ZaDora Williams is busier than ever. As a therapist and social worker in Portland who services the African American community, her waitlist has grown exponentially since Portlanders began rallying around the Black Lives Matter uprising.

Many people seeking counseling services at Williams’ private practice, Sankofa Center for Healing, are participants in the protests spurred by the police killing of George Floyd in Minneapolis.

When Williams initially noticed this trend, she looked into how the regular deployment of tear gas and munitions might be impacting her clients’ mental health. She was shocked to find that while chemical irritants continue to be deployed on protesters, there was little peer-reviewed research exploring this topic.

So, in June, as part of the research team at Don’t Shoot Portland, she helped expose the mental and physical health risks of tear gas being deployed on Portland’s demonstrators.

“If you’re tear-gassed, that can also bring about anxiety and trauma symptoms,” she said. “Just witnessing someone getting tear-gassed, you can experience vicarious trauma.”

A review widely cited in that report — which aided Don’t Shoot Portland in landing temporary court-ordered relief on the use of tear gas under certain circumstances — was particularly revealing. It showed the prevalence of post-traumatic stress disorder and depression after collective actions like the ones taking place in Portland are comparable to the impacts of natural disasters, terrorist attacks and armed conflicts.

Compounding the trauma of a daily life punctuated by panic-inducing crowd-control munitions are centuries of oppression of Black people. It’s happening now, and it’s happened for a long time, said Anthony Jordan, the addiction services manager for Multnomah County. He was moved to open Agape Healing and Consulting to provide training to workplaces following the 2012 killing of Trayvon Martin, a Black teenager in Florida. 

“I started doing research and looking at the manifestations of slavery and family history, and the impact that slavery had on my family over time,” Jordan said. “It started making sense to me that this situation with Trayvon Martin had impacted me, not necessarily because of his death but because of all the other historical things that had been felt. And it was unresolved.”

When Jordan spoke with Street Roots in July, he’d seen 10 requests for trainings in the span of a single week; it’s a lot more than he’d get in a week before the movement began.

Adding to the current moment is the increased sharing of photographs and video footage of violence perpetrated against Black people on TV and across social media.

Making a spectacle of violent footage on TV and across social media, Jordan said, has deep historical roots related to the lynching of Black people in public squares. The difference now is that the audience is much larger because of today’s technology.

“To show us in the public square doesn’t seem like a new concept. They’re not understanding the impact it’s having on the people who look like the people they’re showing over and over again,” he said. “It’s like, sometimes I wonder, what is the purpose? We know he was killed by the police. Do you have to show us so much to prove the injustice?”

Paired with a raging global health crisis that disproportionately affects people of color in the U.S., the psychological impact of the moment for many is impossible to ignore.

“I think it’s exhausting. It’s exhausting for more than one reason because I think a lot of Black people, before anything — the pandemic, before the protesting, before any of those things — they were already experiencing significant racial injustices and systemic racism,” he said. 

Williams said most Black therapists she knows are fielding the same influx of new patients she has seen at her practice. When she spoke with Street Roots in July, she acknowledged she was on a waitlist for therapy services herself. 

“There’s not enough mental health services to meet the needs of the African American community right now,” she said. “That’s one of the detrimental effects right now, is that people need the services because they’re fighting against the system that is oppressing them. And then you also have to be harmed during the process.”

Since protesting began, Williams is seeing more clients with symptoms like hypervigilance, panic and anxiety.

A word in the name of Williams’ practice, sankofa, comes from the Ghanaian language Twi.

“It means to go back and fetch what has been lost or taken,” she said. 

It’s often accompanied by the image of a bird walking forward, its head turned, looking back at the path it has carved. Looking back, Williams said, is a necessary part of sustaining oneself in the present moment. 

“That’s kind of my approach,” she said. 

Williams said that to better understand the Black experience, the history of abuse in the medical and school systems must be understood. Growing up on the east side of Chicago, she couldn’t help but notice how many Black children were diagnosed with attention deficit hyperactivity disorder or punished for behavior when their symptoms aligned more closely with signs of traumatic stress. 

“Historical trauma is here; we feel it. It’s killing us; it’s killing Black moms. It’s due to institutionalized racism and implicit biases,” Williams said. 

For those seeking services that account for these culturally specific traumas, the population of therapists and counselors in Oregon is overwhelmingly white.

A report from the Oregon Health Authority in 2018 surveyed more than 3,000 professional counselors and licensed marriage and family therapists across the state, and more than 90% of respondents were white. Black therapists and counselors encompassed less than 1% of the workforce, and even fewer were Indigenous.  

The numbers do little to reflect the needs of Black people experiencing the burden of racism, who are disproportionately affected by higher rates of mental health issues. The increased need for mental health services is national, NPR reported in June. 

“It can be challenging not seeing someone that looks like you helping you,” said Jonicia Shelton, who works as a therapist at Portland Public Schools and runs her own private practice, Talks with June.

“I think we forget sometimes that we’re impacted by white people, and that people aren’t taking that into consideration,” she said. “It is always a different feel to have someone who looks like you talk with you. Because a lot of their experiences are close to yours.”

At the moment, Shelton has around 30 clients and — much to her dismay — she also isn’t able to accept any more. When she was 5, she lost her mother, and growing up, she began unpacking the inner workings of her own family’s trauma. Interactions with a social worker growing up led her to pursue mental health and social work.

Shelton urges people who can’t find or afford a therapist to engage in self-care by talking to trusted mentors and unplugging from social media. 

“Everybody doesn’t have to see a therapist all the time,” she said. “They can go to church, they have preachers, they have life coaches, they have teahcers that they love.”

She said that she knows a lot of people who would make amazing therapists but that the difficulties of attaining and affording licensures stand in the way.

Williams sees that, too. She said recruitment of Black individuals to mental health fields is lacking, and it’s really noticeable in school systems where Black counselors and therapists are few and far between. 

“And then the support of, when we get Black people into those fields, what does the support look like, to sustain and keep Black people in those lines of work?” she said. “There are significant gaps around even practitioners just not taking the time to account for what the Black experience is, and how that may be showing up.” 

The concept of trauma-informed care seeks to ensure, in part, that workplaces and health care systems account for the systemic impacts that racial, historical and familial trauma may have on people. Those who lead workshops on the topic, such as Steffannie Roache, have seen an increased demand for education around it since the protests began in late May.

Roache also provides culturally specific therapy services for Black, Indigenous and people of color at her private practice, which is also at maximum capacity. It’s overwhelming, she said. 

“That’s one of the difficult parts of what’s going on right now,” she said, “is people trying to feel OK and do what they need to bring about social justice, but at the same time, they have their own mental health issues, anxiety and depression.” 

She said she is seeing far more requests than usual for her workshops and has had to turn some of them down.

In June, Roache participated in Trauma Informed Oregon’s web discussion series, which features the Black mental health care providers doing this work in the state. The organization, formed in 2006, seeks to share resources around trauma-informed care, and is “aimed at preventing and ameliorating the impact of adverse experiences on children, adults, and families,” according to its mission statement.

On one hand, Roache said, she’s glad to see companies and organizations wanting to learn.

“On the other hand,” she said, “there’s a demand for us — and it’s not just me — there’s a demand for us to be the teacher-trainer for free.”

Roache compares the requests to asking the victim of a violent crime to teach the perpetrator about the negative impacts of their actions.

“When you are wanting to engage honestly, you want people at the table to actually help make changes to policy, procedures, to make real change; then we can chat about that,” she said. “It’s got to be more than this piecemeal, one-off ‘check the box’ sort of thing.” 

Will this increased interest in providing more equitable mental health care practices across the state be sustained when protesting in the streets stops? 

“I’m hoping that people will become more trauma informed, especially as it relates to race and what’s going on in the world,” Shelton said. “I definitely think it’s going to continue to grow and get better as long as we’re in this pandemic because people will open up the doors more. We shall see.”

Charley McNeely, the director of outreach, inclusion and community engagement at Trauma Informed Oregon, said sustaining the momentum will require far more than an increased interest in trauma-informed training. She seeks to highlight marginalized populations and the movement of trauma-informed care and to make sure the care is inclusive to the people who need it most. 

Right now, she’s documenting the experiences of people with different racial, class and gender identities during the coronavirus pandemic, and through the Black Lives Matter movement. She’s also working on providing families with information navigating the uncertain future of the upcoming school year, while working with Trauma Informed Oregon to determine how the organization will move forward through the pandemic.

She told Street Roots that trauma-informed care can be summed up in two words: meaningful relationships. And while it’s been challenging to craft those relationships online during the pandemic, McNeely said that the United Sates’ current crossroads have pushed the concepts of trauma-informed care from theory to practice.

“I think it shows that there’s a need for trauma-informed care to happen all the time,” she said. “Now is the time to make it, operationalize it and make it part of your infrastructure and how your organization operates. It’s the perfect storm for that to happen, unfortunately.”

Creating a more trauma-informed workplace means undertaking a whole cultural shift, McNeely said, and true change calls for better representation for people of non-dominant culture identities in the Oregon Legislature, passing laws and using inclusive language. 

“I think having a seat at the table from the very beginning is where it starts if you want to shift power,” she said. 

Email Street Roots Staff Reporter Jessica Pollard at jessica@streetroots.org. Follow @JessicaJPollard on Twitter.

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