Bill Cosby Forgot Mental Illness

Two taboo subjects exist for black Americans: male gay sex and mental illness. The refusal to discuss them has had devastating results.
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For decades, because of their rather similar suffering and the common thread running through their histories, African Americans and American Jews looked at and talked to each other with great sympathy. Their past, crowded with pain, compelled them to consider themselves soulmates; and despite a recent palpable rift between the communities, there are unspoken conditions acknowledged by some, denied by others that plague the two people. Many Jews acknowledge and admit that mental health issues bedevil their community. African Americans, despite their blood drenched past refuse to even broach the subject of mental illness.

Many of my Jewish medical colleagues readily admit that they regularly avail themselves of mental health assistance and care. They are, they say, better for it. They suffer no repercussions nor are they regarded as lesser people by their community.

Like Bill Cosby, I have watched and written much about how the black community let its children down: by not being responsible parents; not working harder to curb inter-community violence, teenage pregnancy, drug abuse. Unlike Michael Eric Dyson, one of Cosby's bitter critic, I have applauded his courage to speak out, to withstand the arrows and slings of bitter opposition.

Bill Cosby and his corroborator, Dr Alvin Poussaint recently wrote, Come on People, a book in which they emphasize and tie personal responsibility to the community's progress. I too agree that blacks need to take care of each other; to reexamine their actions with more diligence. But the role mental health plays in the affairs of the community is at best glossed over.

I believe mental health needs to be more vigorously emphasized since it's central to everything that has transpired to black America over the last four hundred years. I don't by this suggest that black America place the burden of what ails it at white folks' door step, nor am I saying that America's white rulers' actions didn't exacerbate blacks' pain, magnifying the pain of mental illness.

Two taboo subjects exist for black Americans: male gay sex and mental illness. The refusal to discuss them has had devastating results; not the least of which is HIV/AIDS has become a disease of poor black women. And even as we refuse to discuss it, many blacks manifest symptoms of widespread and deep mental illness. Our jails are full of mentally ill blacks. Indeed much that black Americans do points to deep mental illness. Black America would do well to "out" mental illness. Manage it with therapy rather than incarceration.

Blacks are not different from other people. They do not enjoy pain, seeing their neighbors and siblings suffer, many spending long durations of their lives incarcerated. But most live lives of desperation, depressed and deeply mentally ill. Alcohol and "crack" cocaine are the anesthetics of choice for black America. Depression is a condition blacks didn't impose upon themselves; it's resulted from environmental and historical factors.

Unlike Professor Dyson, I don't think Cosby blames black victims. I do however feel that all well educated black Americans should be better informed about and be willing to discuss mental health in the black community. It's my hope that Cosby, Poussaint and others including Dyson, would entertain a wider debate about the role mental health plays in black Americans' daily lives.

As a physician I believe we must first acknowledge that there's a problem. Let's then talk about it and when appropriate entertain instituting therapy. I'm an advocate of talk therapy. Any two people can talk about "why" they do certain negative things. More can form groups that would discuss their feelings - how they react to life's issues, in anger, violently or with depression and suspicion. The involvement of groups serves two purposes: defining the problem, allowing everyone to realize they are not alone. In many instances, talking about mental problems, dealing with them head on is an important step towards a cure.

I wanted to know what many survivors of the Holocaust did once they realized they were free from the German Gestapo, gas chambers and certain death. Not all danced or enjoyed the sunlight; in fact many committed suicide. Bipolar conditions, depression, shame, a sense of worthlessness, all contributed to their not feeling "quite human." A generation later, their children acknowledge the pain and the weight of the Holocaust and all the terrors that befell Jews for many centuries. By acknowledging this, they have resorted to facing their demons; hence the ubiquitous therapy sessions that my friends attend. It allows the Jewish community to stay on an even keel.

It's not different for the black community. In view of the great black silence and unwillingness to discuss mental illness and health, it's imperative that leaders of the community meet to devise ways to confront this issue, which plagues and holds the community prisoner. Cosby's and Poussaint's voices must be added to a rising chorus to deal with the black mental health epidemic.

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