Eddie Wiley, 34, is sure he struggled with undiagnosed depression as a teenager. But unlike then, he is now equipped with the necessary tools and resources to safeguard his mental health. Even still, he admits the mpox outbreak over the summer induced a level of fear for him and other gay millennials whose only connection to a similar experience was through the stories they’d heard of those lost during the early days of the HIV epidemic.

“Even though I was in the maintenance phase of my mental health journey when mpox came out, it totally blew my mind,” Wiley says. “It caused so much fear and anxiety.”

A contract media specialist and podcast host at Engaging Arkansas Communities, a Gilead COMPASS grantee and nonprofit with several locations across Arkansas. Wiley’s journey towards achieving better health outcomes for himself and the local queer community did not manifest without navigating stigma and shame, particularly after his HIV diagnosis in 2014.

“I was known in Memphis for passing out condoms and doing linkage to care. I was supposed to be the example,” Wiley says. “And so, for me, it was more of an internalized stigma. I was depressed for a really long time. I probably went a year and a half without therapy and just trying to cope on my own.”

Wiley tells GLAAD that he was presented with a new set of challenges when he sought help from a professional through the employee assistance program at his former job.

“The people they referred me to were not reflective or did not have the experience working with someone like me—Black, queer, and living with H I V,” he says. “I’m a huge proponent for telling people that [finding a suitable therapist] it’s just like shopping. You may have to try and try again with your therapist because they may not be a good fit.”

Machel Hunt, an accredited relationship counselor and psychosexual therapist based in Atlanta, GA, says it’s vital for individuals to recognize that unresolved trauma exists and is ongoing.

“It’s important that we think about what pre-existing conditions exist so that we can prepare for things that will come up, whether it’s a diagnosis for HIV or mpox or another infection that will leave an indelible scar,” he says.

According to Hunt, Black gay and bisexual men must prioritize their mental and emotional health, especially during public health outbreaks such as mpox; in the same way, physical and financial health is prioritized.

“Oftentimes, we ignore our mental health in lieu of physical things because it’s so much of what we see and appreciate. So much of the currency we exchange with each other is about physicality,” Hunt says.

“My first approach is to acknowledge the trauma—acknowledge where we are as Black men, as Black gay men, and acknowledge where we are in the context of public health, which is really at the bottom of the list,” he says.

“We’re at the highest risk for H I V, even though PrEP is available, and the highest risk for mpox, even though there are vaccines available,” he adds.

A particular pathology driving poor health outcomes?

Wiley tells GLAAD that while he received the mpox vaccine, many of his peers decided to forgo vaccination.

“In their mind, they were doing risk reduction by reducing the number of people they came in contact with, although they were still going on trips and attending [social gatherings] kickbacks,” he says.

New data released in a study by the Centers for Disease Control and Prevention (CDC) shows that vaccinated people have substantially less risk for contracting mpox compared with those who are unvaccinated. The CDC identified no major safety concerns after nearly 1 million doses were administered. But still, Black and Latino gay and bisexual men remain overrepresented in mpox cases and under-vaccinated for the virus.

Hunt believes a particular pathology drives the decisions made by some Black gay and bisexual men resulting in poor health outcomes.

“If we don’t feel good about ourselves, then what exactly are we protecting? If we don’t value our bodies and value ourselves as individuals, then what’s the reason to protect [ourselves]?” Hunt asks.

Atlanta-based counselor and social worker Hakim Asadi says healing begins when individuals are in tune with and not neglectful of their emotions.

“Oftentimes, we don’t listen and tend to bypass our emotional experiences. But our emotional experiences can give us insight into what’s triggering,” Asadi says.

“When I give myself agency, I give myself permission to change. So if it’s intergenerational trauma that didn’t start with me, I can realize this is how my grandmother and mother responded. And so this is how I automatically assume that I’m supposed to respond,” he says. “And so, by teasing it out, I give myself agency over my own experience. I don’t have to respond this way.”

Asadi asserts that individuals already have the tools to unlock their inner healing.

“Understanding that you already have practices for your healing, we just need to name it our healing,” he says.”

“Self-help is a way of starting. Meditation is a great fit for that,” says Hunt, who also urges individuals to identify places and spaces that evoke joy to aid in overcoming trauma.

“And if you have the resources to get therapy, make sure you find the right one,” he adds. “Not all therapists are equal.”

The Substance Abuse Mental Health Services Administration (SAMHSA) has established a disaster distress helpline that provides 24/7, 365-day-a-year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters, including infectious disease outbreaks.

Mpox is not a disease that lives in isolation. As such, a holistic approach to treatment must be prioritized, including a focus on mental health.