, and 16% of those have a diagnosable mental illness.  However, the disparity is striking.  African-Americans are 20% more likely than whites to say they suffer from serious psychological issues.  They also feel worse, in terms of sadness, hopelessness and worthlessness, than whites. Stigma-related attitudes are more likely to be held by African-Americans than whites, and cultural competency amoung mental health providers remain a real issue.  Perhaps most significant: 15.9% of all African-Americans are uninsured, compared to 11.1% of whites.

LGBT Americans
LGBT Americans are three times as likely to suffer from mental health conditions than the rest of the general population.  According to the National Alliance on Mental Illness, much of this is due to “minority stress,” including, “social stigma, discrimination, prejudice, denial of civil and human rights, abuse, harassment, victimization, social exclusion and family rejection.”  Suicide is also a major issue within this community, with suicide for LGBTQ Americans aged 10-24 being described as “one of the leading causes of death.”  LGBTQ individuals are four times as likely to attempt suicide than the general population, and 38-65% of transgender individuals experience suicidal ideation.

Rural Americans
Clearly, rural Americans are different than some of the other groups here.  But, that doesn’t change a central fact: They have similar challenges when it comes to mental health than many other groups.  Rural Americans have roughly the same rate of mental illness as the rest of the population.  However, poverty is higher in many sections of rural American, and stigma presents a huge cultural barrier to seeking care. Additionally, rural Americans have problems with accessing care due to practitioner shortages and transportation issues.

American Indians
This is astonishing: The suicide rate among males, aged 15-24, who are American Indian or Alaskan Native, are 2-3 times greater than the suicide rate for whites.  Additionally, 21% of all Native Americans had a mental illness over the past year, and they experience psychological distress at a rate 1.5 times more than the general population.  High levels of poverty, a rural location, poor transportation and low rates of health insurance (33%!!) all lead to low treatment usage.

There is more, but these were just some of the low lights.

I don’t want to necessary explore this from a policy perspective – at least, in this entry.  I’d rather approach this from the personal perspective.  In this sense, I suppose I am lucky; I’m a white, male, young adult, whose only claim to any sort of minority status is that I am Jewish.  That being said, I cannot imagine how difficult it must be – to be a member of one of these communities and have your ability to get and receive care be compounded by factors beyond your control and things that shouldn’t make a difference anyway.

Now, to ignore what I just said: Speaking a a policymaker, it’s pretty clear that there is no one size fits all approach to ending mental health disparities.  A ton of factors play a part, including access to care, stigma, availability of practitioners, cultural competency, discrimination and more.  Mental illness is a huge problem, and an under discussed one.  I suppose that’s why I’m blogging and lending my name to this effort.

We have to do better.