A third of black women in study of disadvantaged neighborhood have PTSD
Chicago Tribune - 3/23/2017
March 23--Nortasha Stingley doesn't remember a lot about the weeks after her 19-year-old daughter was shot and killed nearly four years ago. All she could do was cry. All she wanted to do was scream.
After Stingley lost 40 pounds in a matter of weeks, her sister finally took her to see a doctor, and she was diagnosed with post-traumatic stress disorder.
"It's still a battle," said Stingley, 40. "I died and they just forgot to bury me. It's a struggle."
Like Stingley, many African-American women in disadvantaged neighborhoods have PTSD, experts say. A recent Northwestern Medicine study that examined the South Side neighborhood of Oakland found that 29 percent of the 72 African-American study participants have the disorder and an additional 7 percent exhibited a large number of signs that are part of a PTSD diagnosis. Researchers said they believe that points to a need for more mental health services and screenings in poor neighborhoods.
Stingley, who lived in Park Manor at the time of her daughter's death, was not part of the research.
Women who already had mild to severe depressive symptoms were chosen for the study, which was published in the Journal of Racial and Ethnic Health Disparities, a peer-reviewed publication, in December.
PTSD is a potentially debilitating anxiety disorder that may develop after exposure to a shocking, scary or dangerous event, according to the National Institute of Mental Health.
Participants in the study all reported details about traumatic experiences, like witnessing a son being shot more than 10 times, domestic violence, car accidents or a father being killed at home. Exposure to violent crime is more likely to occur in disadvantaged communities, according to the study.
Living in an environment of poverty and violence can worsen pre-existing depression or trigger the onset of a new depressive episode, researchers found. It also can lead to PTSD or subthreshold PTSD, meaning a number of symptoms characterizing PTSD are present.
"People are struggling," said Inger Burnett-Zeigler, a clinical psychologist and one of the authors on the study. "People are struggling severely, and I think that sometimes the negative implications of mental illness are really underestimated."
According to the 2015 U.S. census, the average income of the Oakland neighborhood was $47,202. The population is heavily dependent on Medicaid, with more than a third needing some kind of assistance.
Other Chicago neighborhoods have worse numbers. Park Manor has an average income of $44,402. The city of Chicago has an average income of $74,003.
As violence surged in 2016, Chicago recorded the deadliest year in nearly two decades. According to Tribune data, the city saw 4,368 shootings and 787 people killed. In Oakland, 55 people were shot and three killed. In Park Manor, there were 193 shootings and 12 homicides. And violence is on a similar pace in 2017.
Because the Tribune violence database defines shootings by addresses and not neighborhoods, the ZIP code that covers Oakland is linked to sections of other neighborhoods. But homicide entries are defined by specific neighborhoods.
Dr. Michael Malone, who worked in Englewood for 11 years before spending the past four years in Bronzeville, said he has many patients who are dealing with trauma and struggling with PTSD.
"Sometimes the PTSD is missed or a lot of times, it could be the patient not being forthcoming with past trauma or past physical abuse, and it's something that is definitely out there," said Malone, who is Stingley's doctor. "Unfortunately in the inner city where we are, that's something that needs to be addressed more, and the study was right on. As I'm reading through it, I'm thinking of different patients in my head that we've diagnosed."
For Stingley, life dramatically changed when her 19-year-old daughter Marissa was gunned down blocks from their home.
"She was like, 'I love you so much Ma, don't nobody love you like I love you,'" Nortasha Stingley recalled her daughter saying before she left.
Marissa Stingley was shot in the head while a passenger in a car stopped at 73rd Street and King Drive.
After Nortasha Stingley found out, she screamed at police to get away from her.
"I had literally lost my mind. I snapped," Stingley said. "I was just gone. ... I just remember trying to figure out where she was at, and I just couldn't understand."
Since then she has been through therapy, rounds of medications and treatments to combat PTSD. Her body has changed, and frequent doctors visits are now a regular part of her life.
"She was just not herself, and you could tell," Malone said about her first visit after the shooting. "She took it incredibly hard, as any mother would, but she was a completely different person, so to speak, when we saw her that day and has been since that day to some degree, unfortunately."
The study is not comprehensive, involving one neighborhood and a small sample size. More research is needed, but the findings are consistent with previous, narrower studies about the effect of disadvantaged neighborhoods on residents, Burnett-Zeigler said.
Making mental health available at primary care and community hospitals is the first step toward ensuring that people get screened and receive high-quality care, especially in a city where treatment options are shrinking, Burnett-Zeigler said.
Mental health resources on the community level are needed, but crime victim services also are crucial, said Susan Johnson, executive director of Chicago Survivors. They can help educate, support and counsel those who have been exposed to violence, whether directly or indirectly. No one gets used to seeing dead bodies or hearing gunfire, Johnson said, and those stressors have a "profound effect" on the ability to function.
Malone said talking to patients immediately after they have been exposed to trauma helps the healing process, but often there aren't enough mental health providers in disadvantaged neighborhoods to do that.
Stingley said educating people about PTSD and increasing mental health services would be a huge benefit. But most days, she just wants someone who will listen without judgment.
"We have to figure out ways that we can get it out better and get help because it's like a cancer," Stingley said. "When you hold things in, cancer, what does it do? It eats you from the inside out."
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