This story is part of Voices, which is a project that seeks to facilitate civil discourse and build awareness about diversity at Iowa State.

Mental illness can affect anyone. It doesn’t matter how old or young you are, what your financial situation looks like or what gender, sexual orientation or race you identify with. Although mental illness can affect anyone, it can also affect people in different communities differently than others.

Because the risks for mental illness are extremely difficult to generalize, as every patient has different experiences that have influenced their mental health, mental health professionals look at every patient on a case-by-case basis, rather than generalizing based on any single factor. However, statistically, differences have been found among race, gender and sexuality.

The transgender community

“I’ve seen a lot more transgender people in the last couple of years than I saw at all over the first eight years that I worked here,” said Dr. Carver Nebbe, a psychiatrist at Thielen Student Health Center. “I think that’s a lot because it’s become more acceptable and more people are going through the process or seeking information about it.”

Nebbe said that a lot of the increase in transgender patients is due to the fact that if a person is considering starting the process of gender reassignment, they first need to complete a psychiatric evaluation.

“One of the things that makes any kind of surgery less likely to be successful is mental health problems,” he said.

This is called the biopsychosocial health model, which recognizes “the impact of psychological and social factors (emotional states, beliefs, social factors and behaviors) on the development and outcomes of illness and disease.” Studies have found that patients with depression are more likely to experience intense pain both short term and long term after surgery. 

Seeking treatment

Another difference Nebbe brought up was the difference in how patients seek treatment. He said that medication is cheaper, easier and less time consuming than therapy and when people do decide to take the therapy route, they prefer to, at least initially, speak with someone that they can identify with, whether that means in terms of gender, ethnicity or culture.

In terms of seeking treatment from professionals who share the same likeness, physically or culturally, Student Counseling Services staff psychologist Erin Pederson believes that it’s difficult to generalize and it depends on the person seeking treatment.

“Maybe seeing someone of a similar identity is a way in. If you come in and say ‘oh, there’s another Indian person here, this is a safe space,’ but really what makes people stay is just having someone who just cares about them and is listening to them,” said Spurty Surapaneni, a doctoral intern at Student Counseling Services. “At that point, I think that takes over the need for having a counselor that is the same identity.”

The Minority Stress Model

One thing that all of these professionals can agree on is the role discrimination and rejection play in anyone’s mental health.

Dr. Carolyn Cutrona is not only the head of the psychology department at Iowa State, but she was also the president of an organization called Parents and Friends of Lesbians and Gays and the president of the board of Iowa Safe Schools which aims to “provide safe, supportive, and nurturing learning environments and communities for LGBTQ and Allied youth through education, outreach and advocacy.”

Through her experience with LGBTQ youth and clinical psychology, she has found truth in what is named the “minority stress model.”

“The minority stress model says that there’s nothing intrinsically wrong with LGBTQ people … There was a belief at one time that being gay or lesbian was a sickness and with it came all of these mental illness symptoms, but it is that they are stigmatized and rejected by society,” she said. “So that’s very stressful and it is stress that leads them to be more depressed on average and attempt suicide more often.”

She said that it isn’t uncommon to find that the minority stress model will affect any underrepresented individual, whether that be sexual orientation, race, etc.

“When someone feels oppressed or marginalized in a space, when someone feels responded to in a way that sends an unwelcome message, that’s more draining on our energy if we’re experiencing that,” Pederson said.

Nebbe also said that the greater risk for abuse and harassment that those with alternative gender identities experience also puts them at higher risk for mental health issues.

Cultural stigmas

In addition to the discrimination or harassment that these groups might encounter from their peers, there is also the stigma associated with some of their cultures.

“I think culture plays a huge role in [stigmas] and the messages that students get,” Surapeneni said. “I know in the international Asian-American population, students have talked about how mental health is discussed in their home countries … I hear them constantly say, ‘Well, this isn’t something that I would typically talk about in my country.’”

Getting help on campus

In terms of international students, Surapeneni and Pederson agreed that sometimes these students may not know that mental health services are available to them on campus, or that some students feel like their problems aren’t big enough or severe enough to utilize the counseling services on campus.

“If you need help and you need a space to talk and work through what’s going on with you, then you’re not wasting anyone’s time,” Surapeneni said.

Cutrona also said that some students, especially as she has found, male or veteran students, have a hard time admitting that they have a mental health issue that they need help with. She reminds students that working towards mental health “isn’t overcoming a weakness – it’s overcoming a challenge.”

Pederson and Surapeneni urge students to either walk into the counseling center or to utilize the Let’s Talk program which is run by volunteer graduate psychology students from 3 p.m. to 5 p.m. Monday through Thursday in the Multicultural Center.

Thielen Student Health Center also has mental health services available to students. 

Want to talk?

This story is part one of two. If you are an underrepresented Iowa State student who would be interested in telling your mental health story, contact Voices Editor Megan Salo at [email protected].