♪♪ ♪♪ ♪♪ >> Attorney Rawle Andrews Jr., Executive Director of the American Psychiatric Association Foundation, next on "The Chavis Chronicles."

>> Major funding for "The Chavis Chronicles" is provided by the following.

At Wells Fargo, diverse representation and perspectives, equity, and inclusion is critical to meeting the needs of our colleagues, customers, and communities.

We are focused on our commitment to diversity, equity, and inclusion both inside our company and in the communities where we live and work.

Together, we want to make a tangible difference in people's lives and in our communities.

Wells Fargo -- the bank of doing.

American Petroleum Institute -- through API's Energy Excellence Program, our members are committed to accelerating safety, environmental and sustainability progress throughout the natural-gas and oil industry around the world.

Learn more at api.org/apiEnergyExcellence.

Reynolds American, dedicated to building a better tomorrow for our employees and communities.

Reynolds stands against racism and discrimination in all forms and is committed to building a more diverse and inclusive workplace.

At AARP, we are committed to ensuring your money, health, and happiness live as long as you do.

♪♪ ♪♪ >> We're so very honored to have the Honorable Rawle Andrews, the Executive Director of the American Psychiatric Association Foundation.

Welcome to "The Chavis Chronicles."

>> Thank you so much, Dr. Chavis.

Privilege to be here with you.

>> So, how does a brother from Houston, Texas, become a distinguished lawyer and now over the foundation of the American Psychiatric Association?

>> Blessings on blessings, Dr. Chavis.

I can tell you that if you had told me back in the '80s that I would be in the current role that I'm in now, I would have laughed you out of town because I wanted to be a trial lawyer almost from the first I could remember.

And for the first 16 years of my career, that's what I did.

And because I served on a number of boards, that led me to go do another 15 years at AARP.

And I was doing legislative affairs, external affairs, and so forth.

And once we got to the pandemic, I started bumping into health disparities.

And one of the things that I noticed for the first time is that we weren't treating our mental health in the same way we treat our physical health.

And I just couldn't figure out how to do anything with that.

And then finally, I saw an opportunity back in September of '21 and I moved over and the rest is history.

>> Well, you know, COVID exposed so many health disparities.

Tell us how important, from your informed perspective, mental health is to any community, but particularly for communities of color.

>> What ends up happening is that we do prioritize and we'll go see a doctor for diabetes, for podiatry, or anything like that, but then we try to just ride it out when it comes to taking stress to anxiety or depression.

You know, one of the things we saw, Dr. Chavis, in the pandemic, you know, you had these smaller memorial services and funerals.

So people didn't have the ritual to say goodbye the way they used to.

And so now you add generational trauma from slavery, Jim Crow, and all those other things, adverse childhood experiences, and then you add a pandemic where you're locked away for you know, two or three years, and you don't have anywhere to go with that.

And what we've learned, anxiety, PTSD, eating disorders, depression -- all treatable conditions.

But we have to know what those conditions are and we have to be supportive of those -- or ourselves -- when we need that help.

>> When one just normally has a physical exam on an annual basis, does the physical exam include mental health analysis?

>> So, what the federal government has started doing since the pandemic, because it exposed these disparities, is they're asking primary care physicians to do more, to ask at least one question about mental wellness.

But I can tell you right now there are more pediatricians, as our children get ready to go back to school, who are dealing with the mental health of our young scholars than all the psychiatrists in the United States.

And so what we have to do when we go see the doctor and they ask, "How you feeling?"

-- "Yes, I came in because my knee is bothering me, but there's some stress behind that, and there might be something more behind it."

So give them the whole picture.

Don't just stop at, "My knee's been hurting for a couple weeks and I can't figure out what to do."

>> In the African-American community, there are a lot of taboos.

>> Yes.

>> What's your recommendation of how to stop this from being a subject matter that we fear or we are afraid to even discuss?

>> So, a couple things real quick.

One of the things we've done is fashion the mission, where we're promoting the mental wellness of individuals and communities where we live, learn, work, worship, and play at the APA Foundation because we believe a growing community network of trusted messengers is the best way to beat these taboos.

So, if we go to the faith community and clergy is better educated and informed, that's the first person they're gonna go to.

And if you tell them, "Just pray it away," then all of a sudden, faith without works is dead.

The work might be going to see somebody or changing some behavior that we're engaged in.

School teachers and principals.

You know, instead of closing down all our libraries and making them detention centers, if you see that one of our young scholars is off the spectrum and you use our Notice.

Talk.

Act.

at School framework, you're gonna see the signs and symptoms, you're gonna have some bridge words instead of barrier words to talk more intelligently with a young scholar, and then we're gonna give you a tool belt, a little digital medicine kit where you can say, "Here are some things we can do," and get the parents involved and the caregivers and so forth.

But I think what we really have to do is also work with our younger doctors.

So, our psychiatrists are physicians who have a specialty in psychiatry.

We can't be so book-smart that we can't reach the patients and the caregivers.

And so we host about 200 resident trainees a year in a special professional development program at the APA Foundation so that they can be the whole doctor for the whole patient.

>> You know, a lot of studies have come out about the overall disparities between medical treatment.

I was really shocked to hear that Black women, in particular, are treated differently than other women by the medical fields, including psychiatry.

How do you overcome some of these racial disparities?

>> So, again, I think a program like our fellowship program for resident trainees is there, but I think your kind of program, where you're bringing in thought leaders to talk about these issues, is equally important because all our doctors go to the same medical schools.

They have to take the same exams to get certified.

They do the same residency.

But if you come from Appalachia, you're gonna have a better health outcome than somebody who lives in Buckhead in Atlanta or Riverside Terrace in Houston, with the best ZIP codes you could have.

And now you're afraid, Dr. Chavis, to have children because the reality of it is our sisters are dying in childbirth, one of the most natural acts of humankind.

>> Disproportionately dying.

>> Disproportionately dying.

And then when they don't die, you know, the second leading cause of death for our young girls is death by suicide.

And so you reach in this 10 to 34 years of age -- 10!

-- and you've decided that my day was terrible today at 10 years old and it's gonna be a million times worse tomorrow and there's nothing we can do about that?

So again, that's why we want to stay in the schools.

I got somebody in Michigan right now talking to school teachers today about how to be better educated and informed about mental wellness.

And I think if I could leave your audience with one message, let's not talk about mental illness.

Let's not talk about mental health.

Let's talk about mental wellness.

I want you to be whole and well, and I want you to want me to be whole and well.

And when we're not whole and well, then brown liquor is not the solution to kind of ease my pain.

Doesn't mean you can't take a sip from time to time, but you can't self-medicate your way when your brain is telling your body something.

It's controlling everything.

>> From an academic perspective, are schools prepared to handle the issue of mental wellness from K through 12?

>> So, historically, no, they have not been, and particularly in communities of color, because we have what I described as these adverse childhood experiences.

Sometimes, we call them ACEs.

And so this is trauma in the house.

It could be any number of things.

Obviously, we've seen with our young girls.

Sometimes, that's abuse or they witnessed abuse.

And then you grow up with that.

You never had a chance to unpack it and you're just going through life.

And, so, the schools receive them, they have them all day, and they think they're acting up.

And what do the schools do?

The schools' solution is kindergarten-to-prison pipeline, instead of bringing in the interventions.

Then you have a Supreme Court -- Not to be political, but the reality of it is, the Supreme Court says race doesn't matter.

When in the history of the United States has race not ever mattered?

It does matter, whether it's on your mind or is behind your mind.

And I think one of the things that I'm going to be asking folks to do as we go through the fall and into the new year, now that we have to change our construct, Dr. Chavis, about how we admit students to school, when they write those essays and they tell you the pain of the journey that they've been on, we can't just say, "Oh, you know what?

Dr. Chavis has been through a lot.

He's a perfect candidate.

I got to now build some structures and some collateral material to deal with what he's bringing to the campus," right?

And whether you're first generation or multi-generation, if your story is one of pain and you want to turn that into purpose, we got to build something to help do that.

>> Well, with the Supreme Court decision, now Affirmative Action is out.

So there's going to be increased stress among students of color, first trying to get into college and then remaining in college to graduate.

How do you recommend that students, whether they're in HBCUs or predominantly white institutions, deal with the stress of formal education today?

>> It goes back to the trusted messengers, because the reality of it is, the higher-education experience is a different experience.

When I came to law school, professional school is a different experience.

And so I think you've got to be willing to seek out peers and peer mentors who can help you kind of find your path, because it's not something that's easy to just gut it out.

You know, I'm blessed that I had a father who had gone to Meharry and went to medical school.

My mother had gone to Thurgood Marshall.

I had seen the books.

I didn't really know what the experience was going to be.

My daughter starts Yale Law School next week.

And so even though she didn't see everything, she's been around professionals.

But when you need help, I don't think people need to believe they can just gut it out or "I'm just going to turn off all my devices."

That's not going to be enough.

And I think, again, what we're working with these colleges and universities is telling them, "Set up a new curriculum or some support systems where you deal with the essays that these young scholars have done."

But beyond that, how do we work with some of these -- the Divine Nine sororities and fraternities.

They have to do more.

Student Government Association has to do more.

University program council, the band, the front porch.

People say sports is the front porch, but in HBCU, the band has to do more.

And if the band director can do more to help our scholars, then I think, ultimately, we're creating a quilt, a patchwork of technical support systems that can at least be there for somebody to help them find a way, a pathway to hope and help.

>> Overall, there's a shortage of African-American doctors.

There's a shortage of people from communities of color going into the healthcare field.

How do you make sure that we get people in the pipeline in the medical field, but particularly in the psychiatry field?

>> So, we have got a grant from HHS to do a pipeline program where we bring in about 65 college students and a little bit over 100 medical students every year.

And we give them a book allowance.

We introduce them to some subject-matter experts.

>> Is it undergraduate and graduate?

>> Undergraduate and graduate.

And then we bring them to a couple of our big meetings so they can see how folks operate.

But the reality of it is, we're still catching them too late.

You know, where we need to catch a young doctor is in fifth or sixth grade.

And the reality of it is, that was our original STEM.

So I don't want people to think that the only thing you can do in technology is code.

You know, doctors, nurses, pharmacists -- that's how we got to where we are, and then Silicon Valley became whatever it is.

And if that's what you want to do, computers, then perfectly fine.

But we can't survive if we don't have doctors who understand our history so when I come in with whatever my condition is, that doctor understands my experience, so he, she, or they is going to better be able to do a history of me in a way that is empathetic and humanistic, not just, "Well, you know, you're probably eating soul food.

You know, you're hanging out too late at night," and so forth and so on.

Okay, well, it's CIAA.

What you think I'm gonna do?

[ Laughs ] >> How does your foundation work with the National Medical Association of Black Doctors or National Association of Black Nurses all around the country, these professional organizations?

Is there collaboration with the American Psychiatric Foundation?

>> So, we have collaboration with the National Medical Association, both through the APA, which is our parent organization, the American Psychiatric Association, and the foundation through our fellowship program.

But we just launched, Monday, a national campaign called Mental Health Care Works.

And the website is www.mentalhealthcareworks.org.

And, essentially, what we're talking about is treatability of mental wellness.

So PTSD, depression, anxiety, so forth and so on.

We interviewed -- surveyed over 2,500 people before we launched the campaign and we found out what their barriers were.

And instead of talking about stigma, this is the first what we call positive public awareness and literacy campaign around mental wellness.

We're not talking about stigma.

We're talking about fear.

We can do something about your fears.

We're talking about shame.

We can do something if you feel ashamed of your condition.

And the one that I think will resonate most in communities of color is discrimination.

So if you're discriminating against somebody because they have a mental-health condition, now, all of a sudden, people will turn a moment into a movement to stop discrimination because somebody is clinically depressed.

>> Tell me something about this campaign that you've launched across the country about mental wellness.

>> Historically, our American organizations had challenges around race and gender, so they didn't allow persons of color -- >> Like the American Medical Association.

>> All these.

And they were long overdue to change their member-only policies and practices.

This is the first American association I know that intentionally has launched a nationwide campaign around mental wellness.

And the first three personas, the first three visuals that you saw -- Simone, African-American female, 33 years old, postpartum depression, Diego, 65-plus, Hispanic Latino male, widower with prolonged grief disorder, depression, and then Lizzie, 19-year-old Filipina, and Lizzie has high anxiety and had pretty much shut down.

And so, yes, we will be building other personas.

There will probably be eight or nine of them by the time we're finished.

We're trying to have somebody that everybody can relate to, because relatability is key.

But, again, for an American organization to intentionally say, "We're not going to lag behind and put the user --" This is the summer of "Barbie," right?

The easiest thing for me to have done was to put out somebody who looks like Barbie and say, "Eating disorder, and I want you to resonate with the campaign."

We didn't do that.

We were intentional about this.

>> Multicultural reality, multilingual reality.

Your American foundation is taking into concert the change in demographics.

>> Right.

>> Do you see this in other professional organizations?

>> I believe so and I hope so, because the reality of it is, you know, I have an analog heart from a segregated hospital in Third Ward, Texas, all the way to a digital mind here in 2023, having a conversation with you about mental wellness.

And I think if other people see that there are other pathways to help and hope -- I'm just one example.

I don't think I'm, by any means, the only example.

But I think we will help millions of people, because the second-leading cause of death in our community cannot be death by suicide, after all we've been through after all these centuries.

And our young scholars are just deciding, "I can't take it anymore.

I have to go."

>> That's why the work that you do with the Psychiatric Association Foundation is so important.

Tell us about the call-and-response.

Are people responding to your messaging?

Are people responding to these solutions that you've identified?

>> So, one of the things that was very important to us and me was a thoughtful execution of our campaign.

So the first thing we did, beyond the surveys and the other research that we put together, we went to the APA membership in May, in San Francisco.

We told them what we wanted to do, we told them what it would cost to do it, and we told them, because it was a crisis, we couldn't wait to do some kind of capital campaign and hope for the best.

So we actually got permission to pull money out of our endowment, the seed money to kick it off, and that's when we started cutting the videos like you saw in the subway station.

After we did that, we started a test phase.

So, we were in Raleigh-Durham, Denver, Colorado, and the Baltimore-Washington national-capital area so that people could see our stuff both on the ground, as well as on social media.

People will be seeing that kind of visual when they go through airports, when they're not only on the bus, but when they're waiting on the bus.

And, so, we need to, again, turn this very high interest in mental wellness -- And everybody talks about it now.

They don't necessarily do anything about it.

You know, at least a third of the folks who talk about mental health need help and don't get it, and we need to change that narrative.

But more importantly than that, when we take these first steps of telling people how to talk to their doctor better and telling the doctor how to listen more attentively to the patient and the caregiver, we think we're going to see millions of people getting better.

>> For families that may have some individuals in their family that are struggling with mental-wellness issues, what would you recommend just in terms of literature so they could get a handle on some possible solutions?

>> So, there is a book that just came out by Dr. Annelle Primm -- P-R-I-M-M. And this talks about, particularly in the multicultural community, mental health and being multicultural.

And it goes through microaggressions.

It goes through imposter syndrome.

It talks about substance-use disorder, whether that's chemical or liquid.

And so people can kind of see a journey.

The other thing we would do is encourage folks to go to that mentalhealthworks.org website, because we have any number of materials that are already up there and more to come.

But if somebody in your audience is struggling right now or they know somebody is struggling, the new 988 hotline, the crisis hotline, is active.

>> Give out that number again.

>> It's just 988.

If you text or dial 988 on your phone, you will be able to get somebody to reach out to you.

>> Anywhere in the United States?

>> Anywhere in the United States.

>> 988.

>> 988.

And this is -- It's a little bit over a year old.

First came out in July of 2022.

And they're getting it better every day.

But operators are standing by.

Don't hesitate.

And the good thing about 988, because it is a crisis-intervention hotline, they don't always immediately go to law enforcement as the first response.

They might bring out a social worker or some other crisis-intervention specialist to see what's happening, because most of the time, you don't need a police officer when you're having a mental-health challenge.

>> Does your foundation, association recommend better training of law-enforcement officers or first responders, that they don't criminalize mental-wellness issues?

>> And I've met with some members of law enforcement, mostly sheriffs and police chiefs, because in our county and city jails, 2 million people every year get booked who really have a mental illness.

>> 2 million?

>> 2 million a year.

And so what we launched is what we call a Judges and Psychiatrists Leadership Initiative.

And, so, we train -- I think we've trained over 1,500 judges now across 500 counties in the United States so that they could be better attuned.

One of the other things we've talked to these sheriffs and police chiefs about is doing multiple assessments when somebody is arrested, because if you don't put them in the right pod, then you're going to have a problem in your jail, too, because you've got people interacting who shouldn't be interacting together.

But, more importantly, what we're asking these judges to do, no matter what the prosecutor or the police do, if somebody needs diversion and deflection to mental-health services, get that person the help they need, because, unfortunately -- And Rikers was probably one of the worst situations -- >> In New York, Rikers Island.

>> Rikers in New York.

Where you lock somebody up.

You never charge them.

They sit for 3 or 4 months.

They ultimately get released.

Sometimes in solitary confinement.

Now they're worse than they went in and they were struggling in the beginning, and you just throw them back on the street.

And then everybody says, "Oh, we have recidivism."

Well, what did you think was going to happen if you didn't build some systems and structures?

Now, one little anecdote.

There is a judge in Miami -- Steve Leifman in Miami-Dade County -- and he's actually working with a team to build a facility in Miami-Dade, in the 305, that's going to be a diversion facility.

So when the judge signs the order that "We can defer you and deflect you," you got a place to send them.

>> Attorney Rawle Andrews, thank you for joining "The Chavis Chronicles."

>> Thank you, sir.

>> For more information about "The Chavis Chronicles" and our guests, please visit our website at thechavischronicles.com.

Also, follow us on Facebook, X, formerly known as Twitter, LinkedIn, YouTube, Instagram, and TikTok.

Major funding for "The Chavis Chronicles" is provided by the following.

At Wells Fargo, diverse representation and perspectives, equity, and inclusion is critical to meeting the needs of our colleagues, customers, and communities.

We are focused on our commitment to diversity, equity, and inclusion both inside our company and in the communities where we live and work.

Together, we want to make a tangible difference in people's lives and in our communities.

Wells Fargo -- the bank of doing.

American Petroleum Institute -- through API's Energy Excellence Program, our members are committed to accelerating safety, environmental, and sustainability progress throughout the natural-gas and oil industry around the world.

Learn more at api.org/apiEnergyExcellence.

Reynolds American, dedicated to building a better tomorrow for our employees and communities.

Reynolds stands against racism and discrimination in all forms and is committed to building a more diverse and inclusive workplace.

At AARP, we are committed to ensuring your money, health, and happiness live as long as you do.

♪♪