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African American Behavioral Health Center of Excellence: Building Equity in Responses to Substance Use Disorders, Mental Health and More

By Alex Skov
ATTC Network Coordinating Office

As the past year’s public health crisis has raised our consciousness of the effects of historic inequities on the physical and behavioral health of African Americans, it has also demonstrated again and again that the need for accessible and culturally responsive services far exceeds our capacity. For example:

  • In 2019, 6.5 million African Americans in the U.S. reported having first-hand experience with a substance use disorder, mental illness, or both, according to data collected by the Substance Abuse and Mental Health Services Administration (SAMHSA). This marked a 10.1 percent increase over 2018.
  • Similarly, overdose deaths caused by synthetic opioids have risen sharply among Black Americans during the past decade, with fentanyl-related overdose deaths climbing nearly 1,000 percent from 2013 to 2016 alone, per the Agency for Healthcare Research and Quality.
  • The COVID-19 pandemic has further complicated these issues for racial and ethnic minority groups as it became more challenging to access mental health and substance use treatment services throughout 2020 and the first half of 2021.

As the country strives to return to its pre-pandemic normalcy, the African American Behavioral Health Center of Excellence is prepared to help transform behavioral health services for African Americans by endeavoring to making these services safer and more culturally appropriate and responsive while also improving accessibility and effectiveness.

“When we in behavioral health look at the racial, ethnic, gender and sexual minorities who often suffer from poor mental health outcomes, we sometimes need to dig deeper to see all the factors that are driving that,” the Center’s Principal Investigator Dawn Tyus said. “Yes, the inaccessibility of high-quality care is a significant problem, but that problem is being compounded by the taboo or stigma attached to needing or receiving behavioral health services in African American communities. So when we go after disparities in access to services, we need a strategy that also includes efforts to dispel the cultural stigma. Our goal is to help the community normalize these conditions—and normalize the need for help.”

Housed in the National Center for Primary Care at Morehouse School of Medicine and funded in 2020 by SAMHSA and the U.S. Department of Health and Human Services, the African American Behavioral Health Center of Excellence has spent the first of its five funded years focused on studying the breadth and depth of the challenges that are contributing to health disparities, raising awareness of the historical and systemic factors that have led to and perpetuated these inequities, and growing solid partnerships with the larger community of like-minded individuals and organizations working toward true solutions.

Having already hosted multiple webinars and published several articles, the new CoE is taking an approach that Tyus describes as “systematic and structural,” looking at the long-term effects of systemic racism on behavioral health disparities.

“We’re making sure we’re talking a lot about looking at the history and the trauma of these communities, so that providers know how to engage them and really treat them safely, and understand some of the cultural nuances that they should be considering in designing and implementing their practices for communities of color,” Tyus said.

These operational aspects include employing individuals of color to work in communities of color and actively engaging community members in conversation to help eliminate any implicit biases that may exist in an organization. Tyus notes that clinicians may face a learning curve in this respect, particularly those who are new to working with African Americans, or new to thinking about the impact of traditional “color-blind” approaches.

“Nobody is blaming anyone for what our society never taught us; it’s also finding joy in learning what it is that you need to help people feel happy, healed, and whole again,” Tyus said. “It’s about being responsible for stepping outside of the box and looking for those resources that are culturally competent to deal with Black and Brown communities.”

While clinicians and professionals in the health fields are important figures in the effort to improve behavioral health for African Americans, they are not the only audience the Center hopes to reach.

“We know it’s not only a public health approach that we’re going to need,” Tyus said. “It’s going to take a community—it’s going to take a country—for all of us to find that collaborative synergy to make this happen. Because we want to see at the end of these five years that we’ve made an impact. And the way you make an impact is not in a silo, but together as strong, collaborative partners.”

Along with its many professional partnerships and its Executive Advisory Board full of national leaders in behavioral health, public health, and health equity, the Center of Excellence has also been building its community ties. Notable among these are members of the Black Stakeholder Engagement Council, made up of community partners representing barbershops, beauty salons, gyms, churches, and Black sororities and fraternities, among other institutions. As the Center’s visibility, events, and product creation increase, Tyus anticipates that the Council will expand its membership accordingly, to help spread these resources to meet their communities’ needs.

As the Center of Excellence takes its next steps to engage the public and behavioral health and allied fields, its staff is mindful of its ultimate goal.

“The thing that we’re all most excited about,” Tyus said, “is seeing real-life, impactful change that is sustainable for communities of color.”

To learn more about the African American Behavioral Health Center of Excellence, visit