Members in a day-long summit at Northeastern University (NU) last week took a deep dive into the challenges facing Bostonians confronting mental health issues while also juggling the many stressors of city life.
The event, convened by the Boston Public Health Commission and NU’s Institute for Health Equity and Social Justice Research, included candid discussions about the connections between “social determinants” like poverty, housing stress, and systemic racism.
Speakers included Michael Curry, a Roxbury native who is now president and CEO of the Massachusetts League of Community Health Centers, who said that mental health is often considered the “caboose of healthcare.”
“It’s the afterthought when we talk about diabetes and heart disease, and cancer, but I would argue you can’t have physical health unless you got mental health,” said Curry.
Samara Grossman, director of BPHC’s Center for Behavioral Health and Wellness, said that the purpose of the day-long conference was “to learn from each other, share strategies, and envision new ways to address social determinants of mental health so that all Boston youth, families, elders, and communities have the support they need to flourish.
“Our goal is to create a fair, just, and equitable behavioral health system in Boston,” said Grossman. “We aim to improve mental and behavioral health outcomes, particularly for those affected by racism and systemic inequities.”
The summit included panels and workshops throughout the day, including one that focused on economic insecurity that was moderated by Segun Idowu, Boston’s Chief of Economic Opportunity and Inclusion, where Charlestown resident Magaly Galvis shared her experience as a mother of children with mental health challenges.
“There are mornings when [my son] just can’t bring himself to class, and people don’t understand that,” said Galvis. “Sometimes teachers and neighbors think he’s just being difficult. What we need most is understanding and compassion. People need to see mental health struggles are real and they can happen in any family.”
Galvis, who has had to stop working to care for her child at times, putting more strain on the household. “This kind of pressure takes a toll on the whole family, especially when you are struggling to make ends meet,” she said.
“It’s so important we talk about economic insecurity and poverty as public health challenges that need to be addressed with urgency,” said Alyssa Benalfew-Ramos, a public policy executive and public health practitioner. “Traditional public health must partner with finance and housing to design and implement solutions that will create equitable mental health outcomes for all.”
She added: “How are we ensuring that we’re actually connecting people to resources? Things like financial navigators, benefits coordination, free legal aid, eviction prevention funds, and other longer-term resources.”
Benalfew-Ramos was joined by Professor Jenny Zhen-Duan, a researcher, and Cyril Ubiem,
the senior vice president of Programs and Services at Harvard Street Neighborhood Health Center.
Alisa Lincoln, director of NU’s Institute of Health Equity and Social Justice Research, noted that even in a city reknowned for its clinical care “once people are struggling with symptoms of distress or mental illness, our systems – often fueled by stigma or inadequate national level investment in mental health promotion, prevention, treatement and recovery support – worsen structural exclusion and further limit access to resources that promote health, mental health, healing, and well being.”
Charlestown resident Magaly Galvis, right, shared her experience as a mother of children with mental health challenges. Cassidy McNeeley photo
Unstable employment and frequent moves have been linked to higher rates of mental health outcomes, Lincoln said.
The Mass League’s Curry, who grew up in the Lenox Street public housing development, said he recalls watching his neighbors “weathered to disease.”
His sister Veronica, who died recently, suffered from asthma. When he was a child, Curry asked his mother what caused his sister’s asthma, which led to a lot more ‘whys’ to follow. Why do we live in a house with roaches and rats? Why don’t we move? Why are we poor? Why are we treated differently?
“Just two and a half weeks ago, my sister died,” said Curry. “She had diabetes, some mental health issues, [was] on medication. She should still be here, but she wasn’t managing her mental health. Because she wasn’t managing her mental health, she wasn’t managing her physical health. That’s why she’s not here.”
He added: “There’s a thing in the Black community, we say ‘Black don’t crack.’ It’s the resilience of our skin, it’s the fact that we survived slavery 1619-1865, reconstruction, Jim Crow, racism, busing. I always tell people, ‘Black don’t crack, but the crackings on the inside.’
“Everyone would crack to endure those circumstances and conditions: poverty, housing insecurity, food insecurity, racism, violence, trauma. We have to have the conversation.”
A second panel, moderated by Sheila Dillon, the chief of housing and director of the Mayor’s Office of Housing, focused on housing insecurity. She was joined by panelists Thaddeus Miles, senior director of Diversity Initiatives at MassHousing; George Huynh, executive director of VietAID; Toy Burton, founder and executive director of DeeDee’s Cry Suicide Prevention & Family Support; and Stephanie Ettinger de Cuba, executive director of Children’s HealtWatch and Research.
“Building affordable housing, especially with support services, is a key to making sure we are meeting folks’ needs in the city of Boston, including those who have mental health issues,” said Dillon.”
Unfortunately, changes at the federal level might make this more difficult, she added. “If some of the housing threats come due, there isn’t a local solution to the problem; it’s so big. Right now, we’re sort of thinking about worst-case scenarios and what we do with thousands of unhoused people; it’s that scary. I won’t say I have a solution or we have a solution collectively, [but] I will say that everybody is meeting on a very regular basis, trying to come up with ‘what ifs.’”
She also hopes the Mayor’s Office of Housing can make its resources more accessible and focused on mental health.
“What we do at the office of housing is we run around, we try to get back rent paid, or we try to get someone a pro bono attorney, or we try to get them out of there, but what we never do is we never have our colleagues at public health or the nonprofits call and say, ‘Hey you’ve been through an awful lot, are you okay?’” said Dillon. “It would be a very decent step to make sure the family is okay because they had been through a traumatic event.”
