by Ayobami Adebayo and Daniel Laroche
The continued murders of unarmed African Americans have been extremely traumatic for everyone including, Black educators and students. These traumatic events in the Black community that are caught on camera and shared on social media have a lasting effect that continue to contribute to health and wealth disparities. These are the reflections of a physician and a medical student on the current climate of our nation during the continued murders of unarmed African Americans and methods educators and medical students can use to cope with these traumatic experiences to remain effective in their professional responsibilities and development.
Traumatic Effects of Social Media
Modern-day video capacity and social media has drastically desensitized us to violence. Repeated police murders of Black people and domestic terrorist killings of Black people are seen again and again on social media and the internet repeatedly. Now thanks to widespread video technology we can watch the trauma through our own eyes. Nowadays, students are alerted on their phones and mobile devices to view footage of people from their own community being murdered while trying to do something as simple as sharing a picture or responding to a text message. Ideally no child, teenager, or adult should be subject to this type of content. In addition, gun violence and lack of reform has begun to directly affect the healthcare community, as violence and attacks now take place in the hospital setting. In June 2022, an African American physician was targeted and killed alongside colleagues in Saint Francis Health System in Tulsa, Oklahoma. The patient stated that he targeted the physician after a surgery he performed that left him with ongoing back pain. This is highly unfortunate, as African Americans only make up 1.9 percent of orthopedic surgeons overall. The barriers we must overcome are daunting, and the killings of African American physicians makes things much worse. This violence occurred at the hands of patient who was of African descent.
The trauma caused by watching and hearing about these horrific events are detrimental to both providers and patients. These events often leave African American medical providers very upset and frustrated which ultimately can potentially affect how effective they are in their workspace. The potential drop in effectiveness can cause tension with patients, their families, and even amongst the medical care team. There is a strong link between traumatic events seen online and the mental health of African Americans, and aging.
A recent study completed found that police killings of unarmed Black Americans have a direct impact on the mental health of Black Americans. The results of this study estimate that the killings of unarmed black Americans contribute to an additional 55 million excess poor mental health days among Black American adults. This large number can also be compared to the effect diabetes has on the African American population as it contributes to an additional 75 million poor mental health days for black American adults. These findings suggest that the effects of police brutality against African Americans can negatively affect their mental health to a similar degree that diabetes does.
Another study found that higher rates of traumatic events seen online had led to greater levels of PTSD and depressive symptoms among African Americans. The effects described above are a result of secondary traumatic stress and can lead to depression, emotional trauma, and suicide if not properly addressed. These effects are even exacerbated in the days just following the events as a study found that 43 percent of medical providers suffer from symptoms of depression and PTSD following a traumatic patient event. Just as certain medical specialties, undergo higher levels of emotional distress due to different secondary trauma providers in each specialty face, this can also be applied to the community of African American educators. African American physicians and educators have emotional distress levels that are higher than their counterparts because of experiences like these senseless killings and racism they must endure in the field which ultimately affects patient care. In a similar light, previous studies have shown African American and Hispanic high school students, exposure to localized police violence and the shooting of unarmed suspects leads to persistent decreases in grade point average, increased incidence of emotional disturbance, and lower rates of high school completion and college enrollment.
Finally, the effects of this trauma on the mental health of African Americans is starting to show some adverse physiological effects. Harvard’s David R. Williams recently found that African Americans are aging more rapidly than Whites. Compared to their White counterparts, African Americans are about 7.5 to 10 years older. This accelerated aging and rapid deterioration is thought to be an effect of all the traumatic and stressful exposures African Americans deal with in our social environment. All of these are factors that continue to hold the Black community behind while also contributing to emotional distress.
Disparities Highlighted by the COVID-19 Pandemic
The pandemic caused by COVID-19 did not just expose the pre-existing health disparities leading to increased death rates in African American communities, it also exposed the effects trauma can have on medical providers when caring for the ill. This same trauma can be compared to the suffering the African American community goes through when Blacks are murdered on camera. Many physicians are traumatized and depressed due to events that occurred out of their control, which include these ongoing killings. The effects of this trauma in the scope of COVID-19 included medical providers reluctant to report to work, the desire to quit their jobs, earlier retirement, along with high levels of stress and anxiety. The African American community already has a shortage of doctors with less than 5 percent being African American. This population cannot afford a loss of more physicians due to burnout, stress, or PTSD. The proper interventions must be put in place to protect providers.
Therapeutic Solutions for Trauma
There are multiple ways educators and students can work to overcome trauma and remain effective in their line of work. Educators must be able to manage emotional reactions and find ways to implement strategies geared towards self-care in their daily routines. A focus on self-care is important to reduce the effects of stress reactions. Diet, exercise, meditation, and spirituality is often essential to keep balance and harmony. Using a proactive approach with a counselor is also an option. Medical schools, hospitals, and educational institutions should be proactive to offer supportive counseling during episodes of seeing and experiencing trauma.
Usually, when individuals undergo trauma, they seek help after the fact. Instead, a proactive approach should be used. Providers should seek counsel often to develop positive reactions to stress and reduce the detrimental effects that occur when faced with a traumatic event. Seeking counsel and help is not a form of weakness but rather an educated effort to reduce distress. A survey completed in 2010 showed that 68 percent of providers that took place in a severe patient safety protocol did not seek counsel or support. Another study found that although 68 percent of providers were at risk of developing PTSD, only 13 percent of providers attempted to receive treatment. These numbers need to change, without seeking support or counsel, these adverse patient events will begin to negatively affect physicians, their families, and patients. Unfortunately, these numbers are even lower in the African American community due to the stigma behind mental illness and seeking treatment. Even though the African American community would benefit immensely from counseling and therapy, they elect not to pursue those types of treatment because of the stigma behind mental illness and how that image might be another barrier to opportunities they are deprived of in society.
Mind-Body therapy and yoga have also been proven to be extremely effective. In a study that evaluated victims that were involved in 9/11, the authors found that yoga which included mindful breathing, meditation and mantra repetition was effective in relieving PTSD symptoms. The effects that yoga and mind body therapy have on PTSD symptomatology is comparable to the psychotherapeutic and psychopharmacologic methods seen in psychiatry today. For providers who may not want to partake in yoga, any type of exercise or physical activity is also proven to relieve PTSD symptoms. However, this may not be a sufficient option when used alone compared to mind body therapy.
Trauma–focused art therapy is another alternative for providers and educators that may not be able to verbally express their thoughts and experiences. Verbally explaining traumatic events can be triggering and can be a reason African Americans avoid pursuing therapy as well. Art therapy provides a great alternative in this case because it is a nonverbal approach. Participants in a study that utilized art therapy stated that it created a more relaxed environment and left less space for intrusive and traumatic thoughts.
Equine-assisted therapy has been shown to provide satisfaction and a decrease in depressive symptoms post-treatment in military veterans. When horse riding is implemented in an effective treatment protocol, the benefits in symptomatology are clear with an increase in quality of life; Further studies prove that in addition to a decrease in PTSD symptoms, there is also an increase in the ability to self-cope with trauma. This can be applied to medical professionals as well during vacation time off.
We need to heal as a community, and these are effective methods that students and educators can use to cope with the trauma experiences.
Ayobami Adebayo is studying for his medical doctorate at Albert Einstein College of Medicine in the Bronx, New York. Daniel Laroche is a clinical associate professor of ophthalmology at the Mount Sinai School of Medicine and president of Advanced Eyecare of New York.