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By Robin Jay, BHC Editorial Director

One Sunday afternoon in 1999, Atlanta Constitution journalist John Head was doing some renovating at his Atlanta home and was listening to a radio program as he tinkered. A familiar voice caught his attention. It was Rosalynn Carter talking about how she got involved with mental health as an issue, both when she was first Lady of Georgia and First Lady of the United States. At the end of her interview, Mrs. Carter spoke about The Rosalynn Carter Fellowships for Mental Health Journalism of the Carter Center Mental Health Program. Each year, The Carter Center awards stipends to ten professional journalists in the United Sates, southern Africa, and Romania, to produce a significant work on mental health or mental illnesses. The purpose was to help spread awareness of this important issue in the media, and to encourage journalists to learn more about and cover more stories on mental illness. John was moved to apply. He proposed a book about access to mental healthcare in minority communities. His application was accepted.

The excited journalist was given access to nationally recognized experts to interview during his research period. Surgeon General David Satcher was one of his notable resources. John soon realized he needed to narrow the focus of his book and chose to cover an issue he had dealt with personally: Depression. The specific focus of his book became black men and depression. “I really count that Sunday as one of the most fortunate days of my life. It really was being in the environment of the fellowship program, and talking with people about stigma and mental illness and about the need to break through that put me in an environment where I could, for the first time, talk about my own experience with depression,” said John. “ “I really had not spoken to anyone about it and, in fact, when my siblings and my mother read the book, they said they had no idea of what I had gone through. They new something was wrong, but I had never told them the details. So it is creating an atmosphere and getting information out that allows people to not be ashamed and to understand that treatment is available.”

During his research, John found that very little had been written about the topic of black men and depression. The original title, Standing in the Shadows, details John’s struggle with depression as he uncovers the cultural ideals that cause black men to bury their emotional pain. Because of the taboo topic within the culture – it’s seen as a sign of weakness – the majority of cases of depression in black men go untreated, until a rock-bottom incident leads them to the emergency room, a homeless shelter or incarceration.

John says in his book that neglecting emotional disorders in black men equates to racial suicide – that the cultural taboo goes back to the time of slavery when it was thought that black people didn’t posses a psyche and, as a result, didn’t have the propensity to feel psychic pain. And, rather than taking responsibility for inflicting pain, those involved with slavery instead grew to stereotype black men as violent. Standing in the Shadows (also titled Depression in Black Men) also covers the role of the family, changing role of black women in society, and the church as factors influencing the stigma of depression in black men. “My book is a call-to-action for the black community and the psychiatric community to end the silent suffering of black men,” said John.

When was writing the book, John found the best way to convey to people issues about mental health was to actually tell people’s stories, not just to quote numbers or experts. “ I found that very often people who would be willing to talk to me would then say, “Oh no, you can’t use my photo, in fact, you can’t use my name. I’m willing to talk to you, but I don’t want you to use my name.” And what I would always say is that I would not write an article about mental illness and then, by saying that I was making up a name for someone, that you should be ashamed if you have a mental illness. So I always tried to talk people into allowing me to use their names, and if possible, photograph them. And then I sort of had this ‘look whose talking’ moment. I was someone who was trying to get people to tell their story in order to help people understand about mental health and mental illness, and yet I was not willing to tell my own story. I really decided that if I was going to write an honest book, I had to tell my story, too.”

John found that researchers talked not only about the barriers to care, but also the cultural influences that made it very difficult for black men to seek help. In general, men are less likely to seek help for depression than women.

“But I think it is heightened for black men partly because of our own cultural idea of what manhood is and how important it is. I talk in the book about how black men’s manhood has been taken away from them historically; the whole idea that the black man was always a ‘boy,’ but within the community itself, that manhood was emphasized in that you would see small black boys, very young, referred to as little men, not little boys, and the idea that you wanted to achieve this image of manhood that involves strength, involves silence, that involved not showing emotions, that involved always being in control, always being able to pull yourself up. These kinds of traits are the traits that argue against opening yourself up and trying to get help. So I think for those reasons, it is more difficult in a way for black men to struggle with depression simply because of the idea that depression is not an illness, which is an idea that’s been prevalent in the black community, but rather it’s not an illness but a character flaw or a weakness. And if you have that idea, then you don’t want to admit that you’re struggling with depression, and if you’re not able to identify what it is that you’re struggling with, how can you get help?

So one of the things John hoped to do with his book was to start a conversation in general about depression, but also a conversation specifically among black men about depression to create an atmosphere where they were no longer ashamed to talk about their own struggles and to reach out to get help for depression. “If I had been able to do that during my own struggles, I think I would have gotten help quickly. In looking back, I can see that for more than 20 years I struggled with untreated clinical depression. I finally got help when I reached a point when there was nothing else that I could do. I reached a point where I was really in so much pain and feeling so hopeless struggling with this condition that I knew that I could not go on if I didn’t help. And I did want to go on. I have three sons and I realized that I really did want to have a with them and be there for them, and so I think that was what motivated me finally to get help and to start my own recovery. And in a very real way, once I did that I got a second change at life and it’s made obviously a huge difference for me.”

John now writes frequently about mental health issues and travels the world speaking to groups about about his book and the issue of Black Men and Depression. Both titles of his book can be found on Amazon.com. To learn more about author John Head, read the full transcript of our interview that follows.

BHC: John, I understand that you were one of the judges from The Carter Center Journalism Fellowships this year. How long have you doing that and were you originally one of the recipients of a journalism fellowship?

John Head: Yes, I was a fellow in the ’99/2000 class, which I believe was the second group of fellowships that they had. After my fellowship was done, they asked me if I would be willing to serve on the advisory board for the program and I was very happy to serve. I’ve been doing it ever since. Its been one of the great experiences of my life, being involved with the program.

BHC: John tell us a little bit about how you found out about the program the year that you applied and what the program meant to you at the time.

JH: Well, actually I was doing some house renovation on my own one Sunday. When I do that kind of thing, I like to have to radio on and I was listening to a show called “The Infinite Mind,” and I heard this familiar southern voice on the program. It was Roselyn Carter and she was talking about how she got involved with mental health as an issue and the issue that she took on both when she was First Lady of Georgia and First Lady of the U.S. At the end of the interview, she mentioned this program that she had for journalists who would submit an application purposing to do a project about mental health and the Carter Center would basically support or give them a stipend for a year to work on the project. So I proposed to do a book about access to mental healthcare in minority communities, and my application was accepted.

I started the fellowship program, but eventually it evolved into being advised by people in the program including advisory board members then to narrow the focus of the book that I was planning. I finally narrowed it down to black men and depression and I did that because I finally reached a point during the fellowship and in my interaction with people at The Carter Center and with other fellows, where I was finally able to talk about my own struggles with depression. I felt that I could not write an honest book if I wrote a book about mental health and I didn’t write about why this was personally important to me. So it became a book about black men and depression and my whole story was part of the book. The Carter Center Fellowship gave me entree to all kinds of researchers and experts and therapists and people. One of the really great sources that I had for the book was Surgeon General David Satcher. The fellowship program opened those kinds of doors for me that I could call people and say that I was working on the book and that I was on a fellowship with The Carter Center, and that gave me the kind of cache that people felt it was okay to talk to me. So in that regard the program was really valuable, but also the purpose of the program, which is to take journalists and to put them in an environment where they can get the best factual information they can about mental health and use that to report on mental health is really the thing that is most helpful.

I have to say that The Carter Center doesn’t try to push journalists in a particular way or to say that this is absolutely what you have to say or we want you to be an advocate; they want journalists to be informed about mental health and the issues surrounding it and then go back to their jobs and use that information and use that perspective of having the most accurate information possible to write about mental health or to report on mental health, and to me that’s really one of the great values of the program.

BHC: John, tell us a little about your background. Were you a journalist when you applied for this and in what capacity?

JH: I was a journalists when I applied for the program. By then I had about 15 years experience as a journalist. I was on the editorial board of the Atlanta Constitution and I wrote editorials for the newspaper and a column. Mental health was not my beat; I was not an expert on mental health. I had been interested in mental health for a long time in part because of my own struggles, and so it was sort of a natural for me when I heard about this program for journalists to apply.

Once I got into the fellowship program, I decided that I not only wanted to write the book, but I also wanted to report on mental health for the newspaper. So I left the editorial board and sort of took mental health as my beat as a reporter and reported on mental health for the newspaper. And after the fellowship year, I actually had completed my research and had an outline for the book and had started writing the book. The book wasn’t completed, but it was well underway by the end of my fellowship year. I actually was lucky enough to get a contract offer from Random House to publish the book, and so I had a contract to write the book and actually wound up leaving the newspaper in order to finish the book. I haven’t been back to newspaper since then. I’ve been freelancing and doing other things until recently and also doing a lot of traveling and speaking about mental health because I found that people would come across the book and sort of say, “Hmm, I didn’t know that anyone had written a book about black men and depression and wonder who this person is and whether he would be able to talk to their group about depression, especially groups that were concerned about black men and depression. They would contact me, but whenever I could if I got an invitation to speak about the mental health, about depression, I’ll always do it. So I spent a lot of time doing that and I’ve since we moved to California from Atlanta. I was based in Atlanta, lived in Atlanta, we moved to California about three years ago and about a year and a half ago, I actually took a job at MHN, which is a behavioral health company. I’m writing mostly about mental health, so I’m back to an area that I’m still very much interested in and still happy to be involved in it in this way.

BHC: And so John in listening to you, I see that the initial participation that you had with The Carter Center journalism fellowship really resulted in three things: one is it help spread awareness about a very important area of mental health that hasn’t been written about much before, so it helps spread awareness about black men and depression; it also then provided our media with a journalist who now was more familiarized and compelled to want to write about mental health so it educated you about mental health and what issues needed to be brought about within our country; and it also then led to an opportunity for you on a long-term basis with your career. So I think that’s fantastic. And it all came about just from being outside listening to a radio program.

JH: Very much so. I really count that Sunday as one of the most fortunate days of my life. I want to add to those three things. It really was being in the environment of the program, the fellowship program, and talking with people who talked about stigma and mental illness and talked about the need to break through that, that really gave me, put me in an environment where I could for the first time talk about my own experience with depression. I really had not spoken to anyone about it, and in fact, when I wrote the book, my siblings and my mother read the book and said they had no idea of what I had gone through. They new something was wrong, but I had never told them the details. So that again focus on creating an atmosphere and getting information out that allows people to not be ashamed throughout a lot of people to understand that treatment is available and the recovery is possible I think is really one of another great things about the fellowship program.

BHC: John, was your topic Black Men and Depression the focus based on your experience with depression or were there other aspects that led you to that focus?

JH: I initially started out with this sort of very wide topic of access to mental healthcare in minority communities, and that would mean all minority communities, and the people at the fellowship program very wisely told me that they felt that the initiative to narrow the focus if I really wanted to do an effective project. They didn’t really pick a subject for me, but I was writing about mental health for the newspaper at the time and one of the things that I found in writing about it for the newspaper was that the best way to convey to people what the issues surrounding mental health and mental illness meant was to actually to tell people stories, not just to quote numbers or experts or research, but actually tell stories of people who had dealt with mental health issues, and so that’s what I tried to do.

But I found that I would very often find people who would be willing to talk to me and then when I said, ‘well I’d like to have a photographer come out and get a picture a photo of you,’ they would say, “Oh no you can’t use my photo, in fact, you can’t use my name. I’m willing to talk to you, but I don’t want you to use my name.” And what I would always say is that I really did not want to and would not write an article about mental illness and then, by saying that I was making up a name for someone, that I was saying basically that you should be ashamed if you have a mental illness. So I always tried to talk people into allowing me to use their names, and if possible, photograph them and I knew it was kind of a small thing for people to do, but I found people were willing to do it. And so I sort of had this ‘look whose talking’ moment, someone who's trying to get people to tell their story in order to help people understand about mental health and mental illness and yet I’m not willing to tell my own story. I really decided that if I was going to write an honest book, I really could not, not tell my story. (I had to tell my story.) So that was when I decided to narrow the focus to black man depression and to use my experiences in trying to convey information about this. I found that there had been very little, almost nothing, written specifically about black men and depression, so I sort of in a way while were still on that topic, had to use my own story in order to sort of have a jumping off point of talking about how things stood.

BHC: When you finished the book, tell us the title that ultimately you came to so that those who are listening to this can find it online or in their bookstore if they’d like to purchase a copy. And then also let’s talk about your research – what did you find about the prevalence of depression among black men and then tell us a little about your personal story if you would.

JH: Well, the book initially published under the title “Standing in the Shadows: Understanding and Overcoming Depression in Black Men” that was the hard cover title, the paperback title was simply, “Black Men and Depression.” As for what I found out in doing research for the book is that there generally it is not thought that there is a racial component to depression or to mental illness. In other words, that people are not susceptible to mental illness simply based on race, but one of the things that David Satcher said to me, and he also said in his report on mental health and minorities was that a burden of mental illness was felt heavier in minorities communities because of a number of factors, including the lack of access to care and also heightened stigma. So that it was different struggle to be struggling with depression or other mental illnesses in minority communities, and I think that is especially true for black men for a number of reasons.

In talking with researchers, they talk about not only the barriers to care, but also the cultural influences that made it very difficult for black men to seek help, and in general men are less likely to seek help for depression than women. That’s the case in general, but I think it is heightened for black men partly because of our own cultural idea of what manhood is and how important it is. I talk about it in the book, how black men’s manhood has been taken away from them historically; the whole idea that the black men was always a boy, but within the community itself that manhood was emphasized in that you would see small black boys, very young referred to as little men, not little boys, and the idea that you wanted to achieve this image of manhood that involves strength, involves silence, that involved not showing emotions, that involved always being in control, always being able to pull yourself up, these kinds of traits are the traits that argue against opening yourself up and trying to get help. So I think for those reasons, it is more difficult in a way for black men to struggle with depression simply because of the idea that depression is not an illness, which is an idea that’s been prevalent in the black community but rather it’s not an illness but a character flaw or a weakness. And if you had that idea, then you don’t want to admit that you’re struggling with depression, and if you’re not able to identify what it is that you’re struggling with, how can you get help?

So one of the things I hoped to do with the book was to start a conversation in general about depression, but also a conversation specifically among black men about depression and to create an atmosphere where if you’re having that conversation, you’re not ashamed to talk about your own struggles or your not ashamed to reach out to get help for your depression. If I had been able to do that during my own struggles, I think I would have gotten help quickly. I mean, as it was looking back, I can see that for more than 20 years I struggled with untreated clinical depression, and finally got help when I reached a point when there was nothing else that I could do. I mean I reached a point where I was really in so much pain and feeling so hopeless struggling with this condition that I knew that I could not go on if I didn’t help. And I did want to go on. I have three sons and I realized that I really did want to have a life that I could live with them and be there for them and so I think that was what motivated me finally to get help and to start my own recovery and in a very real way once I did that I got a second change at life and it’s made obviously a huge difference for me.

BHC: John when you were going through depression, did you personally have a realization that what you were experiencing with depression or was it, by virtue your innate tendencies, not to realize that because you had to be strong, you couldn’t show weakness. Were you aware that it was depression?

JH: Well I feel that I sort of lacked the cultural vocabulary to say what I was going through. I grew up in a small southern town in Georgia and when I was growing up, the idea that someone could be treated for an emotional problem, the idea that you would go to a doctor to try to help with what was going on with you mentally was not something that I had ever heard of, and my only encounter with mental health when I was growing up was that, from time to time, there might be someone in the community who wound up being sent to the state insane asylum. And once that happened, they were never heard from again.

So the idea that someone could actually be treated and recover from a mental illness was completely foreign to me, and that was really sort of what I grew up with and I really resisted identifying the things that I went thought that had anything to do with mental health. ThenI finally came to understand what depression was but I resisted the idea that that was really what was my problem. I felt more inclined that was I was going through was simply because I deserved it, because I was a bad person, I was a week person and that something again that could be treated, and I had people in my life who urged me to get help, who thought that professional help was what I needed, but I resisted that.

It was primarily my wife who really talked about professional help. My wife is a doctor, so she is trained as a doctor and so she knew something about what she was talking about, but I just resisted the idea and just refused to get help. Counseling was, I just couldn’t conceive of sitting there and talking to somebody about my problems, so I resisted. I finally reached a point where I felt that I was again this awful person and such a bad a negative influence on my family that I moved out, I left my family. I was in the same city, but felt that they’d be better off without me in the household.

I finally reached the point where I felt there was nothing that I could do, that I would never be better, and I was really at the point of suicide. I really think that what stopped me (and I was virtually going through at one point a dress rehearsal for suicide) that I really realized that I was in serious trouble and that if I wanted to survive and to be there for my sons the way I wanted to, that I had to get help. And that was the time when I admitted that I needed professional help and sought out help and was very lucky because I initially thought that I was embarking on a journey that would be very short, that I would go see someone and they would prescribe something for me and within a couple of weeks I’d be fine. I didn’t do any research about the therapists I was seeing, I simply chose the person who was closest to me. I went to see her and I was very lucky because she was a very good therapists, great person, and she helped me. And I soon realized that the journey was not going to be for a couple of weeks, that it’d be much longer, and in fact it’s probably a journey that I’ll be taking for the rest of my life. But as I said, it’s making that decision really did both literally and figuratively give me my second chance at life.

BHC: John is there anything else about your book, about your experience as the Carter Center Journalistic Fellow for those who might be encouraged to apply for a fellowship next year? Any other thing you’d like to say about that?

JH: Well I would encourage journalists with an interest in mental health to apply to the program and the program is looking for people who are trying to shed light on aspects of mental illness and mental health that are not receiving enough attention, things that will enlighten people, things that will get the kind of information – the kind of accurate information out there that will allow people to see exactly what it is you’re talking about when you talk about mental health and mental illness. So I would encourage people, journalists, who are interested to apply. And The Carter Center is interested in journalists from all fields including the so called ‘new’ media. So if you’re interested apply, it’s a great program. The only other thing I would add is that the fellowship program my whole experience and again the way it’s effected my personal perspective really convinced me that there is hope for people who are struggling with depression, and I know that one of those symptoms is that you feel completely hopeless, but I would urge people who are listening who are struggling to know that there is hope. You can get better and I would urge anyone who feels that they need help to get help.

BHC: John thank you very much it’s been truly a pleasure to talk with you.

JH: Well thank you.

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