JACKSON, Miss. (AP) — The barber’s chair may be the new therapy couch for parts of the South where mental health care is in short supply.

In Mississippi, one of six Southern states ranked in the bottom 10 for mental health care access, approximately 60 Black barbers have been trained over the past year to engage their clients in mental health discussions that may not otherwise happen.

“As a barber, people listen to our advice a lot, and the training just brought that out more,” said Antonio Wiggins, who cuts hair and teaches at the Trendsetters Barber College in Jackson, Miss. “I didn’t even realize I was helping people mentally and how important that was.”

Conversation is part of the allure in barbershops like Trendsetters.

Men will wait 6 to 7 hours on a Saturday for a cut and spend the day swapping sports opinions, vetting conspiracy theories or debating grandiose hypotheticals — “What’s the worst thing you think has ever happened?”

“We like to say we’re like the Black country club,” Wiggins said. “You come to the barbershop and people automatically feel comfortable. It’s the barbershop talk.”

In June, Wiggins was one of 20 who participated in the latest round of training by The Confess Project, an Arkansas-based group that has taught Black barbers across the South how to fold emotional support into that “shop talk” and de-stigmatize those conversations in predominantly male waiting areas.

Wiggins said the training showed him that what goes unsaid can be just as important to listen for.

“I’ve had clients (before) who committed suicide, clients who had depression,” Wiggins said. “This has made me pay attention more to different words a client might use. Or if a client wants to let others get before them, basically they don’t really want a haircut and maybe want to talk more. It makes me pay more attention, because it may be something that could save that person’s life.”

BARRIERS TO MENTAL HEALTH CARE

Studies have shown Black people nationwide have a higher risk of post traumatic stress disorder (PTSD) than other ethnic groups. That risk is heightened in Southern states like Mississippi where high rates of poverty, violence and abuse can deepen trauma.

Still, in Mississippi and other parts of the South, barriers to mental health access remain high.

The state ranks No. 48 nationally for mental health care access, according to a report released this year by Mental Health America (MHA), which analyzed how many people received treatment and how many adults couldn’t get treatment due to cost, among other factors.

The lack of access received national attention in 2017 when the federal government seized oversight of the state’s mental health care system. U.S. District Judge Carlton Reeves ruled, in part, that the state unnecessarily institutionalized people in state hospitals and “has major gaps in its community care.”

Mississippi also had the second fewest psychiatrists per capita in 2018, according to 2018 report by University of Michigan Behavioral Health Workforce Research Center.

“Mississippi has pretty much turned its back on mental health issues,” said barber Darius Campbell, who also participated in the Confess Project. “There’s no funding for mental health issues. The only place we really have to deal with mental health is the state hospital and for the most part, everybody don’t belong there. Some people just need that little sit-down to release what’s on their mind and what’s on their heart.”

Overall, the South accounts for six of the bottom 10 states for mental health care access nationwide, according to the MHA report: Georgia, Mississippi, South Carolina, Alabama, North Carolina and Tennessee.

The Confess Project has worked with barbers in each of those states except Alabama. And Confess Project founder Lorenzo Lewis said he has seen encouraging results.

“On the micro level we’re working to build stronger, healthier relationships,” Lewis said. “On the macro level, we see that poverty may be decreased. Men come in the shops that have better employment outcomes and better mental health.”

Tiffany Haynes, an associate professor at University of Arkansas for Medical Sciences, studied the barriers to mental health care for Black people who live in rural areas. In that 2017 study, she found that high costs and lack of insurance were primary factors as well as a shortage of healthcare providers in the region.

Haynes also found that within the Black community, a clear need for mental health care often clashed with a lack of access to mental health literacy and deeply-rooted stigmas against seeking therapy.

“Participants in our study talked a lot about stigma. In smaller communities, it’s really hard to access these services without someone else knowing what you’re doing,” Haynes said.

That stigma is something Lewis knows all too well.

Lewis lost his father in the third grade. He still remembers someone telling him to “man up.”

“I think that experience manifests with a lot of men,” Lewis said.

Lewis likes to use personal experience to connect with the barbers he’s training, and as someone who is both a 10-year behavioral health worker and a formerly incarcerated juvenile diagnosed with depression, Lewis likes to say he understands mental health needs both “personally and professionally.”

But it was in his aunt’s beauty store in Little Rock, Ark., where he found a nurturing environment and his first mentor.

“That’s where I saw that I could be the best I could be. And I saw lives being changed there all those years,” Lewis said.

BARBERSHOP THERAPY

In retrospect, barbershops seem ideal for filling in mental health gaps for Black Mississippians.

The barber chair is a great equalizer, where every member of the community sits with self-improvement already in mind. And barbers are familiar, relatable faces in a space known for non-judgement and discretion.

Black mental health workers comprise only 2% of American Psychological Association members, according to a 2017 staffing analysis.

“I learned during the COVID shutdown that barbershops are most people’s counseling sessions,” Campbell said. “If you could be a fly on the wall and listen to some of the things that’s shared, you’d be like, wow, they don’t ever need to shut barbershops down again.”

The inclusion of barbers such as Campbell, who owns a shop in the 1,100-person town of Terry, Miss., could mean a boost in mental health literacy in rural areas.

In the past year, Campbell said he saw “a lot of broken young men” coming into his shop, which led to his involvement with The Confess Project. While many are not yet comfortable with opening up, he said he continues to apply lessons he’s learned. He watches for those avoiding eye contact or drooping their head.

“Now when I see bigger issues, I know the questions to ask,” Campbell said. “Or I don’t open up with questions and I start by saying, ‘Man, you are so worth it. You don’t know how much you helped me today,’ and they say, ‘Wow, for real?’”

Wiggins, a longtime barber who has seen kids grow from kindergarten to college from behind the barber chair, said he knows of clients with diagnosed mental illnesses. But more often, he sees someone who needs a kind ear.

There was the mother who would always come to get her eyebrows shaped. After one session, she didn’t get up from the chair and instead burst into tears and began talking about her son’s drug habit.

“She was asking what advice I can give and if I can talk to him. And I did, because I cut his hair also,” Wiggins said. “Stuff like that happens all the time.”

When a regular of his, James Bennett, came into the shop three years ago, Wiggins knew how he wanted his hair cut: a taper on the side and taken low all over.

And after seven years of cutting Bennett’s hair every weekend, Wiggins also knew something was off.

“I knew something was wrong because he had his head down the whole time. We’d normally be laughing and joking and talking about regular barbershop stuff,” Wiggins said. “I didn’t know he had a gun in his pocket that night.”

As Bennett put it in a recent phone call, an ongoing divorce had him angry enough to “do crazy stuff” and “want to hurt somebody, anybody.”

Wiggins, sensing the recklessness in his friend, told Bennett not to do anything that would steal time from his mother or his three children.

A week later, Bennett returned to the shop. He explained that he had a gun the week before and thanked Wiggins for being the voice he needed to hear.

“I went back and told him, ‘You helped me out. You probably wouldn’t be cutting my hair no more because I’d be locked up in jail,’” Bennett said.

Three years later, Bennett still frequents the shop. Sometimes he looks for answers, but since that night in 2017, he also looks for others who need the help he was once given. Reflecting on that night, Bennett said therapy had been an option for him, but he didn’t feel comfortable speaking with someone who hadn’t had a similar upbringing.

“I’m not saying a therapist can’t help me but at that point I was looking for someone who’s been through it,” Bennett said. “For Black people, the barbershop is where men go to speak with other men to get a point of view from everybody. I sit and listen and take all of it in, and it works for me. It keeps me positive.”

Sometimes, getting a little off the top can take a weight off your shoulders.