Baltimore City

Black women face unique mental health challenges, psychologist says

Psychologist La Keita Carter addresses attendees at a seminar on black women and trauma at Baltimore City Community College.
The seminar was put on by the Black Mental Health Alliance.

The psychologist La Keita Carter didn’t sugar-coat her message when she addressed a group of black women on Saturday at a conference designed to improve their mental health. It’s imperative, she said, that people who are suffering and in shock seek counseling.

“When trauma symptoms persist and you don’t get help, you are disabling yourself,” she told 130 participants who registered for the Trilogy of Trauma seminar organized by the Black Mental Health Alliance.


“The prefrontal cortex is the part of your brain responsible for adulting — for organizing, initiating and deciding how to manage your Saturday. Your children don’t have it because their brains keep growing until they’re 25. When you’re in distress mode, your prefrontal cortex shuts down because your brain is doing more important things.

“You may say later, ‘What was I thinking?’ Technically you weren’t thinking because that part of your brain was disabled.”


The seminar was the first of three linked workshops being held on the Baltimore City Community College campus aimed at teaching members of the black community techniques for coping with trauma.

Jan Desper Peters, the Alliance’s executive director, said that the impetus for the seminars grew out of the 2015 death of Freddie Gray.

“We held perhaps six meetings over a few years, and discussions of historic and race-based trauma kept coming up,” she said. “We felt it was so important that we wanted to break the topic down into groups.”

A seminar for black children will be held April 13 on campus, and a workshop for black men is scheduled for June 15.

Speaker Shelter Dziya said black women face unique mental health challenges because they’re battling two forms of discrimination (a phenomenon known as “intersectionality”): one based on skin color and one based on gender.

“Black women experience domestic violence more often than any other group,” said Dziya, who teaches psychology at the University of Maryland, Baltimore County. “But they are less likely to report it because shelters and the mental health system are not designed to meet their needs.”

Black women may hesitate to call the police, she said, if they fear their husbands and sons won’t survive the criminal justice system. When black women do flee, shelters often lack African-American hair and skin products.

And when black women reach out for professional help, they can have trouble connecting with a therapist. Fewer than 10 percent of mental health professionals in the U.S. are black, she said.


Until those percentages can increase, Dziya is coaching white mental health professionals on how to best assist black clients.

Therapy is traditionally geared toward helping patients overcome self-destructive behaviors. But that approach isn’t always appropriate for clients who are black and female, she said.

“If black women are experiencing discrimination at work, it’s not their fault,” Dziya said. “Therapists can help these patients develop coping strategies, such as interrupting microaggressions on the job.”

One seminar attendee, Daniel Scott, 35, took this message to heart.

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“Black women of my generation have a hard time finding black men who are educated and at our financial level,” she said. “I have just been through a tumultuous relationship with a man that really damaged me emotionally.

“We’re taught in our culture to ‘ride it out.’ People always say, ‘Ride it out, girl. It will be all right.’


“But it won’t be all right. We should encourage and empower women to hold out until the right man comes along.”

Long trauma can cause permanent changes to the structure of the brain. That’s why it’s important, Carter said, to halt the stress response before it begins disrupting daily life.

Carter said the prefrontal cortex (“the CEO of your brain”) calls the shots under normal circumstances. But during periods of stress, the amygdala (which helps process emotions) takes over. The amygdala sends a distress signal to the hypothalamus, which coordinates communications between the body and brain. In response to what it perceives as a threat, the hypothalamus triggers the “fight or flight” response, channeling all the body’s resources into escaping or vanquishing the danger. Our hearts pound, our pupils dilate, our breaths become rapid.

“We cannot sustain this hyper-vigilant state indefinitely,” Carter said.

“People who are constantly in a reactive mode are exhausted. A mental health provider can help get you over that hump. In order to be a fully effective mother, wife, daughter or sister, we have to get to the point where we can let the prefrontal cortex do its job.”