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The Librarians Are Not Okay - The Atlantic

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Mental Health First Aid USA - Mental Health First Aid

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Mental Health First Aid is a national program to teach the skills to respond to the signs of mental illness and substance use.

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If you or someone you know is struggling, you are not alone. Find support, services and treatment options that may help.

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Download Infographic PDF [PDF - 574 KB]

6 Guiding Principles To A Trauma-Informed Approach

The CDC's Office of Readiness and Response (ORR), in collaboration with SAMHSA's National Center for Trauma-Informed Care (NCTIC), developed and led a new training for CPR employees about the role of trauma-informed care during public health emergencies. The training aimed to increase responder awareness of the impact that trauma can have in the communities where they work. Participants learned SAMHSA's six principles that guide a trauma-informed approach, including:

1. Safety

2. Trustworthiness & transparency

3. Peer support

4. Collaboration & mutuality

5. Empowerment & choice

6. Cultural, historical & gender issues

Adopting a trauma-informed approach is not accomplished through any single particular technique or checklist. It requires constant attention, caring awareness, sensitivity, and possibly a cultural change at an organizational level. On-going internal organizational assessment and quality improvement, as well as engagement with community stakeholders, will help to imbed this approach which can be augmented with organizational development and practice improvement. The training provided by CPR and NCTIC was the first step for CDC to view emergency preparedness and response through a trauma-informed lens.

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Infographic: 6 Guiding Principles To A Trauma-Informed Approach

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There are a number of benefits to using a trauma-informed approach, not only for patients but also for providers and staff. Many patients with trauma have difficulty maintaining healthy, open relationships with a health care provider. For patients, trauma-informed care offers the opportunity to engage more fully in their health care, develop a trusting relationship with their provider, and improve long-term health outcomes. Trauma-informed care can also help reduce burnout among health care providers, potentially reducing staff turnover.

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Learn about how trauma-informed care shifts the focus from "What's wrong with you?" to "What happened to you?"

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A huge list of resources, articles, and trainings for library staff.

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Let me first say that I am not good at self-care. I would even venture to say that I stink at it. In fact, one of my primary motivations in writing this article was to invest more time in thinking about managing my own self-care. This is something that is difficult for librarians-school librarians in particular.

Self-care is a fraught topic in schools. While administrators encourage us to look after ourselves, we are simultaneously assigned lunch duties, where we monitor the cafeteria while shoveling down yesterday's cold leftovers, hall duty, afterschool clubs, and early morning meetings. Unlike classroom teachers and public librarians, there are no scheduled "breaks" or planning periods for many of us, and we can't leave students alone to, for example, take a moment in the restroom.

Attempting to work at full throttle without those breaks has led to a high rate of burnout. Teacher librarians are leaving the profession at the rate of 9,200 per year (Kachel, D. E., & Lance, K. C. Changing Times: School Librarian Staffing Status. Teacher Librarian, 45(4), 14-63). There are many factors to consider, of course, including lack of money for the positions. As school librarians are increasingly required to prove our relevance and fight for funding, the rate of turnover is only increasing.

At the American Library Association (ALA) Annual Meeting, there were several sessions on self-care, including "Self Care is not Selfish," "Balancing Baby and Book Discussion," and "Sidestepping Stress." All of those were presented by public and academic librarians, which puts a bit of a different spin on the topic. It was heartening to hear how they deal with the stress of working so intensely with the public. But school librarians have a slightly different set of stressors, and those need to be addressed. By us. So, while there was a lot of overlap, school librarianship requires some different strategies.

We all know the signs of burnout. The ALA speakers' lists included: tardiness, missed deadlines, "going through the motions," exhaustion, and feeling overwhelmed. These are similar to those experienced by school librarians-although, we can probably add impatience, brain fog, increasing introversion, and deficit mindset to our list.

To avoid burnout, the speakers advised that we say "no," work within time limits, hydrate, and break up tasks. These are all solid suggestions that, with a little bit of tweaking, apply to school librarians as well. We'll talk about them one at a time. Remember, this is a list of tips to help stave off burnout, which is about mental health more than anything else. The crushing weight of prolonged stress can't be easily brushed aside. So, take care of your mental health. You're not alone in struggling with a demanding profession, and school librarians are not replaceable. Get help if you need it.
Say no
That's easier said than done when we must continuously justify our jobs. Saying "no" really isn't in our personalities-or even an option much of the time. We can't say no, but we sure can say, "Help!" and we need to more often than we do.

Many tasks can be delegated to library committees, student interns, and library volunteers. Library committees are great for setting policy and taking a lot of the decision making about large, impactful programming off your hands. Interns can tackle shelving, make signs, and tidy up. Library volunteers can handle tasks as they are able and skilled. USE THEM! Believe me, I know how difficult it is to not have total control, but the library is a community place and the community needs a hand in running it.
Work within limits
This is genius. It was so, so freeing for me to declare that I would not work after 6 p.m. One day I received an email at 5:45 p.m. saying that a teacher needed something before their first period class the next day. But, because I promised myself I was trying these strategies, I got up early the next day to help out. Technically, 5 a.m. is before 6 p.m.

Creating scheduling limits was awesome and awful. The timing worked fine for me, because I'm a morning person and it preserved my evening with my family, giving me time to relax and refocus. I also was not allowed to freak out about anything that came my way after six. If you are not a morning person, declaring that you will not work before 8 a.m. may work better. It was a lovely feeling to take a very intentional scheduled break. It won't work every day, but more often than not, scheduling a bit of time each day when work is verboten helps a lot. You are worth it.
Hydrate
As the speaker encouraged us to "hydrate," I laughed a little to myself, thinking about the difficulty of taking a bathroom break. This is a notorious issue among teachers, nurses, and truck drivers. Symptoms of dehydration make a nice Venn diagram with the symptoms of burnout. Brain fog, exhaustion, and lethargy co-occur. In other words, hydration is really important. For school librarians, it is less about input than output. While it easy to walk around with a water bottle while working; the challenge of getting bathroom breaks is really the crux of why we're chronically dehydrated.

Scheduling strategies are a possible solution here as well. While everybody is different, kidneys process 800-1000 ml per hour. So, somewhere between 45 minutes to an hour after consuming water, you'll have to use the restroom. That can help us better gauge when we need a break.

Other suggestions for timing your breaks include doing so when another teacher is present. For example, when you are co-teaching and students are engaged in a task, slip out for a minute after letting your colleague know that you'll be right back. For elementary school librarians, it might be possible to steal those two minutes when teachers bring their students for library time. Asking a fellow professional to hang out with their own class for a moment is reasonable and necessary from time to time.

Lastly, grab a buddy. If there is a flexibly scheduled person in your building, ask if he or she can spell you once or twice a day for breaks or trade with a teacher or someone else close by to the library who is trying to hydrate better also. It's worth the asking.
Break up tasks
Constantly feeling overwhelmed is often the flashing warning that burnout is nigh. No amount of breaks or water will cure the fact that you are walking around with a crushing to-do list. We have to get out from under if we have any hope.

Breaking up tasks into smaller lists makes them seem more approachable. As opposed to writing, "Plan reading challenge," try making it smaller: "make challenge booklist," "write reading challenge announcement," "make reading challenge sign (student)." And yes, put whomever you are delegating the task to right next to it. Because it is so satisfying to cross things off the list, having a longer list of small things releases more dopamine.

Apps such as Google Keep, Momentum, and Wonderlist are efficient and easy. If you enjoy gamified rewards for completing items on your list, Habitica, Epic Win, Forest, and Carrot To-Do may be more your style. Reward yourself for crossing things off. You deserve that small shot of happiness.
Other tips
Try a desk day. This is a strategy that I picked up from the podcast Before Breakfast by Laura Vanderkam. In essence, we schedule a day to do all of our hidden tasks. Circulation, shelving, planning, cataloging, etc. and all those sit down tasks can be grouped together in a block of time once a week-leaving the rest open for the usual round of activity. I am not in any way advocating for closing the library during those times. When I tried this, it was more about intention than execution. No, it is not possible to have seven uninterrupted hours, it is possible to not intentionally schedule work time on top of teaching time.

Invest in organization. Money is an investment, but so is time. Making an organizational system in August will pay dividends in February. Pausing to make a task flow that will work long term may help with that overwhelmed feeling.

Get inspired. Go to a conference, read some positive blogs, join a book group, hang around with somebody brilliant, or brainstorm something brilliant yourself. You can't change others, but you sure can change your own situation and your own attitude. Take back that power over your own small little universe and make changes to stave off burnout.
A 20 year veteran of Albemarle County Public Schools, IdaMae Craddock, M.Ed is the librarian at Albemarle High School in Charlottesville, VA. She has a precocious daughter, an understanding husband, and a lazy dog named Peacha.

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Let me first say that I am not good at self-care. I would even venture to say that I stink at it. In fact, one of my primary motivations in writing this article was to invest more time in thinking about managing my own self-care.

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by Suzanne LaPierre on February 15, 2021

One of my colleagues used to say: "We get to work in the candy store." Indeed, many outside the profession may read the title of this article and joke: Health hazards of librarianship? Like what, paper cuts or falling off book ladders? However, as the COVID-19 pandemic brought to light, there are health risks entailed by all front line workers, as well as some more specific to library employees.

Professional ethics, as outlined by the American Library Association Code of Ethics, include a duty to "advocate conditions of employment that safeguard the rights and welfare of all employees of our institutions." The purpose of this article is to highlight some issues to be considered when it comes to that pledge.
Shift Work Impacts Physical and Mental Health
Librarians, especially public librarians, typically do shift work, covering some evenings and weekends, often on a rotating schedule. Even more disruptive to regular eating and sleeping patterns, those shifts tend to be irregular from day to day and week to week. Studies on the effects of shift work have found negative impacts on mental health as well as physical health. The two are often intertwined, such as when disrupted sleep cycles contribute to stress.

According to research published in European Journal of Neuroscience: "Shift work, defined as work occurring outside typical daytime working hours, is associated with an increased risk of various non‐communicable diseases, including diabetes and cardiovascular disease. Disruption of the internal circadian timing system and concomitant sleep disturbances is thought to play a critical role in the development of these health problems." In addition, irregular shifts create difficulty managing care for dependents, which can further increase stress and economic burdens.
The Psychological Impact of Emotional Labor
Even for those fortunate enough to have stable schedules, studies show that jobs requiring a high degree of "emotional labor," including librarianship, can lead to job-related stress and burnout. Common to the "helping" professions, emotional labor is defined by Oxford Languages as: "the management of one's emotions in order to present oneself and interact with other people in a certain way while doing a job."

A typical day in the public library includes many situations that rise to personal emergency level for customers - a student's report is due tomorrow, someone with limited computer skills must fill out an online job application, a child is lost, someone needs information about a serious illness. Customers' problems often become librarians' problems. Occasionally customers become angry over fines or rules and take their distress out on staff. Good customer service means handling such situations gracefully. A study published in Library & Information Science Research found that the emotional labor reported by all types of librarians was associated with emotional exhaustion, cynicism, and job dissatisfaction, all of which can also impact professional efficacy.
Harassment and Unwanted Attention
As Gretchen Corsillo writes in Ending Sexual Harassment at the Public Library, this is an all-too-common occurrence. In many library systems, customer service guidelines specify that information staff should walk a customer to the stacks, find the desired item, remove the item from the shelf and put it in the customer's hand. The goal of this personal service- as opposed to "it's over there in 703.5" (pointing), is to ensure the customer isn't left to wander confusing stacks alone, potentially not finding the item yet too uncomfortable ask for more help. It also enables a deeper reference interview to occur while walking together. Once in a while though, this can be misinterpreted as "this person must be interested in me" or even "s/he is intentionally leading me to a more private space. Here's my chance!"

At public service desks, there is little an employee can do to hide from unwanted attention from individuals who have misinterpreted professional care as personal interest... or worse, those who simply enjoy harassing service employees. Library pages, whose shelving work requires them to circulate around public areas, also become targets. The emotional distress of handling unwanted advances or outright harassment can be hazardous to the psychological well-being of employees. In the worst cases, it can even lead to stalking and become a risk to physical safety.

As Katie MacBride writes in #TimesUp on Harassing Your Public Librarian, while many service professions deal with this behavior, libraries are unique in that customers can stay as long as they want: "What if anyone could walk into your workplace, ask you as many questions as they wanted on virtually any subject, from the moment the doors open in the morning until they close at night?"
Covid-19 and Exposure to Diseases
Librarians are among those who have died of COVID-19 after being exposed as front-line workers. Yet, librarians may not be high on the list to receive vaccines. Librarians were included in the same category with teachers as essential workers to be prioritized for vaccination in the July 2020 CDC AIPC Work Group report. However, the December 2020 CDC AIPC interim guidance does not specifically mention librarians among those prioritized in either Phase 1b or Phase 1c of vaccine distribution.

The very nature of public libraries-open to anyone and full of shared resources-puts their employees at greater risk. Unlike schools, where students are limited to a traceable group, public libraries are accessed by an unlimited variety of visitors. They are full of touchable shared surfaces and materials. While risking their own exposure, library employees are often under the additional stress of having to enforce new rules specific to the pandemic, sometimes to a resistant public.

Recent discussions over COVID-19 risks in libraries have provided an opening for discussing wider health implications of library work. Staff members who are healthier physically and mentally are better able to provide quality public service. Therefore, safer working conditions and fair compensation for employees benefit all.

References
Brown, J.P., Martin, D., Nagaria, Z. et al. Mental Health Consequences of Shift Work: An Updated Review. Curr Psychiatry Rep. 2020; 22, 7. https://doi.org/10.1007/s11920-020-1131-z

Corsillo, GK. Ending Sexual Harassment at the Public Library. Public Libraries Online. March 30, 2018.

Kervezee, L, Kosmadopoulos, A, Boivin, DB. Metabolic and cardiovascular consequences of shift work: The role of circadian disruption and sleep disturbances. European Journal of Neuroscience. 2020; 51: 396- 412. https://doi.org/10.1111/ejn.14216

Mattesona, M, Miller, S. A study of emotional labor in librarianship. Library & Information Science Research. 2013; Volume 35, Issue 1, 54-62. https://doi.org/10.1016/j.lisr.2012.07.005

Macbride, K. "#TimesUp on Harassing Your Public Librarian," Shondaland, January 31, 2018. https://www.shondaland.com/act/a15876574/timesup-on-harassing-your-public-librarian/

Peet, L. IMLS. CDC: On Staff Safety, Handling Paper in COVID-19 Pandemic. Library Journal. April 8, 2020.

Tags: covid-19 and libraries, health hazards of librarianship

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Health Hazards of Librarianship: Not Just Paper Cuts

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by Suzanne LaPierre on February 15, 2021 One of my colleagues used to say: "We get to work in the candy store." Indeed, many outside the profession may read the title of this article and joke: Health hazards of librarianship? Like what, paper cuts or falling off book ladders?

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In Brief

Vocational awe describes the set of ideas, values, and assumptions librarians have about themselves and the profession that result in notions that libraries as institutions are inherently good, sacred notions, and therefore beyond critique. I argue that the concept of vocational awe directly correlates to problems within librarianship like burnout and low salary. This article aims to describe the phenomenon and its effects on library philosophies and practices so that they may be recognized and deconstructed.

by Fobazi Ettarh
Author's note: I use "librarians" here very broadly. I am not limiting the term to those who have the MLIS because vocational awe affects those who work in libraries at every level. I would argue that it often affects staff more than it does librarians due to the sociodemographics of people in staff level positions as well as the job precarity that many staff positions hold.
Introduction

On its face, it seems natural that libraries and librarians should celebrate these stories. Indeed, these librarians are working to save the democratic values of society as well as going above and beyond to serve the needs of their neighbors and communities. However, when the rhetoric surrounding librarianship borders on vocational and sacred language rather than acknowledging that librarianship is a profession or a discipline, and as an institution, historically and contemporarily flawed, we do ourselves a disservice.

"Vocational awe" refers to the set of ideas, values, and assumptions librarians have about themselves and the profession that result in beliefs that libraries as institutions are inherently good and sacred, and therefore beyond critique. In this article, I would like to dismantle the idea that librarianship is a sacred calling; thus requiring absolute obedience to a prescribed set of rules and behaviors, regardless of any negative effect on librarians' own lives. I will do this by demonstrating the ways vocational awe manifests. First, I will describe the institutional mythologies surrounding libraries and librarians. Second, I will dismantle these mythologies by demonstrating the role libraries play in institutional oppression. Lastly, I will discuss how vocational awe disenfranchises librarians and librarianship. By deconstructing some of these assumptions and values so integrally woven into the field, librarianship can hopefully evolve into a field that supports and advocates for the people who work in libraries as much as it does for physical buildings and resources.

Part One: The Mythos of Libraries and Librarianship

Librarianship as Vocation

The word "vocation" (from the Latin vocatio) is defined as "a call, summons," and stemmed from early Christian tradition, where it was held that the calling required a monastic life under vows of chastity, poverty, and obedience. Indeed, from its earliest biblical instantiations, a vocation refers to the way one lives in response to God's call. Although the word has since become used in more secular contexts, my use of the word "vocation" to describe contemporary views of librarianship skews closer to its original religious context, especially concerning the emphasis on poverty and obedience. Many librarians refer to the field of librarianship as a calling. ,  Their narratives of receiving the "call" to librarianship often fall right in line with Martin Luther's description of vocation as the ways a person serves God and his neighbour through his work in the world. The links between librarianship and religious service are not happenstance. Indeed, the first Western librarians were members of religious orders, serving the dual functions of copying and maintaining book collections.

The Library as a Sacred Place

The physical space of a library, like its work, has also been seen as a sacred space. One could argue that it is treated like a sanctuary, both in its original meaning (keeper of sacred things and people), and in its more contemporary meaning as a shelter or refuge. Again, the original libraries were actual monasteries, with small collections of books stuffed in choir lofts, niches, and roofs. The carrels still prevalent in many libraries today are direct descendants of these religious places. The word "carrel" originally meant "working niche or alcove" and referred to a monastery cloister area where monks would read and write. Reflecting their conjoined history, churches and libraries had similar architectural structures. These buildings were built to inspire awe or grandeur, ,  and their materials meant to be treated with care. Even now the stereotypical library is often portrayed as a grandiose and silent space where people can be guided to find answers. The Bodleian Library, one of the oldest and largest libraries in Europe, still requires those who wish to use the library to swear an oath to protect the library: "I hereby undertake not to remove from the Library, or to mark, deface, or injure in any way, any volume, document, or other object belonging to it or in its custody; not to bring into the Library or kindle therein any fire or flame, and not to smoke in the Library; and I promise to obey all rules of the Library."

Although contemporary architectural designs of libraries may not evoke the same feelings of awe they once did, libraries continue to operate as sanctuaries in the extended definition as a place of safety. Many libraries open their spaces to the disadvantaged and displaced populations in the community such as the homeless or the mentally ill. In the protests and civil unrest following the shooting death of unarmed black teenager Michael Brown in Ferguson, Missouri, the Ferguson Municipal Public Library (FMPL) became a makeshift school for children in the community. When the story went viral, there was an outpouring of books, supplies, and lunches for the children. The hashtag #whatlibrariesdo became a call to action and resulted in a huge spike in PayPal donations to FMPL. In addition, the sign on the library's door stated, "During difficult times, the library is a quiet oasis where we can catch our breath, learn, and think about what to do next." In this way, the library becomes a sanctuary threefold, a place where one can listen to the "still, small, voice," a shelter for displaced populations, and a source of humanitarian aid. Since Ferguson, similar responses have occurred in libraries after major events in other areas such as Charlottesville, Virginia. And, in the current sociopolitical climate, much of the discourse surrounding these libraries center them as "safe spaces."

Librarians as Priests and Saviors

If librarians are priests then their primary job duty is to educate and to save. Biven-Tatums notes that public libraries "began as instruments of enlightenment, hoping to spread knowledge and culture broadly to the people." The assumption within librarianship is that libraries provide the essential function of creating an educated, enlightened populace, which in turn brings about a better society. Using that logic, librarians who do good work are those who provide culture and enlightenment to their communities. Saint Lawrence, the Catholic Church's official saint of librarians and archivists, is revered for being dangled over a charcoal fire rather than surrender the Church archives. Today, librarians continue to venerate contemporary "saints" of librarianship. One example is the "Connecticut Four," four librarians who fought a government gag order when FBI agents demanded library records under the Patriot Act. And now Kowalski joins the ranks as a library "saint" through the literal saving of lives with Naloxone. All of these librarians set the expectation that the fulfillment of job duties requires sacrifice (whether that sacrifice is government intimidation or hot coals), and only through such dramatic sacrifice can librarians accomplish something "bigger than themselves."

Part Two: Locating the Library in Institutional Oppression

It is no accident that librarianship is dominated by white women. Not only were white woman assumed to have the innate characteristics necessary to be effective library workers due to their true womanhood, characteristics which include missionary-mindedness, servility, and altruism and spiritual superiority and piety, but libraries have continually been "complicit in the production and maintenance of white privilege." These white women librarians in public libraries during the turn-of-the-century U.S. participated in selective immigrant assimilation and Americanization programs, projects "whose purpose was to inculcate European ethnics into whiteness" Librarianship, like the criminal justice system and the government, is an institution. And like other institutions, librarianship plays a role in creating and sustaining hegemonic values, as well as contributing to white supremacy culture. James and Okun define white supremacy culture as the ways that organizations and individuals normalize, enact, and reinforce white supremacy. Cultural representations of libraries as places of freedoms (like freedom of access and intellectual freedom), education, and other democratic values do not elide libraries' white supremacy culture with its built-in disparity and oppression. In fact, each value on which librarianship prides itself is inequitably distributed amongst society. Freedom of access is arguably the most core value of librarianship. It runs throughout the entire Library Bill of Rights and is usually defined as the idea that all information resources provided by the library should be distributed equally, and be equitably accessible to all library users.

There have been, however, vast exceptions to this ideal. Quantitatively, the most significant of these exceptions was the exclusion of millions of African Americans from public libraries in the American South during the years before the civil rights movement. White response to desegregation efforts in public libraries varied. While some libraries quietly and voluntarily integrated, other libraries enforced "stand-up integration," removing all of the tables and chairs from the building to minimize the interaction of the races in reading areas, or shut down the branch entirely. The result of these segregationist practices in libraries was a massive form of censorship, and this history demonstrates that access to materials is often implicated in larger societal systems of (in)equality. This should then hold true for other library values as well.

Part Three: Martyrdom is not a long-lasting career

Up until this point, it might seem like I believe librarians should not take pride in their very important work. Or that librarians who love their work and have a passion for library values possess some inherent flaw. This is not my intent. Rather, I challenge the notion that many have taken as axiomatic that libraries are inherently good and democratic, and that librarians, by virtue of working in a library, are responsible for this "good" work. This sets up an expectation that any failure of libraries is largely the fault of individuals failing to live up to the ideals of the profession, rather than understanding that the library as an institution is fundamentally flawed. Below, I mention the primary ways vocational awe negatively impacts librarians.

Awe

We've now uncovered the roots of vocation within librarianship and its allusions to religiosity and the sacred. The vocational metaphor helps us understand cause. However, it is important not to forget awe, which represents the effect. Merriam-Webster defines awe as "an emotion variously combining dread, veneration, and wonder that is inspired by authority or by the sacred." As mentioned earlier, libraries were created with the same architectural design as churches in order to elicit religious awe. Awe is not a comforting feeling, but a fearful and overwhelming one. One of its earliest uses was within the Hindu epic Mahabarata. The God Krishna inspired awe in the protagonist Arjuna and commanded him: "Do works for Me, make Me your highest goal, be loyal-in-love to Me, cut all [other] attachments..." A more modern, secular example of awe is the military doctrine "shock and awe," which is characterized as rapid dominance that relies on the use of overwhelming power and spectacular displays of force to paralyze the enemy's perception of the battlefield and destroy their will to fight. In both cases, awe is used as a method of eliciting obedience from people in the presence of something bigger than themselves.

As part of vocational awe in libraries, awe manifests in response to the library as both a place and an institution. Because the sacred duties of freedom, information, and service are so momentous, the library worker is easily paralyzed. In the face of grand missions of literacy and freedom, advocating for your full lunch break feels petty. And tasked with the responsibility of sustaining democracy and intellectual freedom, taking a mental health day feels shameful. Awe is easily weaponized against the worker, allowing anyone to deploy a vocational purity test in which the worker can be accused of not being devout or passionate enough to serve without complaint.

Burnout

Under-compensation

"One doesn't go into librarianship for the money" is a common refrain amongst library workers, and the lack of compensation for library work is not a recent phenomenon. A 1929 report summarized that "improvement in these conditions has not yet reached a point where librarianship may be said to receive proper recognition and compensation." And in the 2017 Library Journal 's Placements and Salaries survey, graduates overwhelmingly pointed to underemployment issues as a source of unhappiness, including low wages; lack of benefits; having to settle for part-time, temporary, or nonprofessional positions; or having to piece together two or three part-time positions to support themselves. Librarians' salaries continue to remain lower than those for comparable jobs in professions requiring similar qualifications and skills. Statistics like these point to the very secular realities of librarians. Librarianship is a job, often paid hourly. It's not even everyone's primary job. It has sick time, and vacation-or should-and imagining these facts aren't important because of the importance of the library's mission only serves the institution itself.

Through its enforcement of awe through the promotion of dramatic and heroic narratives, the institution gains free, or reduced price, labor. Through vocational mythologies that reinforce themes of sacrifice and struggle, librarianship sustains itself through the labor of librarians who only reap the immaterial benefits of having "done good work."

Job creep

Job creep refers to the "slow and subtle expansion of job duties" which is not recognized by supervisors or the organization. As this article argues, librarians are often expected to place the profession and their job duties before their personal interests. And with such expectations, job creep can become a common phenomenon. The problem with job creep manifests in multiple ways. One, what employees originally did voluntarily is no longer considered "extra" but instead is simply viewed as in-role job performance, which leads to more and more responsibilities and less time in which to accomplish them. Employees who cannot do more than what is in the job description, perhaps for personal or health reasons, are consequently seen as not doing even the minimum, and management may come to believe that workers are not committed to the organization, or its mission, if they don't do extra tasks. Returning to Chera Kowalski and all of the other librarians currently training to administer, and already administering, anti-overdose medication, this expectation has gone so far as to create a precedent for Representative Maloney to introduce the Life-saving Librarians Act. No longer are these trainings voluntary "extra" professional development; it will likely soon become part of the expected responsibilities of librarians across the country.

Adding duties like life-or-death medical interventions to already overstrained job requirements is an extreme but very real example of job creep. And with the upholding of librarianship as purely service-oriented and self-sacrificing, what is a librarian to do who may not feel equipped to intervene as a first responder? Or a librarian who is dedicated to, say, a library value of children's literacy or freedom of information, but because of past traumas, cannot cope with regular exposure to loss of life on the job? Librarianship as a religious calling would answer that such a librarian has failed in her duties and demonstrated a lack of purity required of the truly devout. And without the proper training and institutional support that first responders, social workers, and other clinicians have, librarians, through such job creep, are being asked to do increasingly dangerous emotional and physical labor without the tools and support provided to other professions traditionally tasked with these duties. As newspapers, Clinton, and librarians around the nation celebrate Kowlaski and others like her, we must ask if those voices will chime in to also demand the therapy and medical services typically needed for PTSD and other common ailments of those working in such severe conditions. Do we expect those benefits to manifest, or librarians to again quietly suffer the consequences of their holy calling, saving society at the expense of their own emotional well-being?

Diversity

By the very nature of librarianship being an institution, it privileges those who fall within the status quo. Therefore librarians who do exist outside librarianship's center can often more clearly see the disparities between the espoused values and the reality of library work. But because vocational awe refuses to acknowledge the library as a flawed institution, when people of color and other marginalized librarians speak out, their accounts are often discounted or erased. Recently, Lesley Williams of Evanston, Illinois, made headlines for being fired from her library due to comments (on her personal social media accounts), illustrating the hypocritical actions of her library in regards to the lack of equitable access to information. Although she was advocating for the core library value of equitable access, similar to that of the "Connecticut Four," her actions were regarded as unprofessional.

As I mentioned earlier, vocational awe ties into the phenomena of job creep and undercompensation in librarianship due to the professional norms of service-oriented and self-sacrificing workplaces. But creating professional norms around self-sacrifice and underpay self-selects those who can become librarians. If the expectation built into entry-level library jobs includes experience, often voluntary, in a library, then there are class barriers built into the profession. Those who are unable to work for free due to financial instability are then forced to either take out loans to cover expenses accrued or switch careers entirely. Librarians with a lot of family responsibilities are unable to work long nights and weekends. Librarians with disabilities are unable to make librarianship a whole-self career.

Conclusions

Considering the conjoined history of librarianship and faith, it is not surprising that a lot of the discourse surrounding librarians and their job duties carries a lot of religious undertones. Through the language of vocational awe, libraries have been placed as a higher authority and the work in service of libraries as a sacred duty. Vocational awe has developed along with librarianship from Saint Lawrence to Chera Kowalski. It is so saturated within librarianship that people like Nancy Kalikow Maxwell can write a book, Sacred Stacks: The Higher Purpose of Libraries and Librarianship, not only detailing connections between librarianship and faith, but concluding the book by advising librarians to nurture that religious image conferred upon them. The ideals of librarianship are not ignoble, and having an emotional attachment to the work one does is not negative in itself, and is often a valued goal in most careers. What I have tried to do with this article is illustrate that history and expose the problematic underpinnings. Because vocational awe is so endemic and connected to so many aspects of librarianship, the term gives the field a way to name and expose these things that are so amorphous that they can be explained or guilted away, much like microaggressions. And, through the power of naming, can hopefully provide a shield librarians can use to protect themselves.

The problem with vocational awe is the efficacy of one's work is directly tied to their amount of passion (or lack thereof), rather than fulfillment of core job duties. If the language around being a good librarian is directly tied to struggle, sacrifice, and obedience, then the more one struggles for their work, the "holier" that work (and institution) becomes. Thus, it will become less likely that people will feel empowered, or even able, to fight for a healthier workspace. A healthy workplace is one where working around the clock is not seen as a requirement, and where one is sufficiently compensated for the work done, not a workplace where "the worker [is] taken for granted as a cog in the machinery."

Libraries are just buildings. It is the people who do the work. And we need to treat these people well. You can't eat on passion. You can't pay rent on passion. Passion, devotion, and awe are not sustainable sources of income. The story of Saint Lawrence may be a noble one, but martyrdom is not a long-lasting career. And if all librarians follow in his footsteps, then librarianship will cease to exist. You might save a life when wandering outside for lunch, but you deserve the emotional support you'll no doubt need as a result of that traumatic event. You may impress your supervisor by working late, but will that supervisor come to expect that you continually neglect your own family's needs in the service of library patrons? The library's purpose may be to serve, but is that purpose so holy when it fails to serve those who work within its walls every day? We need to continue asking these questions, demanding answers, and stop using vocational awe as the only way to be a librarian.

Thanks and Acknowledgments

I'm very much indebted to the amazing and knowledgeable editors at In the Library with the Lead Pipe, and in particular to Sofia Leung and nina de jesus for diligently removing all traces of footnote inconsistency, tense changes, and rogue commas, as well as helping me create the best possible version of this article. I would also like to thank Amy Koester for keeping us all on track when necessary, and also being incredibly flexible when life inevitably got in the way. Finally, I would like to thank my partner for providing copious support as she listened to me whine and provided a steady stress writing diet of Salt and Vinegar Pringles and Uncrustables. Any mistakes left in this document are most definitely my own.

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Vocational Awe and Librarianship: The Lies We Tell Ourselves

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Vocational awe describes the set of ideas, values, and assumptions librarians have about themselves and the profession that result in notions that libraries as institutions are inherently good, sacred notions, and therefore beyond critique. I argue that the concept of vocational awe directly correlates to problems within librarianship like burnout and low salary.

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As many librarians will tell you, helping people find the information they need-and especially information they didn't even know they needed-is often the most satisfying part of their job. A less rewarding aspect can be interacting with the visitors a librarian may not be trained to help, such as people with serious mental health problems. In some cases, a librarian may need to escort a patron off the premises-an outcome no one wants that can leave the librarian feeling guilty, frustrated and burned out over time.

In an effort to address this long-standing problem, libraries are increasingly working to educate library staff and the public about ways to support people with mental health and substance use conditions.

"Libraries are now serving as community centers, as gathering places for people across neighborhoods, and not just a place for books," says Kathryn Gardella, project manager for the Mental Health Initiative in California, a public library partnership supported by the Institute of Museum and Library Services. "Because of that shift, staff need to be better equipped to provide excellent service to all patrons."

To meet this need, mental health professionals have started sharing their knowledge in the library setting through lectures for the public, training programs for library staff and sometimes by working directly with patrons who have mental health conditions. The Public Library Association, for example, formed the Social Worker Task Force to identify best practices for addressing the social service needs of library patrons.

"Momentum has definitely picked up in the last five years to find ways to help libraries support the increasing volume of patrons who are experiencing homelessness, substance use conditions and mental illness," says the association's president-elect, Michelle Jeske.

While progress has been made, libraries still need more mental health support-a ripe opportunity for psychologists' expertise.

Training and outreach

San Diego public librarian Joseph Miesner is among those who've been trained in mental health first aid, thanks to the California Mental Health Initiative. Through the course, he learned about the prevalence and symptoms of mental illness and about de-escalation strategies. "It helped me understand that disruptive behavior is not a personal affront," says Miesner, who has worked for the library system for 28 years. "My ability to assist people has improved immensely because I have a better understanding of mental illness, and I'm more empathetic."

He tapped that training when he interacted with a distraught woman who was yelling in the library. Rather than asking her to leave, he sat down with her and said, "I can see that you are very upset. Is there anything I can help you with?" The woman cried as she shared that she had been robbed, that she did not trust the police and that she did not want medical assistance. "I just spent time listening to her, and eventually she gathered her belongings and walked away quietly," he says.

Miesner and three other librarians also learned how to teach mental health first aid, and they have trained nearly 250 San Diego Public Library staff in the last three years.

While librarians like Miesner appreciate feeling more equipped to interact with patrons, library systems are also starting to work directly with personnel who have mental health training.

In New York City, social psychologist Wendy Viola, PhD, is evaluating the city's new Spaces to Thrive program, a partnership between the New York Public Library and the mayor's Office of ThriveNYC that aims to increase public access to mental health information and support. The program, which began in December in 13 branch libraries, includes mental health workshops for the public about suicide prevention, social-emotional learning, social stigma and the relationship between social media and mental health.

The libraries have also started offering training in how to use naloxone (Narcan) for opioid overdose reversal, and participants can take home Narcan kits. Each site also dedicates several shelves to autobiographical, nonfiction and fiction books about mental health. Viola, who is the director of research at ThriveNYC, will be collecting data about the number of attendees at workshops and resources distributed, including brochures about the city's crisis helpline and the Narcan kits, to capture how people are using the library to understand mental health issues.

Social workers are also playing a critical role. In 2009, the San Francisco Public Library became the first public library system in the nation to hire a social worker. Now, dozens of libraries across the nation have social workers on staff.

"We build relationships with people and become a familiar face, so when patrons are ready for help, we can connect them with organizations that provide counseling, medical care, housing and other services," says Leah Esguerra, LMFT, who works in the San Francisco Public Library system. Her team frequently encounters people who are sleeping, which is not allowed in the library system, and they ask these patrons if they are OK. "This question can open up a conversation," she says.

One regular library patron who Esguerra assessed was a veteran who had worked as a nurse. She suffered from post-traumatic stress disorder and a degenerative health condition and had been experiencing homelessness for years. Esguerra met with the woman weekly to provide brief therapy, and after making a few calls, she was able to secure housing for the woman through a local organization. To date, Esguerra has helped find stable housing for more than 200 library patrons.

Beyond large cities

While innovative mental health programs in large, metropolitan libraries are attracting attention, a similar momentum is building in university and suburban library systems. Dawn Behrend, who worked as a full-time master's-level therapist before becoming a librarian, started offering mental health training to her co-workers soon after she began working at the library at Lenoir-Rhyne University in Hickory, North Carolina. "When librarians on staff and at conferences heard about my psychological background, they wanted to know how to handle difficult patrons and practice self-care because their jobs had become so stressful," she says.

Although the university librarians were not typically seeing patrons experiencing homelessness, they were unsure about how to deal with disruptive behaviors among some students who have autism spectrum disorder (ASD). So Behrend started teaching an online professional development course to educate librarians across the country on how ASD presents in children, adolescents and adults, and how to communicate with these individuals. Participants learn that pacing and making loud noises can be methods of self-regulation and that overly bright lighting can also be difficult for these patrons to manage.

"Librarians should review their existing facilities and make adjustments to suit the needs of patrons who are neurodiverse," she says.

Behaviors related to anxiety, such as frustration and anger, are also common in a university library-especially when finals are approaching, Behrend says. She teaches staff how to express empathy and avoid power struggles with students by offering alternative materials, services or spaces to help them deal with their frustration.

At Avon Free Public Library in Avon, Connecticut, where 40% of the city's population is age 50 or older, librarian Tina Panik decided to partner with the senior center to offer more education about mental health. Through funding from the National Network of Libraries and Medicine, the library offered a series of 16 programs on such topics as memory loss, depression and grief. The most popular session focused on how to deal with hoarding behaviors, and was presented by psychologist David Tolin, PhD, director of the Anxiety Disorders Center in Hartford, Connecticut. "Libraries are a great forum for the sharing of information," Tolin says.

Nearly 400 people attended the sessions, with many participants talking openly about mental health issues. For Panik, the series confirmed the need in the community to create safe spaces to discuss struggles that can often remain hidden.

"We are trying to erase the stigma surrounding mental health," Panik says. "Libraries and senior centers are trusted by the public, and we are showing that we are not afraid to talk about these issues."

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As many librarians will tell you, helping people find the information they need-and especially information they didn't even know they needed-is often the most satisfying part of their job.

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Welcome to State of Mind, a new section from Slate and Arizona State University dedicated to exploring mental health. Follow us on Twitter.
The Argentine writer Jorge Luis Borges is often credited with saying that "Paradise is a library." He must not have meant a downtown public library, circa 8 p.m. Such places, like most communal spheres, can be a challenge to oversee. Some people treat them like a sort of roomless hotel, sleeping in chairs and bathing in restrooms. I used to watch a man who looked like the famous woodcut of Blackbeard the Pirate ride the escalator of my three-story library up, down, up, down. For hours. Carrying a duffel bag. He never bothered anyone, so our security officers left him alone. (Can't say the same forthe lady of the evening who was meeting clients in the stairwell.)

Then there are the questions from believers in Qanon. Election deniers. Sovereign citizens. The woman who ranted about the " news" that the World Health Organization was going to "force a vote to allow them to take over the U.S. and force a lockdown like China." (If WHO had that kind of power, why bother with a vote?) The man who asked me how he and a few of his buddies could get into the governor's office to "remove him" over pandemic closures. (Would that all insurrectionists did such thorough research!) Declinism is the feeling that everything is getting harder, scarier, and weirder, and a lot of people seem to have it.

Work in a library, I want to tell them, and you'll learn what weird is.

To be clear: I enjoy the weird. And I am proud that public libraries double as unofficial care centers. In 2015, the Washington Post quoted a librarian who estimated that about half of their regular patrons were either mentally ill or experiencing homelessness. The same article speculated that "the transition from inpatient to outpatient psychiatric treatment that began in the 1960s, including the closure of state-run psychiatric hospitals, may contribute to the prevalence of mental illness among the homeless." In nearly every U.S. state, people with serious mental illness are more likely to be jailed than sent to a hospital.

A library is a more welcoming environment than either of those. Undoubtedly, this is what attracts many people who suffer from mental illness. Sociologist Eric Klinenberg calls libraries "social infrastructure," emphasizing that, in addition to books and materials, they offer welcoming spaces and human interaction. The Ferguson Municipal Public Library became a "safe haven" amid the riots after the 2014 shooting of Michael Brown, staying open when other businesses had closed, to act as a community anchor. After the 2016 shooting of five police officers, the Dallas Public Library provided on-site counselors to assist city residents.

A number of libraries now employ social workers or mental health professionals to step in when needed. Others have partnered with mental health organizations to train librarians in crisis response. In 2017, staff at the San Diego Public Library completed the Mental Health First Aid course developed by the National Council on Behavioral Health. One of the staff, Joe Miesner, tapped into that training when he deescalated a situation with an distressed patron. "I just spent time listening to her," Miesner told the American Psychological Association, "and eventually she gathered her belongings and walked away quietly." Some librarians have even saved lives. Three weeks after being trained to administer the opioid antidote naloxone, Matt Pfisterer, a New York librarian, revived a patron who had overdosed.

Academic libraries have also seen an increase in mental health needs, such as autism spectrum disorder, and have developed programs to meet them. Dawn Behrend, a librarian at Lenoir-Rhyne University who is also a licensed therapist, offers online workshops on providing service to ASD patrons. (She has another course called Assisting Patrons With Mental Disorders Across Library Settings that extends beyond the autism spectrum.)

In 2018, Robarts Library at the University of Toronto opened a family study space. Similar spaces exist at U.S. colleges. The room holds 20 people and includes work stations, toys, and child-sized furniture-perfect for student-parents who are forced to schlep their kids to campus. (I could have used one when I was a graduate student. Maybe I wouldn't have been cashiered out of the computer lab because my 3-year-old was "banging on a keyboard.")

Another trend is library "meditation rooms," which students use for prayer, yoga, scripture study, or just to catch their breath between classes. At North Carolina State University, for instance, the rooms include resources such as prayer rugs, meditation cushions and mats, a sound machine, and colored pencils and paper. One of the most creative programs is Montana State University's Paws to De-Stress, in which the library, in partnership with Intermountain Therapy Animals, lets visitors mingle with registered therapy dogs during the weeks of final exams.

When it comes to LGBTQ patrons, libraries have lots of opportunities. According to the National Alliance on Mental Illness, gay or bisexual adults are more than twice as likely as heterosexuals to struggle with their mental health. Transgender individuals are nearly four times as likely. In addition, 40 percent of transgender adults have attempted suicide in their lifetime, compared with less than 5percent of the general population. The numbers for transgender youths are even higher.

The trick is in offering services to these patrons while also balancing their privacy needs. LGBTQ people have to be circumspect about how, when, and to whom they come out. They have to be, considering the discrimination-and hate crimes-they often face. Libraries should be safe spaces, which could include private rooms for reference transactions, wearing pronouns on a name badge, or circulation slips that don't include the patron's name (to forestall accidental dead-naming). The more LGBTQ books and other materials a library can collect, the better, though the best practice is to integrate them into the general collection rather than create a special collection that someone might be reluctant to ask for. Same with special displays for, say, Pride Month, which can be challenged by right-wing groups. There are subtler ways to advertise resources-a printed bibliography, for example.

Sometimes, as Joe Miesner found out, the best thing we can do for a patron's mental health is listen. Listening is an underrated librarian skill. Too often, when a patron comes to us with a question, our minds jump to the solution. The patron needs this book! They should read this article! They should search this website! Or we refer them so promptly to another organization (maybe we're busy, or tired, or, heck, maybe we're not OK ourselves), they may hang up and wonder, "Wait, did I just get dissed? By a librarian?"

I am the director of the North Carolina Legislative Library, which is part of the state legislature. In the early days of the COVID-19 pandemic, a lot of state agencies were closed. My library was not. Word of this must have gotten around as our reference numbers shot up. Callers were asking about subjects-unemployment benefits, small business loans, birth certificates, job-hunting resources, filing for bankruptcy-that were not in our purview. Why? We were one of the few places to answer the phone. And listen. And try to help. I'm convinced we did help, even if we didn't solve their immediate problem.

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We helped by being ministerial. By being focused. By being present. Listening isn't just a librarian skill-it's a human skill, and a slippery one. It seems facile: just let the other person talk. To do it well, however, we have to shut off our editorial side. Our stand-up-comic side. Our judge-and-jury side. In short, we have to shut off our brains and just be ... what? Nothing. Just be.

It isn't just patrons who need support. Librarians do as well. Our jobs are more stressful than it would appear. We are constantly asked to do more with less, and there is never enough time or staff-or funding. Patrons can be challenging in about a million ways. And there is the ever-present threat of closure. I once worked in the library of a law school that went out of business after losing its accreditation.

Librarians have a unique ability to help people find answers. It's what we've dedicated our careers to doing. Sometimes those answers come from books, journals, the internet; sometimes they don't. We often see people at their lowest moments. We have a duty, perhaps a calling, to reach out in tangible ways.

Mental health has become an any-port-in-a-storm situation. Librarians can provide one of those ports.

State of Mind is a partnership of Slate and Arizona State University that offers a practical look at our mental health system-and how to make it better.

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How Libraries Became Refuges for People With Mental Illness

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Welcome to State of Mind , a new section from Slate and Arizona State University dedicated to exploring mental health. Follow us on Twitter . The Argentine writer Jorge Luis Borges is often credited with saying that "Paradise is a library." He must not have meant a downtown public library, circa 8 p.m.

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Highlights for the 2021 National Survey on Drug Use and Health

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Highlights for the 2021 National Survey on Drug Use and Health

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Covers national statistics gathered by SAMHSA (Substance Abuse and Mental Heath Services Administration), including mental health among youth, adults, suicidal ideation, and mental health service use.

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Your browser does not support the audio element.

Jasmine Cottrell began looking for a therapist in the fall of 2018.

She spent eight months on multiple waiting lists before she found one.

Cottrell moved to Portland from Alabama in 2017. As a Black woman, she struggled to find a therapist who looked like her in a city that's abundantly white.

"It was a journey, I can't lie about that," Cottrell said. "I did a lot of research ... I had been talking with a bunch of Black folks around the country about 'How do you find somebody that gets it?'"

It took months for Jasmine Cottrell to find a Black therapist who was taking on new clients.
Salim Sanchez / Courtesy of Jasmine Cottrell

That challenge can be familiar for Black Oregonians trying to seek culturally competent health care. For years, Oregon has consistently ranked among the worst in the nation for access to mental health care services.

It can be even more challenging for Oregonians of color like Cottrell who want to find a therapist who shares their background. Fewer than one-in-five clinicians in the state are people of color. And less than 1% of the state's mental health care providers are Black.

Cottrell wanted to specifically see a therapist who was a Black woman. That way, she said, the therapist would have a better understanding of her lived experience.

"There are a lot of times where, especially in the society in which we live and the way that the world is right now, that I don't want to have to explain why this is all really kind of crappy," Cottrell said.

"I'm Black in America and that's exhausting some days. It's lit, but it's also exhausting."

Related: 'Death by a thousand cuts': Microaggressions lead to worse mental health for Oregonians of color

It's particularly important for Black Oregonians to see a therapist who understands how race impacts their clients' lives, according to Portland therapist ZaDora Williams. Williams is a licensed clinical social worker and the founder of the Sankofa Center for Healing.

"Going to white clinicians has not been well [for my Black clients]. For even the clients that I see that have had white therapists, it became an education session for them," Williams said. "They just don't have the cultural piece or the understanding of what it is to be Black."

Those issues have only compounded since the onset of the coronavirus pandemic and the racial justice protests after the police killing of George Floyd. The number of Americans reporting symptoms of anxiety and depression has more than tripled since the beginning of the COVID-19 pandemic. Those numbers are even direr for Black and Latino adults who have reported worse mental health outcomes, increased substance use and more suicidal ideation than white individuals.

"These killings, these murders, these deaths aren't new. It's new to a lot of white America," Cottrell said. "I think what happens for me, especially in therapy, is that I am working through some of the anger, our anger and frustration around it."

In Portland, protests have continued nearly every night for more than 130 days. Williams conducted a study on the mental health impacts of the protests with the advocacy group Don't Shoot Portland this summer. They found that just being present at a protest and witnessing police violence against demonstrators elevated people's risks for depression and post-traumatic stress disorder.

Since March, Williams' schedule has been completely booked with clients. Williams said there's a huge need for Black therapists right now - and there aren't nearly enough.

ZaDora Williams is licensed clinical social worker at her private counseling practice, the Sankofa Center for Healing. Williams focuses on providing culturally competent care within Portland's Black community.
M.Martinez

Eventually, Jasmine Cottrell did find a Black therapist at Oregon Health & Science University's Avel Gordly Center. She said it felt validating and has given her more skills to cope.

"One of the things we've talked about is finding the power and confidence in my voice and saying in the moment, 'Hey, this isn't OK,'" Cottrell said. "I don't have to carry the weight of the world every day. I don't have to march up this hill with this flag and teach the whole world why what they did is wrong. I don't have to do that emotional labor, and that is really reassuring."

Related: Trauma passed down through generations impacts Oregonians of color

ZaDora Williams said she works with her clients to help them cope with the reality of being Black in America.

"Sometimes we have to move with radical acceptance of 'it is what it is' and 'how do I still go on to experience joy? How do I not let this just consume me?"

Despite the wait, Cottrell said the search for a culturally competent therapist was absolutely worth it.

"If I could offer any advice, it would be to not give up when you're not getting those calls back," Cottrell said. "Someone's going to cancel an appointment, someone's going to not be able to make something. Get in while you can get on the waiting list and stick it out."

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Black Oregonians struggle to find mental health care amid increasing need

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For years, Oregon has consistently ranked among the worst in the nation for access to mental health care services, and fewer than one-in-five mental health care providers in the state are people of color. Black mental health care providers make up less than 1%.

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Highlights by Race/Ethnicity for the 2021 National Survey on Drug Use and Health

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Highlights by Race/Ethnicity for the 2021 National Survey on Drug Use and Health

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Covers national statistics gathered by SAMHSA (Substance Abuse and Mental Heath Services Administration), including mental health among youth, adults, suicidal ideation, and mental health service use by race.

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DHS's Office of Minority Health Report on Mental and Behavioral Health for American Indians/Alaska Natives

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DHS's Office of Minority Health Report on Mental and Behavioral Health for American Indians/Alaska Natives

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Covers stats regarding mental health prevalence and access to care for Native American youth and adults.

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In 2019, suicide was the second leading cause of death for American Indian/Alaska Natives between the ages of 10 and 34.

American Indian/Alaska Natives are 60 percent more likely to experience the feeling that everything is an effort, all or most of the time, as compared to non-Hispanic whites.

The overall death rate from suicide for American Indian/Alaska Native adults is about 20 percent higher as compared to the non-Hispanic white population.

In 2019, adolescent American Indian/Alaska Native females, ages 15-19, had a death rate that was five times higher than non-Hispanic white females in the same age group.

In 2018, American Indian/Alaska Native males, ages 15-24, had a death rate that was twice that of non-Hispanic white males in the same age group.

Violent deaths, unintentional injuries, homicide, and suicide, account for 75 percent of all mortality in the second decade of life for American Indian/Alaska Natives.

MENTAL HEALTH STATUS

Source: SAMHSA, 2020. Results from the 2019 National Survey on Drug Use and Health: Mental Health Detailed Tables. Table 10.43B
https://www.samhsa.gov/data/report/2019-nsduh-detailed-tables [PDF | 10.22MB]

Source: CDC 2021. Summary Health Statistics: National Health Interview Survey: 2018. Table A-7.
https://www.cdc.gov/nchs/nhis/shs/tables.htm

Percentage of population with serious psychological distress among persons 18 years of age and over, 2018

Source: CDC 2021. Summary Health Statistics: National Health Interview Survey: 2018. Table A-8.
https://www.cdc.gov/nchs/nhis/shs/tables.htm

DEATH RATES

Source: CDC 2021. National Vital Statistics Report, Vol. 69, No. 13. Table 10.
https://www.cdc.gov/nchs/data/nvsr/nvsr69/nvsr69-13-508.pdf [PDF | 2MB]

Source: CDC, 2021. Health United States, 2019. Table 9.
https://www.cdc.gov/nchs/data/hus/2019/009-508.pdf [PDF | 10.22MB]

Source: CDC, 2021. Health United States, 2019. Table 9.
https://www.cdc.gov/nchs/data/hus/2019/009-508.pdf [PDF | 10.22MB]

ADOLESCENTS

Source: CDC, 2021. National Center for Injury Prevention and Control. Web Based Injury Statistics Query and Reporting System (WISQARS) [Accessed 04/21/2021]
https://www.cdc.gov/injury/wisqars/index.html

Source: CDC 2021. High School Youth Risk Behavior Survey Data.
https://nccd.cdc.gov/youthonline. [Accessed 04/21/2021]

Source: CDC 2021. High School Youth Risk Behavior Survey Data.
https://nccd.cdc.gov/youthonline. [Accessed 04/21/2021]

ACCESS TO HEALTH CARE

SAMHSA, 2020. Results from the 2019 National Survey on Drug Use and Health: Mental Health Detailed Tables. Table 8.17B
https://www.samhsa.gov/data/report/2019-nsduh-detailed-tables

SAMHSA, 2020. Results from the 2019 National Survey on Drug Use and Health: Mental Health Detailed Tables. Table 8.21B
https://www.samhsa.gov/data/report/2019-nsduh-detailed-tables

SAMHSA, 2020. Results from the 2019 National Survey on Drug Use and Health: Mental Health Detailed Tables. Table 8.39B
https://www.samhsa.gov/data/report/2019-nsduh-detailed-tables

*All data in the above surveys relate to non-Hispanic American Indians/Alaska Natives.

CDC. National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). [Accessed 04/21/2021]. https://www.cdc.gov/injury/wisqars/index.html

U.S. Surgeon General, 2001. http://www.ncbi.nlm.nih.gov/books/NBK44251

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mental health and american indians/alaska natives

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Mental and Behavioral Health - American Indians/Alaska Natives - The Office of Minority Health

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In 2019, suicide was the second leading cause of death for American Indian/Alaska Natives between the ages of 10 and 34. American Indian/Alaska Natives are 60 percent more likely to experience the feeling that everything is an effort, all or most of the time, as compared to non-Hispanic whites.

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Stats gathered by NAMI (National Alliance on Mental Illness) around mental health prevalence and access to care for Oregonians.

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The Diversity of Oregon's Licensed Health Care Workforce

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The Diversity of Oregon's Licensed Health Care Workforce

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Among several findings of note, this report from the Oregon Health Authority details the severe shortage of BIPOC licensed counselors and therapists in Oregon, meaning that many BIPOC aren't able to receive culturally competent mental health services (page 5).

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2022 National Survey on LGBTQ YouthMental Health - Oregon

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2022 National Survey on LGBTQ YouthMental Health - Oregon

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Stats on mental health prevalence and access to care for LGBTQIA+ youth in Oregon.

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Report on Investing in Culturally and Linguistically Responsive Behavioral Health Care in Oregon

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Report on Investing in Culturally and Linguistically Responsive Behavioral Health Care in Oregon

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From the Oregon Health Authority and the Coalition of Communities of Color, this report looks at the many barriers BIPOC in Oregon face with accessing culturally competent care, including mental health access. (Relevant charts start on page 31.)