Mindset Matters: Understanding The Root Cause Of Eating Disorders With Dr. Carolyn Ross

 

When it comes to body image issues, it’s easy to think of diet as an immediate solution. But a change in diet does not solve the underlying issues surrounding that. Dr. Carolyn Ross is an expert in integrative medicine and the CEO of The Anchor Program, a non-diet online (telemedicine) program for individuals with binge eating disorders, emotional eating, and food addiction. She sits down with host Rodney Flowers to discuss the importance of understanding the root cause and gives expert advice on how to deal with these issues.

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Mindset Matters: Understanding The Root Cause Of Eating Disorders With Dr. Carolyn Ross

I am excited about this episode. I have my sister in this space with me, Carolyn Ross. You are going to love her. She’s an author, speaker and expert in using integrative medicine for the treatment of food and body image issues and addictions. She is the CEO of The Anchor Program, a non-diet online program for individuals with binge eating disorders, emotional eating and food addiction problems. She is board certified in preventive medicine and also in addiction medicine and is a graduate of Dr. Andrew Weil Fellowship in Integrative Medicine. I am so delighted to have her with me once again on the show. Welcome, Dr. Carolyn Ross.

Thank you, Mr. Rodney Flowers. I love being on the show and hanging out with you in any way.

It’s always a pleasure to be with you and to experience your presence. You’re so pleasant at all times but I know you’re a powerhouse. I know you have a lot of knowledge, experience and you’re passionate about addictions, food disorders and all of the things surrounding integrative medicine. I know you have a very powerful story. I’ve heard your story before. You’re someone who has just studied your field but you have some real-life experiences that are driving your passion for what it is that you do. I’m happy to have you here. Thank you for coming back and sharing with us.

Thank you, Rodney, for having me. I’m happy to be here.

Besides the COVID and all of these other things that we have experienced, what’s new with you?

You need to be optimistic and realistic at the same time. The glue that binds them is gratitude. Click To Tweet

My twelve-week Anchor Program has expanded and is growing. I love that program because it’s a way for people who have binge eating and food addiction to access experts like me and my team to help them deal with their problems. That’s not something that’s easily available because most people are still in the diet mentality, going from one diet to the next diet. It’s a passion for me because I have a passion for helping women. Women spend a lot of time and money worrying about how they look instead of who they are. My passion is to help them shift and reclaim that power away from the diet industry and put it into their lives so they can live their authentic passion. That’s what’s new for me. It’s expanding, growing and I’m excited about it. Other than that, we’re all in shock from 2020. I’m still recovering. How about you?

I’ve been busy trying to put a message forward about how to navigate this adversity and pull out the good in this level of uncertainty that we’re all experiencing. There is a lot of good in it but it’s harvesting it and that a lot of times the adversity itself could be a distraction from understanding and experiencing the good. Much respect to those people who have lost loved ones and are having a hard time navigating this.

At the same time, I want people to look for the opportunity, to see the opportunity and to have a vision of what could come out of this because that’s how we get to the other side, in my opinion. It’s having a vision just like with addictions and food disorders. Being able to see yourself even though you may have an addiction but see yourself as a sober individual as someone who’s not allowing the addiction or the food disorder to dictate how you live your life but you’re managing and navigating it. Having that vision of yourself in that light is important.

It’s important to say that a lot of people with food issues and addiction issues have struggled in 2020 with all of the challenges that we’ve had so there have been more deaths from opioid overdoses. There has been an increase in alcohol use disorder. There have been people with binge eating disorders whose disorder has gotten worse. It’s important to acknowledge that this has been a difficult year even though we all want to talk about overcoming the difficult year. I love this podcast that I listened to that interview with Michael J. Fox who now has lived with Parkinson’s disease for more than 30 years. He talked about a shift in his life where he recognized that he was always being optimistic, showing the positive front and thinking, “It’s going to get better. It will be fine.”

He had another big blow that hit him. He felt he hit rock bottom and realized that while he was trying to be a role model to everybody, he was not also being real with what was happening in his life. He could be optimistic but then he was using that as a distraction from some real issues that weren’t going to get better. He talked about how you need to be optimistic and realistic at the same time and that the glue that binds them is gratitude.

When I talk to my clients with eating disorders and addictions, we have to be real, that this is a challenge for people who have traditionally used food or substance as a way to cope. There was a lot of coping that needed to happen in 2020 so let’s be real about that. There’s all that coping and at the same time, there are gifts that we can take away from that. I know, for me, I’ve discovered so many benefits that I’ve gotten out of being in quarantine. All the stuff that’s happened has changed a lot of things for me. I’m cooking again. I always cooked. When I was younger and I had kids, I started going, “I’ll order in or have a snack.” I started cooking and checking out all these The New York Times recipes. I have a stack of them and I’m going through them and trying them.

Some I do really well with, some are almost inedible but I’m working my way through them and I’m enjoying it. That’s something that I’ve discovered during this time. One of the things I didn’t say that’s new for me is I myself had COVID. That was real. When people think COVID isn’t real, it’s real. I was in bed for a couple of weeks. I live alone so it was a challenge to be that sick and to be by yourself. I started getting better and I was all excited to get back to my life and the long-haul of symptoms started.

I started having severe fatigue and shortness of breath that lasted for eight months. I am only now feeling that I’m turning the corner but I still have breathing problems and I don’t have the stamina that I had before. That’s what I’m saying. A lot of people have had some real challenges and I can’t say to you that my lungs will be 100% in 1, 2 or 3 months. I can say I’ve improved and that’s good but there are still challenges out there. I’m grateful that I’ve gotten this far. I’m grateful that I’ve rediscovered my love of cooking, for example. It’s the little things that keep us going, not the big things. It’s the tiny things.

What are some of the alternatives to the coping mechanisms that involve substance abuse, alcohol abuse or food addictions? What are some of the preventive measures that people can take during this time to prevent them from falling into that trap?

There are tips and tools. I could give you a laundry list of tips and tools but for me what this time especially in 2020 and in whatever part of 2021, we have that’s still challenging, is calling us to go deeper into learning about ourselves. Also, what led us to have alcohol problems, drug problems or food problems. A diet is a tip and a tool but it doesn’t fix the underlying issue. I feel like 2020 was an opportunity for people to look inside themselves and to reflect on where they are, where they come from and what they want to change. That’s not something you can do as a tip. As a tip, I can say, “Be more mindful,” “Express your feelings,” because many people learn to hold everything inside. They’re taught by their parents that boys don’t cry. You shouldn’t be so aggressive if you’re a girl. All of those things we’ve been trained in but the bottom line is it doesn’t allow us to be fully who we are because we’re not fully expressing who we are.

We’re talking about being who you are at being able to express who you are. There’s so much that comes up with expressing who you are, the limitations around expressing who you are albeit stories you’ve told yourself about past experiences. Also, maybe the mere reality of a past experience that has occurred, things that have happened to us when we were five that we believe or at some point in our younger lives that we hold on to or we’ve adopted as an identity.

 

Even though we’re older, we want to express something and we want to get that out. There’s so much around it. That in itself could lead to an individual wanting to cope wanting to deal with that. I believe that energy is always in motion. When we talk about emotion, it’s energy in motion but if we can’t express that emotion, it gets stuck. It gets bottled up inside. How do we deal with that? We pour the stuff on top of it to try to keep it down because we can’t let it out.

We let it all out in appropriate ways.

We do that but the source. Before we even get to the coping mechanism so we can deal with the source, is allowing our true selves to come out to be real with ourselves and authentic, which is the challenge. In your work, is this a part of your work with identity and dealing with identity as a part of integrative medicine?

Absolutely. Integrative medicine is all about reconnecting the body, mind and spirit. It’s about being a whole person. Many people especially the people that I work with, with eating disorders and addictions, tend to be more in their minds either living in a story from the past or justifying and intellectualizing why things are the way they are or judging themselves, etc. They’re not often connected to their bodies. They don’t know how their bodies are feeling. They don’t realize that emotions exist and are expressed in the body and so on.

It’s the little things that keep us going, not the big things. Click To Tweet

To be fair, a lot of the patients that I work with, have had troubled childhoods. Those troubled childhoods are not only a story because we know now that can change the brain. If the brain of a child is changed, it may impact their ability or their sensitivity to stress. Something that’s easily manageable for me, maybe to them, “I can’t handle it,” because of that change in the brain from something that happened to them maybe 20, 30, 40 years ago. That’s the reality of the situation. In the past, we used to say that alcoholism was a moral failing, that people who were alcoholics were weak because we thought you could will your way out of alcoholism but you can’t.

Alcoholism affects the brain and the brain is changed by the use of alcohol but before you use alcohol, people who’ve had these childhood experiences, their brain is already changed and it makes them different. It makes it harder for them to do the coping stuff that you talk about and I talked about. It affects your resilience and so on. We’ve got to start with telling the whole truth. It’s not what’s wrong with us, it’s what happened to you is the problem because a lot of people, in their families, have grown up with people saying that, “What’s wrong with you? Why can’t you stop drinking? Why can’t you fill in the blank?” It’s not that. I’ve never met someone who wants to be an alcoholic. I’ve never met anyone who loves to be an opiate addict. They may have loved it in the beginning but after a short period of time, it becomes about how can I cope. How can I keep from being in pain?

Is there this belief with the individual that something is wrong? Does that perpetuate the habit?

Absolutely because society tells them and their families tell them. They may say, “Your brother and sister don’t drink. Why are you drinking? Why can’t you stop?” It does come to the point where you feel like, “What’s wrong with me? Why can’t I be like everybody else?” That’s a logical conclusion, based on the stigma from society. Think about people living in larger bodies and how the diet industry tells them, “You could lose weight, you could be thin if you only wanted to and if you only worked hard enough and if you buy this product and stick with it.” When they fail, they’re told, “It’s your fault. You’re you don’t have enough willpower.” When in fact, it’s the diet’s fault because nobody can stay on a diet forever and ever. It has to be a lifestyle change, not a restrictive diet where you only are allowed to do this and this. It’s difficult to do.

Going in position on the diets, they are misconstrued. It is a lifestyle. Correct me if I’m wrong because you’re the expert here but from my opinion and experience, it is understanding your body and your needs and educating yourself on the foods that you should avoid and what are good for you. Incorporating them into your lifestyle in your life on a daily basis that you can sustain.

In some ways, you’re right but you have to take into account the vulnerability of people who have had these experiences from their past. Those changes in their brain make them even less likely to be able to tolerate any deprivation. For you, the last we talked, you decided to change your eating plan, it was based on health needs, your own research, talking to people about it and so on. It wasn’t about trying to please society or your husband by losing weight. It was an internal and personal decision that you made. It worked for you at least on the last time we talked.

For many people, it doesn’t happen that way. There is a lifestyle. I’ve decided that I’m going to be a vegan. That’s your lifestyle. You have to observe what happens in your body when you’re vegan, if it works for you or if it does work for you. For example, I would love to be a vegan and I did it straight for 6 to 8 months and my body did not like it. I didn’t have the energy that I needed. There were other things that didn’t work. For me, it didn’t work but I was able to pay attention and notice, “This isn’t working for me.” A diet is not a lifestyle change. You can’t use diet in the same sentence as a lifestyle change. A diet is strictly about getting the weight off. It’s all about deprivation. Deprivation triggers the brain of the people who are struggling with food addiction and binge eating to go wacko and crave. They can hold on for a certain period of time and they can’t. That’s the reality of a vulnerable person going on a diet.

What is the remedy for that?

You have to heal the past. You have to reconnect with yourself but you have to heal the past. We talk about the past being a story that we tell ourselves and it is a story. It’s our interpretation of what happened. It can be colored in different ways. Parts of it may be true or not true, etc. but it definitely, in that person’s mind, happened and changed them so we can’t pretend that didn’t happen. We go about life and pretend that this didn’t happen. It’s interesting when you look at the social unrest in 2020. The last time we talked, I was training to do my TEDx Talk on Intergenerational Trauma.

In 2020, a lot of black and brown people like myself have been doing the la-la-la about racism and pretending everything’s fine. There’s no problem. For me, I grew up during the Jim Crow era in the south. I went to segregated schools and all of those things. When I did my TED Talk about that topic, a lot of my past came up for me and it was challenging to face some of the things I had “forgotten about” or pushed to the side because I’m a successful black woman, I’m doing all these great things and I’m navigating in the world.

 

That was a part of me, too. I can’t leave that part of me behind and be whole. I want to bring it into the fold and incorporate it as part of my own authenticity, which strengthens me to be an even stronger person because I have all of these pieces of myself integrated. Think about if you have been traumatized as a child and you try to la-la-la, that’s a piece that’s missing from you and it needs to be brought into the fold.

How do people go about bringing it out into the fold without sacrificing and falling into it because there’s a thin line when we bring that into the fold? Perhaps we need some help with that. Perhaps we need someone to support us with that, hold our hands and watch us because it can be overwhelming when you’re going back especially things that we’ve been covering up. When you uncover it and you finally get a chance to talk about it, it could bring up some things for you. How do we navigate that curve?

Using my example of the TEDx Talk, I had a lot of stuff coming from me and I am a resilient human. This shocked me that I was so overwhelmed and emotional. I felt I was having a breakdown. I was like, “What happened here? I’m a woman who knows about trauma. I know of this stuff and what I had to do is reach out for help.” I never advise anybody to deal with trauma from their background without expert help. With expert help, it’s amazing how much relief you can get in your life when you deal with that stuff. You fear that it’s going to take something away from you but what it does is bring something back to you.

I’m not a shaman. I’m not trying to pretend to but I did a study with some shamans in my integrative medicine training. They feel whenever you’ve had traumatic events that a part of your soul gets sent for safekeeping to another place. They’re saying that if you’ve had these traumatic events, you’re literally missing a piece of your soul. Whether you believe that or not, it’s a great metaphor of what I’m talking about with the pieces of ourselves that we can reintegrate and it gives us a sense of freedom and power in our lives that we never had, maybe.

It opens up space because trauma can take up a lot and you’d be surprised how much space it takes up.

I’m not surprised, Rodney. I do this every day.

Not you.

I know what you’re saying. People would be surprised and that’s what I say when they come for treatment, people are terrified. I don’t want to go there. I don’t want to even think about that. When they do, they realize, “Now I have this space. What can I create within this space?” That’s what I mean when I say that women are my particular passion because we’re mothers, workers, daughters and caretakers. We have so many roles to play so we need all the space we can get in order to fulfill our true potential.

You’ve written some books, Carolyn. Could you tell us about a couple of the books that you’ve written?

I’ve written a number of books, Rodney. Mostly my books are about eating disorders. I have a book on binge eating disorders, one on emotional eating and one on food addiction. Some time ago, I wrote a book about my personal journey to healing from a medical illness that I had many years ago. It was chronic fatigue syndrome and fibromyalgia and I wrote a book about my emotional, personal and physical journey to heal from that. That helped me a lot in understanding how to heal from this darn COVID thing. Those are my books.

What are some mechanisms that we can take because everyone has a certain level of trauma? Maybe not everyone but a large majority of people experience some level of trauma and in their younger days that doesn’t, that isn’t dealt with when we become adults. Getting some help is the obvious thing to do. Not everyone feels the need for help.

I do want to make a little bit of a distinction, Rodney and that is when we’re talking about trauma that’s significant, it’s because of the severity of the trauma, how long it lasted and also whether or not that person had the support they needed to deal with it. There may be people who’ve had horrific trauma but they came from a family that helped them to deal with the trauma and they were there for them so it mitigated that circumstance. Most of the people that I have worked with have not had those families to support them and they’ve had that horrible trauma that may have lasted for long periods of time.

All of my books are workbooks and they all take people through the exact steps that I use to work with my clients. If you want to start and a lot of people I work with have read my books first and they come to the realization, “Maybe I do need more help than just reading a book,” but some of them have read my book, email me and said, “Your book changed my life.” The books can work in that they are using those same exact steps that I use in my work.

Do you have the stats on average based on the population in the United States or abroad of individuals suffering from trauma?

The Adverse Childhood Experiences Study, which is now under the Centers for Disease Control and it’s been going on for twenty-plus years, has identified that 1 in 5 individuals in America has had at least one adverse childhood experience. Whether it be having a parent with a drug problem or mental illness or someone in your family incarcerated, emotional and physical abuse, neglect, sexual abuse, etc. One in five, 20% of Americans have had at least one of those situations in their lives. A smaller number have had even more traumatic experiences. The risk of substance abuse, obesity and over 40 medical conditions goes up with the number of adverse childhood experiences you’ve had.

What do you say to the family members of someone that’s suffering from this type of illness? They suffered too. We don’t talk about them a lot. We talk about the individual. A lot of energy is focused on the person who has the illness but what should someone who’s a caretaker or caregiver for someone who has this addiction or food issue, what’s your advice for them?

Diet is a tip and a tool, but it doesn’t fix the underlying issue. Click To Tweet

I always advise them to go to Al-Anon. Al-Anon is for codependence that makes sure you’re not enabling people who are struggling but it’s important for the family members to learn about what their family members are going through and to be supportive but with boundaries. You have to have a boundary that, “I’ll help you but I’m not going to bring you alcohol,” for example or, “I’m not going to judge you if you’re bingeing but I’m also not going to enable you in any way to do that.” Family work is important for all of these conditions because many times the family members themselves have had trauma or they’ve had alcohol or drug problems themselves.

It’s not uncommon that I work with families especially when I have younger patients to help them learn how to parent in a way. I’ll give you a great example because one of the most exciting things in my life is I’ve had patients with addictions for long enough that they are now having children. Some of them started with me a couple of years ago and they were seriously addicted to opioids and now they’ve been in recovery. I work with them around their choice for a bride and when they have children, they start to see often some of the same characteristics in their children that they have. How do you parent to prevent substance use disorders? That is the most exciting work that I do.

Is your philosophy for people or have you used the strategy to be an example of what’s possible for someone who is in that space and now they’ve come out of it? Now they’re a beacon of hope and possibility for others that may be suffering, been in that space or currently in that space.

I see myself a little differently. I don’t know if my ego is big enough to see myself as a role model. I see myself as holding space for people to be the best that they can be. When I’m working with someone about their children or when I’m working with them on their addiction, in my mind’s eye I’m seeing them already recovered. Whereas they can’t see that. They don’t even have any imagination about how that could happen. They’re so deep into the process. I feel like my role is more to hold space for people and to be able to support them coming to their own place of recovery and their own choices that they make.

How can people reach you Carolyn if they wanted to work with you or learn more about you?

I have a website. It’s CarolynRossMD.com. My website is a good place. I also have a podcast The Dr. Carolyn Ross Show. That’s available on all the airwaves. The books, you can get on Amazon. The Binge Eating & Compulsive Overeating Workbook and the others are all on my website so that’s it.

Thank you for giving us that information and thank you for coming on to the show to grace us with your presence. Once again, good info. They’re more important now that we’re dealing with such a traumatic event. All of us are feeling this and it’s having an effect on us. How we deal with that and how we cope is critical. Unfortunately, so many people are falling into food addictions, alcohol and drug addictions. It’s the responsibility of all of us to take care of each other.

I want to encourage people that when we talk about trauma, I know it seems such a downer. It’s not like I could get on here and say, “The first step is to do this and do that. Everything will be fine.” I’m more into the real thing but it doesn’t have to be a downer. There are lots of ways to work with your past. You don’t have to be a puddle on the floor to recover. You have to be more aware and more mindful in your understanding of things so a lot of it is understanding the effect of trauma, not necessarily the emotional side.

It changes the brain. We didn’t go into a lot of detail about that but could you give us a little bit about how that happens?

Now that we have more studies on genetics, we know that trauma doesn’t change your DNA but what it does is it can change the expression of DNA. That means that a gene for addiction could be turned on with trauma and/or a gene for obesity could be turned on with trauma. Once that gene is turned on, it becomes part of your genetic code and that’s how it’s passed on to the next generation and the next.

We didn’t even get into intergenerational trauma. That’s a whole other topic. I don’t want to depress your readers any more than I already have but that’s something to consider. The way that it shows up often is a change in the gene expression of how people manage stress, making them either hypersensitive to stress. That’s an example of how the gene is changed. They’re learning more and more about that. It’s quite interesting. That’s called epigenetics.

 

There’s a lot of education around that to be had. Not only for those that are suffering from it or going through it but the support members and perhaps individuals like me to know more and be a support for those that are going through that. All of us are on the same team. We all want the same. Sometimes, our teammates experience certain things. We all need help from time to time.

It’s particularly important for us all to pay attention to our children, nephews and nieces and provide whatever nurturing we can to the little ones in our lives because that makes a huge difference. Much more difference on the little ones than it does on us, grownups.

It’s because something looks good on the surface, doesn’t mean that it is good. Sometimes we have to take a deeper look or make an extra phone call or stay on the phone a bit longer. Maybe ask 1 or 2 more questions. Be sincere about how people are doing.

At least we used to all be so busy going here and going there that definitely the quarantine makes you stop and think about what’s important. In my life, what’s important is my family so you definitely put that effort in with them.

Carolyn, as we wrap up the show, I want to ask you one last question. If there’s one thing that we can do as it relates to integrative medicine, the treatment of food disorders and addictions that will help us bounce back from this, dominate it and win in this game, what would that be?

Stop judging yourself. Most people with food addiction or any addiction judge themselves. When you judge yourself, you make yourself feel worse. When you feel worse, you’re more likely to use food or substances. If you could do one thing, I would suggest be aware when you’re judging yourself and interrupt that.

What do we interrupt it with?

A diet is not a lifestyle change. Click To Tweet

Interrupt it with one of your positive statements. You probably have a bunch of those. This is the game-changer so it’s all about changing mentality. Put in affirmation or goal or a comforting statement like, “I slipped up but I’m working on it.” Give yourself grace. For me, that’s what not judging yourself is. It’s grace. A lot of people think they have to keep whipping themselves in order to get things done but you don’t. Give yourself grace and allow yourself to be okay.

Dr. Carolyn Ross, thank you for coming on, sharing with us, being with us and educating us on this important topic that sometimes is overlooked. Thank you for bringing that back to light for us.

Thanks, Rodney.

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It’s another successful episode of the show. Compassion can take us in very long ways. The game that we plan is sometimes hard and tough. We have to be aggressive in order to deal with the opposition that we’re dealing with. We have to show love and compassion for ourselves realizing, “We’re playing our best game.” It’s a tough game. No one is saying that is easy. If we can have that level of compassion for ourselves and reward ourselves for our progress or the incremental steps that we’re able to take on a daily basis. When you’re marching down the field, you don’t have to clear the entire field at one time. It’s great if you can do that but if we can just take incremental baby steps, let’s celebrate those steps.

Let’s get into a rhythm of celebrating those micro wins. That’s what we want. When we get out of rhythm, it’s not time to beat ourselves up. We have compassion for ourselves. We know we can get a rhythm. We’ve been there before. Let’s get back into rhythm and sustain that. Before we know it, we’ve discovered so much of the field and we’re winning and progressing. That’s something that we can celebrate. Until next time, peace and love.

Important Links:

• The Anchor Program
• Dr. Carolyn Ross – Past Guest Episode
• Intergenerational Trauma – TEDx Talk
• Al-Anon
• CarolynRossMD.com
• The Dr. Carolyn Ross Show – Podcast
• Amazon – Carolyn Ross Amazon Author Profile
• The Binge Eating & Compulsive Overeating Workbook
• http://RodneyFlowers.com/get-up-book/
• http://RodneyFlowers.com/essential-assertions-book/
• https://RodneyFlowers.us9.list-manage.com/subscribe?u=01f76a038256f77a6fbc93590&id=307d726734

About Dr. Carolyn Ross

Carolyn Coker Ross, MD, MPH, CEDS is an author, speaker, expert in using Integrative Medicine for the treatment of food and body image issues and addictions. She is the CEO of The Anchor Program™, a non-diet online (telemedicine) program for individuals with binge eating disorder, emotional eating and food addiction. She is board certified in Preventive Medicine and also in Addiction Medicine and is a graduate of Dr. Andrew Weil’s fellowship in Integrative Medicine.

Dr. Ross is the former head of the eating disorder program at Sierra Tucson and has served as a consultant to multiple treatment programs at all levels of care on the treatment of eating disorders and addictions. For the past 4 years, Dr. Ross has been an international speaker and consultant on issues of cultural competence, antiracism and diversity in mental health with a particular emphasis on the treatment of eating disorders in women of color.

Dr. Ross presented a TEDxPleasantGrove talk on “Historical and Intergenerational Trauma in January, 2020. She is the co-chair of the AAEDP-BIPOC (African American Eating Disorder Professionals – Black Indigenous People of Color) subcommittee of iaedp (International Eating Disorder Professional). She is the author of 3 books on eating disorders, the most recent is “The Food Addiction Recovery Workbook.” She is a contributing author to the recently released book: “Treating Black Women with Eating Disorders: A Clinician’s Guide.” She is co-founder of the Institute for Antiracism and Equity – a consulting group that works with University counseling centers, treatment centers and other facilities offering mental health care – training staff and health care professionals – to make culturally competent mental health care more available and accessible to black, indigent and other people of color.