In some Black communities, the line between barbershop and therapist's office blurs

As a youth in Cleveland, Coddie Wilson got his hair cut at All The King’s Men, an old-school barbershop in his predominantly Black neighborhood. For a long time, he said, the two barbers who ran the place lobbed nuggets of wisdom as he sat in the chair, steering him away from trouble.

“They were great mentors,” said Wilson, 31. “They watched me grow up, watched what I went through.”

Trouble eventually caught up with Wilson, who would earn his GED while in prison on drug charges, but he finally set himself right and works at All the King’s Men alongside his former mentors, settling into a role he knows is as much about listening and advising as it is about cutting hair.

With the help of Beyond the Cut, a regional program that recruits barbers to serve as mental health intermediaries for Black communities in northeast Ohio, Wilson has taken on yet another role as shepherd of emotional wellbeing. With mental health a growing crisis for Black communities nationwide, such programs lean into the natural flow of sharing inherent in barbershops and salons, giving barbers and stylists tools to care for their communities.

“They’re already hearing horror stories,” said Mary Louise Tatum, a psychiatric nurse practitioner at Cleveland Clinic who oversees the Ohio program. “Now they’re learning to do it more effectively.”

The Cleveland program, funded by a $70,000 grant, follows in the footsteps of The Confess Project of America, a national program launched by mental health advocate Lorenzo Lewis. That program operates in 32 states, Lewis said, focusing on marginalized and underserved communities.

Barber shops as safe spaces

Outside of the clergy, Lewis said, perhaps no other profession witnesses a community’s life changes as closely as barbers and stylists do, from high school graduations to the birth of a child to the pain of a divorce.

“Barbers and stylists have always been a safe place,” Lewis said. “When you think about the Civil Rights era, the NAACP did a lot of civic engagement through those shops. They’re pivotal for transforming how we talk about mental health, following what has already been laid before us.”

J. Divine Alexander, a Confess Project barber at The LAB Louisville in Kentucky, said anything goes when it comes to barbershop conversation.

“You can talk about a lot of stuff," he said. "Vulnerability too. There’s the whole macho thing, but everyone can talk about everything there.”

In Cleveland, when Wilson heard Tatum speak about her program at the barber college where he trained, the idea of being on the front lines as a mental health advocate struck a chord.

Itching to do more, he entered barber school at a friend’s coaxing, even though he felt out of his element.

Not every client is looking for help, but for those who do, he’s ready to provide. Some don’t realize they need help. Others do but don’t know how to ask for it, or where to get it.

“Nobody’s telling them this stuff,” Wilson said. “People are so secluded going through life. That’s our job, to get people to these resources.”

Black communities face unique mental health challenges

Experts say the isolation of the COVID-19 pandemic exacerbated mental stressors among Black communities prompted by discrimination, racism and widely distributed images of police brutality and prolonged by distrust of the healthcare system and a lack of culturally competent providers.

Suicide rates among Black people have steadily climbed over the last two decades. According to the U.S. Centers for Disease Control and Prevention, the rise has been especially acute among young Black people: Rates among those ages 10 to 24 jumped more than a third from 2018 to 2021, the biggest percentage increase among any demographic.

The U.S. Department of Health and Human Services’ Office of Minority Health reported suicide was the third leading cause of death in 2020 for Black Americans aged 15 to 24; overall, rates among Black men were four times as high as those for Black women. Meanwhile, Black people below the poverty level are twice as likely to report serious psychological distress compared to those with higher financial security.

Among the challenges is the community’s longstanding stigma around mental health care. Just 1 in 3 Black adults with mental illness receives treatment, according to the National Alliance on Mental Illness.

In blue-collar Cleveland, where Black people comprise nearly half the population, Tatum said, admitting emotional distress can be seen as weakness. Suicides, she said, were already on an upward trajectory even before the pandemic.

“When people think of mental health, it’s something that’s taboo,” she said.

Such thinking, she said, has impacts beyond emotional health; lingering stress can increase hypertension and raise the risk of cardiovascular disease, which the American Heart Association and CDC note both plague Black communities.

“We grow up learning to suppress our feelings and our issues,” said Steven Scarver, a barber in Maple Heights, Ohio, in suburban Cleveland. “We deal with it through drug and alcohol use. We lash out in ways that are different. I’ve seen so many friends and family members who don’t even know they’re depressed or that they have anxiety.”

Tatum had heard about the success of similar programs elsewhere and thought: Why not here? She found a local barber college excited about having her pitch the idea to its students.

At first, she faced folded arms and standoffish postures – but as she explained the notion of using their barber roles to create safe spaces for trauma sharing, demeanors relaxed. Some even shared their own feelings of anger, depression or loss.

Among them was Scarver, 38, who said he was diagnosed with post-traumatic stress disorder after six years in the Air Force. Now among Tatum’s so-called “mental health ambassadors,” he cuts hair at Star Beauty Plus, a business that’s part salon, part barbershop and part beauty supply store.

Program participants receive mental health awareness training and resources to distribute to customers at their shops. Tatum ultimately hopes to get participants certified as Mental Health First Aid instructors.

“They’re learning how to respond without being judgmental,” she said. “Hopefully they can save lives or make sure people don’t hurt themselves. It sounds so basic, but today we don’t have the church in the Black community like we used to; it’s not at the center like it used to be. You’re giving people hope.”

Giving barbers practical tools to advocate for mental health

A study co-authored by The Confess Project’s Lewis and published last year in the Journal of Mental Health and Prevention suggested Black barbers can be part of a multipronged effort of gatekeepers trained to support public health through their clients. Furthermore, the authors said, they can be important deterrents to violence.

“The people who are in regular and closest contact with young Black males are in the best position to be able to deter and prevent acts of violence from occurring in the first place,” they wrote.

Scarver, of Maple Heights, said that when he’s dealt with suicidal people in the past, he operated simply on faith. Now, he says, “I have two or three resources and the education behind that to give people something to go with other than, ‘I’m going to pray for you.’ That works – but I’m talking about practicality.”

His training has taught him to identify symptoms of emotional distress and to avoid triggering terminology.

“You don’t want to use words like, ‘you’re tripping,’” he said. “There are ways to communicate without making them feel some kind of way.”

In Louisville, Alexander, 50, said his work with The Confess Project has informed his work with local youngsters. He partners with schools and libraries, cutting hair while guiding kids through a curriculum that encourages them to express their emotions through music. It’s a technique he found useful in dealing with his own anxiety during the pandemic, when he created a song called “Thoughts Out Loud.”

“You never know who’s going through what,” he said. “You have to learn to navigate through and make sure they’re okay.”