McGirt-Adair said these words to an audience at Auburn’s Green River Community College on a sunny summer morning, as therapists, educators and students listened from their seats or streamed in virtually. They were present for a conference and resource fair McGirt-Adair had crafted directly in response to the dynamic of exclusion she has encountered. The goal is to strengthen mental health among Black and Indigenous communities and communities of color in Washington with an effort led by BIPOC clinicians and advocates.
The result was “Reclaiming Wellness” – “because wellness, joy and abundance is our birthright,” she said. The first conference this July drew almost 200 participants and 80 vendors. McGirt-Adair plans to make it an annual event.
On a busy Friday before a crowded Seattle weekend – the Storm played and Taylor Swift concerts impacted the seismic record – trainings and panel discussions focused on topics including racial trauma for clinicians, sickle cell disease and mental health, and health equity. Speakers included the University of Washington’s Dr. Ben Danielson and Dr. Uché Blackstock, who shared her experience leaving academic medicine in a keynote address.
In 2020, at the beginning of the pandemic, Blackstock left academia and was working in urgent care in Brooklyn, where she met a patient who was clearly in distress. “She said to me, ‘Are you Black?’” recalled Blackstock, who noted that she was wearing personal protective equipment during the clinical encounter. “And I said, ‘Yes.’ And then she let out this sigh and said, ‘OK, I just want to make sure that I’m going to be listened to.’”
The patient had been diagnosed with COVID-19 and needed treatment for shortness of breath. “I just knew in that moment that I was the clinician that she needed,” said Blackstock. But too often, that isn’t the case. “I’ve been in so many situations where patients have needed doctors that look like them, or at least can understand where they're coming from,” she said.
Connecting people with providers who can meet them the way Blackstock met her patient in Brooklyn can be challenging, especially when it comes to mental health care in a state with relatively few Black mental health care providers.
Since 2020, McGirt-Adair has pushed against these barriers through the Therapy Fund Foundation, which she founded in 2020 after seeing the impact of COVID-19 and violent racism on the Northwest’s Black community. The Foundation addresses both the expense of mental health care and the challenges providers face by connecting Black Washingtonians with free mental health care and reimbursing Black providers at market rates.
"I think her method has been phenomenal,” said Dr. Patrice N. Douglas, a California therapist who first connected with McGirt-Adair on social media, and whose presentation drew a broad attendance at the “Reclaiming Wellness” conference, where she gave it in person for the first time.
In her opening remarks, McGirt-Adair said she was thankful for Douglas’ work critiquing the Diagnostic and Statistical Manual of Mental Disorders, the gold-standard handbook, now in its fifth edition, used by clinicians to diagnose mental health conditions. “The DSM has been used as a tool to help people better understand their distress, but we have also to talk about how it’s been a tool that’s very much been used to harm communities of color,” she said. “It’s rooted in racism, ableism and homophobia.”
In “DSM-5 for the Culture,” Douglas broke down these limitations, especially in regard to the manual’s ideas about race and racial trauma. The DSM is useful as a diagnostic tool, said Douglas. But clinicians can lean too hard on it, to the detriment of providing culturally appropriate care and acknowledging how racism impacts mental and physical health, she said: “We can’t depend on the manual to do that for us.”
The DSM also leaves a lot out, including racial trauma, despite clear links between oppression and poor health outcomes. “At this day and age of our society, there’s no reason why racial anxiety and racial trauma is not looked at as a medical condition that can potentially harm somebody’s health,” Douglas said.
In her speech, McGirt-Adair put this problem in stark terms. She asked her audience to picture “someone who needs therapy.” “Did you picture someone depressed?” she asked. “Did you picture someone anxious? Did you picture a student? A mom? A senior? Did you picture someone white?”
Too often, she said, we do. “When we visualize depression, we often think of images portraying someone who is typically white and we’re accustomed to seeing the student, a struggling mom, someone who’s newly divorced,” she said. “We do not think of the physically disruptive Black boy growing up in the inner city who just watched his best friend get shot over the weekend.”
Given the preponderance of gun violence and the trauma it leaves behind, she said, “We do this work for the Elijah Lewises, the D’Vonne Pickett Jrs., the George Floyds – so many people in our community whose lives have been taken unnecessarily.” Pickett, a small business owner beloved by his Central District neighbors, was killed in a shooting last year while he and his wife were closing their mail-and-dispatch shop for the day. A tribute to him was held at Climate Pledge Arena in November.
Stories like his – and stories of the communities they impact – are important to understanding who may need therapy and why, said McGirt-Adair, adding that it’s important to challenge the systemic barriers that limit access and support for both providers of color and the communities they serve. “We must ask who has the power and privilege to conduct research and get funding and why?” she said. “Colonized behavioral health says there is no other worldview, and we are here to disrupt that notion and advance health equity for all people.”