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Black barbers as mental health advocates, and interpersonal violence and suicide preventors

Updated: Sep 25, 2023

In the local Community




Abstract Homicide and suicide rank first and third among the causes of death for Black males aged under 35 in the US. Black barbers trained in supporting the mental health of their customers are uniquely positioned to intervene in the deaths of young Black males due to their frequent and personal interactions. However, few studies have explored the impact that these targeted early interventions may have on supporting the mental health of young Black men. Thus, this article undertakes a qualitative interpretative phenomenological analysis (IPA) on the impact that early interventions from trained barbers may have on Black youth. Interviews with 32 barbers were carried out to engage with their life stories as community members, trained barbers, and personal experiences as mental health advocates including lessons learned from related training. Findings revealed that Black barbers: 1) act as a mental health lifeline for the community through their listening; 2) help break down stigmas around mental health; 3) are well positioned to intervene and prevent community and domestic violence; and 4) are also women and can be an inspiration to women in the local community. Overall, this study highlights the challenges and importance of supporting barbers of color communities through the US and the need for future studies on barbers both domestically and internationally.


Keywords

African American; Barbers; Barbershop; Interpersonal violence; Suicide; Mental health


1. Introduction

Homicides and suicides account for the highest and third-highest causes of death among Black males in the United States (US) under the age of 35, which is the definition used for “young Black males” herein. Firearm use made up the highest means of homicides and suicides at over 90% and 50%, respectively (National Center for Injury Prevention & Control [NCIPC], 2023). These traumatic injuries are intentional and highly personal in nature. Subsequently, considerations should be made to see if they may be preventable with effective community-based mental health interventions and support (Bauer et al., 2022; Branas et al., 2021). Homicides, which were highest for non-Hispanic black males, for example, were often caused by “interpersonal conflicts, occurrence in conjunction with another crime, or related to intimate partner violence (particularly for females)” (Fowler et al., 2018, p. 1). Relationships between victim(s) and perpetrator(s) were most often friends or intimate partners. At the same time, this means that the people who are in regular and closest contact with young Black males are in the best position to be able to deter and prevent acts of violence from occurring in the first place. In the case of surrounding community members, this has found to be true with street outreach workers (Dickinson et al., 2021) as well as employees at “schools, primary care, and other community settings” (Bottiani et al., 2021, p. 572).


It is also important to note that these homicides in the African American community can produce a ripple effect and “foster an ongoing cycle of violence in the communities afflicted by this public health disease” (Frazer et al., 2018, p. 3). Violence begets violence, whether in the form of retaliation, preemptive strikes, or immediate responsive actions. As interpersonal violence is a community problem and can result in future crimes, a collective and proactive call to action in the form of target mental health services may be the most powerful step forward. In other words, if interventions on mental health carried out in the confines of a barbershop are effective in preventing one single act of violence or a murder, then it is very possible that other similar acts within the community will also be prevented.


Moreover, compared to other races, young Black males are more likely to keep thoughts of suicidal ideation to themselves, refrain from seeking health care services prior to a suicide attempt, and to have parents who decide not to report suicidal ideation if their child denies such claims (Jones et al., 2019). These factors unfortunately become a major hindrance for early intervention. In should be noted that males in the African American community who were diagnosed with major depressive disorder (MDD) subsequently experienced more long-term chronic symptoms and received less professional care than other races (Goodwill et al., 2021; Price & Khubchandani, 2019; Williams et al., 2007). Within the African American community, clinicians need to pay closer attention to particular “risk factors, presentation of disease, type and severity of symptoms, and modalities of care” (Bailey et al., 2019, p.608) since they are chronic and often more severe when compared with other racial groups (Sheftall et al., 2022). In fact, depression is proven to lead to higher levels of both suicidal ideation and suicide attempts for African American males compared to other races and genders (Omary, 2021) as well as health-related issues such as in increase in inflammation due to depression (Toussaint et al., 2022). Thus, the question must be asked as to what kind of approach to community-based mental health services could be most effective in facing disproportionally high rates of suicide and homicide in African American communities among young Black males.


1.1. A public health approach to traumatic injury prevention

A community-based public health approach to traumatic injury and death prevention describes a key focus as being broad and inclusive, examining “all possible interventions, including changing social norms and passing new laws” (Hemenway & Miller, 2013, p. 1). In the case of directly impacting the lives of African American males, this should include engaging a multitude of people and institutions at the grassroots level such as churches (Brewer et al., 2020; Johnson-Lawrence et al., 2019; Privor-Dumm & King, 2020), local community governance boards (Akintobi et al., 2020), and even barbershops (Ferdinand et al., 2020; Piercy & Troiano, 2018), among others. There appears to be strength in utilizing a multitude of community members (i.e., an emphasis on shared responsibility and collaboration) to best support the mental health of young Black men in their communities, and this is something that would ring true across the spectrum of public health issues and contexts.


However, to be most effective, what this would actually look like in practice will likely depend on the needs and resources of a particular community. Within the African American community, Jones-Eversley et al. (2020, p. 263) suggest that more work needs to be done in developing “culturally sensitive and gender-relevant mental health preventions and interventions to address the overall mental health as well as specific stressors that trigger suicide, homicide, and associated causes of premature deaths among young Black males.” Indeed, community-based public mental health support systems for young Black men in the US need to be specially designed such that they cohere with socio-cultural assessments and services that understand and highlight the unique challenges they are confronted with (Bernard et al., 2021). With these considerations in mind, it is vital to develop a clear understanding of the kind of model that has the capacity to account for a culture and gender specific design when discussing mental health at a community level within a public health approach to traumatic injury prevention.


1.2. Utilization of a culturally informed adverse childhood experiences (ACEs) model

Designing and implementing community-based public health practices and programs specifically designed for young Black men's mental health is complex. Firstly, it must consider and “engage the historical and contemporary racial contexts within which black people experience mental health problems” (Alang, 2019, p. 346). This includes contexts such as persistent educational inequities (Boutte, 2022; Hugh-Pennie et al., 2022), chronic health conditions leading to increased risk of hospitalizations (Grosicki et al., 2022), mistrust of the health care sector (Bogart et al., 2022), problems with access and trust related to receiving mental health services (Thomeer et al., 2023), and generational trauma among Black men (Hampton-Anderson et al., 2021). Indeed, the challenges increase as young Black people shoulder an unequal proportion of the burdens of income inequality, racial inequity, and community violence resulting from “experiences with racism and discrimination, racial disparities in mental health care utilization,