November 1994 "was the best of times, it was the worst of times" for Charleta Tavares. She had just been elected to become the first African American female to serve in the Ohio House of Representatives from Franklin County. She had just touched down in Arizona for a much needed vacation after the strenuous campaign, when she received a phone call that turned everything upside down. Charleta's younger brother Jeff had just taken his life. He was 37 years old.
Jeff was a typical teen from a solid middle class family; he was a good kid, he was popular, handsome, smart, artistic and a talented musician. Then, when he was 17, he was diagnosed with schizophrenia. Jeff, nor his family or friends understood what was going on. But as more and more of the symptoms of his illness appeared, Jeff was confused about what was going on in his life and why many of his friends slowly began to drop away. His family, including his loving mother, his sister Charleta and her husband stood by him and sought out help for him. His dad had passed away at a young age (48) right before Jeff's illness struck.
It did not take long, though, before Jeff's family became frustrated with the mental health system. According to Charleta, no one would listen to their input about Jeff and about what was "normal" for him. "Men of color often have symptoms and behaviors that are different from those of Caucasians. Most of Jeff's treatment providers were either Caucasian or foreign-born with little or no understanding of him. If you don't know a person and are not familiar with what is 'normal' for that culture, it is very difficult to identify what symptoms are illness-related and what symptoms are cultural or unique to that individual. Our family like many others at the time could not get providers to listen to us. We know our loved ones best; we know what 'normal' behavior is for them. It took several years and several different treatment providers before Jeff was finally diagnosed with bipolar disorder," Charleta said.
Charleta feels strongly that families must be a part of the treatment team. "Jeff as a minor was initially covered by his mother's private insurance. However, once he became of age he was dropped from that coverage and then went into a new public system. It is very difficult for our loved ones who are often faced with a sudden change in doctors and systems. They have little or no say in who is providing their treatment, and they just get plain tired of having to re-tell their story time and time again. At least if family members are involved and are listened to, some of this burden and frustration can be lifted," she said. “We must all learn to speak with our loved ones and for our loved ones and we must do it in a way that resonates for all. We have so much to gain, and even more to lose.”
Mental health disorders cut across racial, ethnic and cultural groups equally. Regardless of who we are, a person needs to "click with" or develop a rapport with their treatment providers. Understanding a person's culture is critical to the success of that process. According to Charleta, who today is the Executive Director of the Multiethnic Advocates for Cultural Competence and serves on the Columbus City Council, "We know that ensuring cultural and linguistic competence in our service and care delivery systems is essential to recovery. If treatment providers do not understand the culture and language of the individual patient or consumer, they are at a huge disadvantage in making a proper diagnosis and assisting in the person's recovery."
“Mental health treatment is no different than any other business. To be successful, business owners must understand and appeal to their customer base. This is readily apparent in advertising. I wish it were so apparent in the mental health system. We know mental health disorders impact each racial, ethnic and cultural group equally. If providers are not seeing this diversity of their respective community or region represented by those coming through their doors, then they are not reaching all of the people who are in need of their services. Treatment providers have to do a better job of understanding and reaching out to their client base. Mental health treatment is not a ‘one size fits all’ business and, really, what business is?”
“The experience of my brother’s illness is woven into everything I stand for and do,” said Charleta. “I know that mental illness impacts one in four people so I know that I stand beside people from every culture, every walk of life in what I have experienced. My hope is that more and more people will step forward to share their loved one’s illnesses to improve the systems of care. As we implement health care reform in Ohio, we need to integrate families and cultural competence among other systemic changes in our education, prevention and treatment modalities. We cannot know who will be impacted next, but we do know it is very likely to be someone we know, someone we love, and someone we respect and admire.”
Charleta Tavares extends a challenge and an opportunity to all Stigma Buster readers, “We all need to learn more about mental illness and how we can advocate for better services and treatment to meet the needs of our collective families throughout our state. We must all learn to speak with our loved ones and for our loved ones and we must do it in a way that resonates for all. We have so much to gain, and even more to lose.”
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