In the United States, the legacy of slavery is a cultural wound that remains unresolved and unhealed, and it has resulted in, among other symptoms, the mass incarceration of African American men and women.
More people are imprisoned in the United States than in any other country in the world; and people of color constitute a disproportionate part (60%) of the incarcerated.
The Sentencing Project has further broken down the chances of being imprisoned by race, and the numbers are eye opening:
- African-American men have a 1:3 chance of being imprisoned
- Spanish-speaking men have a 1:6 chance of being imprisoned
- European descendants have a 1:17 chance of being imprisoned
It might also surprise you to know that American Indians are jailed at a 38% higher than the national rate according to the U.S. Commission on Civil Rights.
These disproportionate incarcerations are linked to differential treatment by the criminal justice system, lack of access to adequate counsel, and racial profiling.
As clinicians, we are often called upon to support and treat people during their incarceration, release, and parole. We also support their family members during this time. Understanding how social injustice, like racism, poverty and mental illness, contributes to incarceration is essential to effective clinical care. This awareness allows us to speak up when we see the mental health system perpetuate myths that oppress people; for example, treating substance abuse or incarceration due to drug use as an “illness” rather than symptoms of a far greater problem such as trauma, intergenerational trauma and social injustice.
There are many factors that can contribute to our failure to engage social injustice such as: lack of awareness, “white fragility” and denial, compassion fatigue and a sense of helplessness. We become inured to the ongoing effects of racism and oppression in peoples lives. This also occurs if we do not allow ourselves to experience the daily direct effects.
But as clinicians, we are confronted with the effects of oppression in the lives of our clients every day. Personal and social oppression affect physical and mental well-being.
What do we need to know about that to improve our work with clients? How do we deepen our understanding of our own internalized oppression?
There are so many levels at which this is important, and yet one that directly affects our clients is the concept of allostatic load. Allostatic load is defined as the “wear and tear” effect of chronic stress from daily life on the body and mind. Racism, bigotry and poverty all contribute to allostatic load, and this load accumulates during a lifetime leading to mental and chronic physical illness; especially illness that is autonomically mediated like cardiovascular disease and diabetes. It is believed that to be due to the effects of racism in the U.S., African-Americans have higher early mortality compared to non-Hispanic whites.
In today’s culture of social injustice, we are no longer just clinicians: we are social justice advocates. We take on this role every time we are asked to treat someone who is incarcerated, addicted, or has multiple physical illness co-occurring with PTSD. And it doesn’t stop there.
Our work goes beyond the daily routine of our office–our mandate is to advocate and act. To be successful clinicians, our work in multicultural competency must incorporate anti oppression. To do this, we incorporate understanding about the structural racism at work in our practices, our agencies, jails and the society at large.
Further learning about “Race” in America
Watch: Advance Your Cultural Competency in the Clinical Setting: DSM-5® Guidelines, Ethical Standards and Multicultural Awareness, a CE seminar with Leslie Korn.
Listen: When Ancestry Search Led To Escaped Slave: ‘All I Could Do Was Weep’, an interview with author Regina Mason.
View: The Dhamma Brothers story of the introduction of Vipassana meditation into a maximum-security prison in Alabama.
Leslie Korn, Ph.D., MPH, LMHC, has over 35 years of experience in cross cultural counseling, research, and traditional healing practices. For over 10 years, Dr. Korn was the president of a multicultural consulting firm to design and implement multilingual and multi-ethnic mental health and wellness programs to reduce chemical dependency in urban Boston and rural Massachusetts. She lived and worked in the jungle of Mexico for over 20 years where she directed a public health clinic working alongside traditional healers. She has contributed to the design of cultural revitalization programs for mental health in tribal communities in the Pacific Northwest and Canada and has provided over 40,000 hours of private practice and agency-based clinical treatment to diverse individuals, families and communities.
Dr. Korn has a dual doctorate in Behavioral Medicine and Traditional (indigenous) Medicine and a Masters of Public Health from Harvard School of Public Health. Dr. Korn also earned a Masters in cross-cultural health psychology from Lesley University. She was a clinical fellow in psychology and religion at Harvard Medical School. An approved clinical supervisor, licensed mental health counselor, Fulbright scholar and NIH-funded scientist, Dr. Korn is the author of Nutrition Essentials for Mental Health: A Complete Guide to the Food-Mood Connection (Norton, 2016), Rhythms of Recovery: Trauma, Nature and the Body (Routledge, 2012) and Preventing and Treating Diabetes Naturally, The Native Way (Daykeeper Press, 2010). Dr. Korn is core faculty and fieldwork supervisor in mental health counseling at Capella University and maintains bilingual clinical consulting practice in Puerto Vallarta, Mexico.