Practice Tip of the Week | The Legacy That Named a Month

Bebe Moore Campbell National Minority Mental Health Awareness Month

By Cornelius Metili BSN, RN, PMH-BC 

“Once my loved ones accepted the diagnosis, healing began for the entire family, but it took too long. It took years.”1 

Bebe Moore Campbell spoke those words in 2005. She was referring to her daughter, to bipolar disorder, and to the years it took her own family to find its way to a conversation it did not know how to have. Campbell was an acclaimed author and journalist, but the work that would outlast everything she ever published began at home. Her family was navigating a mental health care system that was not prepared to meet them where they were, and a silence inside the family that made it harder to ask for help. 

Like many caregivers, Campbell searched for help in crisis. What she found first was not a policy or program, but other mothers carrying the same grief and fighting the same battles with insurance, stigma, and fear. Those connections led her to National Alliance on Mental Illness (NAMI)’s Family-to-Family program, a free, evidence-based course for families navigating mental illness.2 She completed the course and became an instructor. But for Campbell, teaching was not enough. She wanted the course in Black communities, in spaces free from the compounding weight of racial stigma. As she told TIME magazine: “African Americans and people of color already feel stigmatized by virtue of our race. Therefore, we really don’t want to own up to something else that could be used against us.”3 

Mental illness can be marginalizing on its own. A diagnosis may carry stigma, fear, and silence before race, culture, sexuality, immigration status, or housing instability are even considered. For minority communities, those burdens compound, making distress harder to name, care harder to seek, and suffering easier to misunderstand. 

Campbell co-founded NAMI Inglewood in a predominantly Black Los Angeles community. What began as a space for Black families grew to serve multiple minority communities, and the chapter became NAMI Urban Los Angeles to reflect the diversity of the population it served.4 

What Campbell was building in 2003 was peer support and cultural responsiveness. The Substance Abuse and Mental Health Services Administration would not formally recognize these as foundational pillars of trauma-informed care until 2014, eleven years later.5 She died in 2006 before those principles were formally named. 

In 2008, July was designated as Bebe Moore Campbell National Minority Mental Health Awareness Month.6 That designation was not ceremonial. It was a call to action, one that the nursing profession is uniquely positioned to answer. 

In 2021, three leading national organizations in pediatric medicine — the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP), and the Children’s Hospital Association — declared a national state of emergency in child and adolescent mental health, naming racial inequity as a contributing factor.7 The declaration did not begin the crisis; it named what years of data had already made clear. Nearly five years later, the emergency persists. Suicide rates among Black youth ages 10 to 17 rose 144% between 2007 and 2020.8 By 2022, the gun-suicide rate among Black teens surpassed that of White teens for the first time on record.9 Among Black children under 13, suicide rates have been reported at twice the rate of their White peers.10 

Campbell’s advocacy began with Black families, but the pattern she named was not confined to one community. For youth living at the intersection of multiple marginalized identities, the risk compounds. Although LGBTQ+ youth represent a minority of the general youth population, they are disproportionately represented among youth experiencing homelessness, with some estimates as high as 40%.11 Housing instability is associated with more than three times the odds of a past-year suicide attempt.12 Among Black LGBTQ youth, 44% reported seriously considering suicide in the past year.13,14 Among Black transgender and nonbinary young people, just over one in four reported a past-year suicide attempt.13,14 

Researchers are now studying marginalized youth with greater specificity than the field has historically provided. This is progress that is both welcome and overdue. Black youth, LGBTQ youth, immigrant youth, Latina youth, and youth experiencing housing instability do not experience risk as a single, uniform category. Nursing practice must be broad enough to recognize disparity and specific enough to respond to the person in front of us. When Black youth enter clinical settings, what may be distress is sometimes treated first as defiance or noncompliance rather than fully assessed as depression, trauma, grief, or unmet need.15 

The barriers to minority mental health extend beyond access to care. Research consistently identifies stigma, self-reliance, mistrust, social network influences, and other cultural and structural obstacles to mental health help-seeking in Black communities.16 

These are not deficits. They are survival patterns. But silence functions as its own form of instruction. When emotional honesty and vulnerability are absent at home, children internalize the message that these experiences are not to be discussed. They learn to conceal their distress, to manage their needs independently, and to repeat the patterns they observe. 

The ED-STARS study gives empirical weight to this concern. Conducted across 14 pediatric emergency departments with 5,514 youth ages 12 to 17, it found that family connectedness — one of the strongest known protective factors against suicide — remained protective for Black youth but was significantly less protective than for White youth.17 When stigma renders mental illness unspeakable within close family relationships, the resulting isolation may compound the very risk connectedness is expected to mitigate. 

Stated plainly: children are struggling in loving homes. This is not a new phenomenon. It is Campbell’s story. It is her daughter’s story. The diagnosis may differ, but the silence is the same. 

Family-to-Family has been validated through randomized controlled trials as an evidence-based intervention,18,19 but its importance in Campbell’s story is more than methodological. It offers families what silence takes away: a space to name mental illness, build skills, and practice acceptance together. The research and Campbell’s instinct are not separate narratives. They are the same narrative, separated by twenty years. Families cannot support what they have never been given space to understand. 

The silence described here is not generationally contained. It is present in parents who cannot name what is happening to their children, in grandparents who respond with prayer but were never given the language to pair faith with honest conversation, and in the young man who has known he is gay since he was fourteen and has never said it out loud because he is not sure his family’s love will survive the truth. Nurses across all specialties and settings will encounter patients carrying this silence. Cultural competence can guide us, but cultural humility is what  prevents us from assuming we already know the patient’s story. Minority Mental Health Awareness Month is not symbolic. It is not performative. It exists because Bebe Moore Campbell helped name a crisis that communities had been carrying long before institutions formally declared it. The 2021 national emergency declaration did not create that urgency; it confirmed that the need remains unresolved. 

Nursing has always been both a science and an art. The science trains the profession to assess, intervene, evaluate, and act with clinical competence. The art asks something different: to listen for what is not being said, to recognize when certainty becomes assumption, and to remain open to the patient’s lived experience. Cultural humility lives in that space. It does not replace clinical knowledge. It deepens it by affirming that the patient remains the expert on their own life. 

This kind of self-reflection may be the most underutilized clinical tool in our profession. It asks us to sit with what we do not know, to question what we assume, and to let what we learn change how we practice. 

In my own practice as a psychiatric-mental health nurse, these are some commitments/takeaways I return to at the bedside: 

1. Treat irritability, withdrawal, and silence as clinical information before labeling them as behavioral problems. 

2. Reframe the power dynamic and position the patient as the expert and authority on their own life. Try and guide the patient through difficult moments without taking ownership of their story. 

3. If you share your patient’s cultural background, name the weight of that. You may be the only person in the room who understands what the family is carrying, and that understanding is both your strength and your vulnerability. It is ok to give yourself permission to set boundaries around it. 

4. Build a habit of reflecting on the experiences that stay with you and process them with intention. A thoughtful debrief is not gossip; it is a professional practice that helps nurses make meaning, strengthen judgment, and care for themselves and their patients more effectively. 

5. Add to your repertoire. One in five people will experience a mental health condition. That means every specialty, every unit, every setting. Pursue evidence-based education in suicide prevention, trauma-informed care, and cultural humility through organizations like the American Psychiatric Nurses Association. These are not niche competencies. They are foundational ones. 

Campbell’s legacy was built on love, community, and leadership. She responded to her daughter’s diagnosis by creating what other families needed: language, support, and a place to be understood. This year marks twenty years since her death. We honor her not only by remembering her name, but by carrying her urgency into our practice and by doing the work that helps us meet our patients where they are. 

REFERENCES  

1. National Alliance on Mental Illness. (n.d.). About Bebe Moore Campbell National Minority Mental Health Awareness Month. https://www.nami.org/stay-connected/events/awareness-events/bebe-moore-campbell-national-minority-mental-health-awareness-month/about-bebe-moore-campbell-national-minority-mental-health-awareness-month/ 

2. National Alliance on Mental Illness. (n.d.). Family-to-Family. https://www.nami.org/Support-Education/Mental-Health-Education/NAMI-Family-to-Family/ 

3. Campbell, B. M. (2005). Between the lines with Bebe Moore Campbell. TIME Magazine. https://time.com/archive/6918760/between-the-lines-with-bebe-moore-campbell/ 

4. National Alliance on Mental Illness. (2023). Honoring and upholding Bebe Moore Campbell’s legacy. https://www.nami.org/blog/honoring-and-upholding-bebe-moore-campbells-legacy/ 

5. Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach (HHS Publication No. SMA 14-4884). https://library.samhsa.gov/product/samhsas-concept-trauma-and-guidance-trauma-informed-approach/sma14-4884 

6. H. Con. Res. 134, 110th Cong. (2008). Expressing the sense of the Congress that there should be established a Bebe Moore Campbell National Minority Mental Health Awareness Month. https://www.congress.gov/bill/110th-congress/house-concurrent-resolution/134 

7. American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, & Children’s Hospital Association. (2021). Declaration of a national emergency in child and adolescent mental health. https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-national-emergency-in-child-and-adolescent-mental-health/ 

8. Cubbage, J., & Adams, L. (2023). Still ringing the alarm: An enduring call to action for Black youth suicide prevention. Johns Hopkins Center for Gun Violence Solutions, Bloomberg School of Public Health. https://publichealth.jhu.edu/sites/default/files/2023-08/2023-august-still-ringing-alarm.pdf 

9. Johns Hopkins Center for Gun Violence Solutions. (2024). Gun violence in the United States 2022: Examining the burden among children and teens. Johns Hopkins Bloomberg School of Public Health. https://hub.jhu.edu/2024/09/12/gun-deaths-us-children-and-teens/ 

10. Sheftall, A. H., Vakil, F., Ruch, D. A., Boyd, R. C., Lindsey, M. A., & Bridge, J. A. (2022). Black youth suicide: Investigation of current trends and precipitating circumstances. Journal of the American Academy of Child & Adolescent Psychiatry, 61(5), 662–675. https://doi.org/10.1016/j.jaac.2021.08.021 

11. Durso, L. E., & Gates, G. J. (2012). Serving our youth: Findings from a National Survey of Service Providers Working with LGBT Youth who are Homeless or At Risk of Becoming Homeless. Williams Institute with True Colors Fund and The Palette Fund. https://williamsinstitute.law.ucla.edu/publications/serving-our-youth-lgbtq/ 

12. The Trevor Project. (2022). Homelessness and housing instability among LGBTQ youth. https://www.thetrevorproject.org/research-briefs/homelessness-and-housing-instability-among-lgbtq-youth-feb-2022/ 

13. Siff, L., & Molock, S. (2025). Pathways to hope: Redefining suicide prevention for Black LGBTQ youth. Mental Health Science, 3(1), e70004. https://doi.org/10.1002/mhs2.70004 

14. The Trevor Project. (2021). All Black Lives Matter: Mental health of Black LGBTQ youth. https://www.thetrevorproject.org/wp-content/uploads/2021/07/All-Black-Lives-Matter-Mental-Health-of-Black-LGBTQ-Youth.pdf 

15. Child Mind Institute. (n.d.). Misdiagnosis of mood disorders in Black teenagers. https://childmind.org/article/misdiagnosis-mood-disorders-black-teenagers/ 

16. Planey, A. M., Smith, S. M., Moore, S., & Walker, T. D. (2019). Barriers and facilitators to mental health help-seeking among African American youth and their families: A systematic review study. Children and Youth Services Review, 101, 190–200. https://doi.org/10.1016/j.childyouth.2019.04.004 

17. Merai, R., Shi, T., Wei, A. X., Ruch, D. A., Bridge, J. A., Pao, M., & Horowitz, L. M. (2025). The moderating role of race/ethnicity in suicide risk and family connectedness in youth presenting to the emergency department. JAACAP Open, 3(3), 448–454. https://doi.org/10.1016/j.jaacop.2024.10.009 

18. Dixon, L., Lucksted, A., Medoff, D., Burland, J., Stewart, B., Lehman, A. F., Fang, L. J., Sturm, V., Brown, C., & Murray-Swank, A. (2011). Outcomes of a randomized study of a peer-taught Family-to-Family education program for mental illness. Psychiatric Services, 62(6), 591–597. https://doi.org/10.1176/appi.ps.62.6.591 

19. Mercado, M., Fuss, A. A., Sawano, N., Gensemer, A., Brennan, W., McManus, K., Dixon, L. B., Haselden, M., & Cleek, A. F. (2016). Generalizability of the NAMI Family-to-Family education program: Evidence from an efficacy study. Psychiatric Services, 67(6), 591–593. https://doi.org/10.1176/appi.ps.201500519