How Does It Impact Mental Health Care?
When it comes to mental health care, there are
In fact, Black patients have had their mental health concerns dismissed, ignored, or simply untreated. Meanwhile, many can’t even begin to afford the increasingly expensive costs of therapy and medication.
Most recently, the Depression and Bipolar Support Alliance estimates that about 5.7 million Americans have been diagnosed with bipolar disorder. However, this number may be higher, as many Black people throughout North America have not sought out treatment or a diagnosis.
At a first glance, maybe it seems simple: Why aren’t people seeking out help from a mental health professional if they’re experiencing symptoms of bipolar disorder? When you look closer, though, there’s a clear racial disparity in mental health care: According to a 2015 study, 86% of U.S. psychologists were white, while only 4% were Black.
The problem? Seeing a mental health professional, like a therapist, counselor, or psychiatrist, who doesn’t understand what it’s like to be Black, can make for a difficult experience when trying to receive help.
Ajoké Amis is a Toronto-based social worker who has Bipolar II Disorder. She recalls speaking with a white therapist about the religious homophobia she faced from her Nigerian mother.
“I was trying to explain how these ideas were imposed on us, and I can’t blame my mother because she was ‘brainwashed,’ [but] he didn’t get it.”
Therapists are supposed to offer understanding safe spaces for all types of issues, feelings, and concerns — so it’s extremely frustrating for a professional to invalidate some of those emotions, simply because they don’t understand a cultural upbringing.
With this specific hurdle in mind, it’s also important to note that society itself can be a factor in poor mental health. One of the things affecting Black people’s mental wellness is anti-Black racism.
The Black Health Alliance defines anti-Black racism as policies and practices that are rooted in education and healthcare that enforce discrimination, stereotyping, and prejudice against those of Black-African descent.
These behaviors can include outright racism and discrimination, as well as more subtle forms such as unconscious bias. Unconscious bias in medicine can show up as not believing Black people who are seeking mental health care, or therapists who are unequipped to take care of Black patients.
Amis explained that anti-Black racism in society has only exacerbated her symptoms.
“The reason why my mental illness is so bad, is because I live in a world that doesn’t see me as human. And it’s so hard to explain that to someone who doesn’t live in a Black body,” she says.
Yasmine Gray, a disabled community-based educator and researcher explains that, “therapists need to understand and recognize anti-Black racism [as] a health issue.”
“It impacts Black people’s health and well-being,” she says. “They need to look at anti-Black racism as an example of trauma. It is chronic, and it is serious, and it does weigh heavily.”
As a result, it’s crucial for mental health professionals to understand that a Black person’s identity doesn’t solely rest on their race. Their individuality can exist at multiple intersections of marginalization, such as being queer, disabled, fat, or an immigrant. This means that “one-size-fits-all therapy” doesn’t exist and won’t help.
Additionally, many Black people are deprived of mental health support because of the systemic oppression they may be facing in their lives. According to Gray, these oppressive forces may include “ableism, sanism, transphobia, queerphobia, [and] fatphobia.”
She also notes that it’s important for Black people to know that it isn’t their fault if they’re encountering barriers to receiving treatment for their conditions.
“If you have a thorough understanding of all these sites of oppression that can impact upon the lives of Black people, you will be better positioned to deliver more culturally competent services,” says Gray.
In order to competently serve Black patients, mental health professionals can’t only attend one-time sessions on diversity. They need to also commit to social justice and helping Black people.
According to Zencare, therapists can become culturally competent by reading theory, attending workshops frequently, and committing to learning about the experiences of their Black clients.
“Therapists who want to be anti-oppressive should be able to critique or hold critiques of the very system that they’re working within and profiting from,” Gray explains. “[They] should be advocates for social justice and confront anti-Blackness, transphobia, queerphobia, classism, sexism, and other forms of systemic oppression.”
“They should view their work as political because it is, and they need to be able to understand how the personal issues their clients are often experiencing are part of broader patterns of inequity in society.”
Along with finding the right therapist, Gray also offered other practical and general ways Black folks can take care of their mental health:
- Mad mapping: This is a safety plan you can create for times of crisis, distress, or high stress. Safety planning in advance while still feeling “well” can make it a little easier before someone reaches a challenging or stressful state.
- Mood-tracking: This can help you to notice any significant or notable patterns in terms of your moods and emotional state, and hopefully begin to identify how your mood shifts in response to certain environments, situations, or even times of day. You can make this as detailed or as bare bones as you like, and it can be done digitally using an app or in a paper notebook or journal.
Some other self-care practices that may be helpful include:
- regular exercise
- prioritizing sleep
- relaxing activities, like meditation and breathwork
- practicing gratitude
Amis also shared some of the things that she manages her mental health.
“I find having hobbies really saved my life,” she says. “Right now, I’m in a book club. I joined a play.” She also found that managing her social media usage was beneficial.
Additionally, she says that having a good support system is crucial. “It’s really helpful to be around other Black people,” she notes. “I’m the most comfortable when I’m around other Black people who also have mental health issues and I can just be more honest and more open.”
Bipolar disorder can often derail normal life, making it difficult to stay in touch with friends, go to work, and take care of hygiene. Because of this, Amis tries to surround herself with friends who are “willing to give [her] grace” when her symptoms rear their head.
While bipolar disorder generally requires more than just regular self-care practices (medication management and therapy can be hugely beneficial), it’s not easy finding a mental health professional that understands it.
Here are some tips on how to find a culturally competent therapist.
- Before you start your search, decide what you’re exactly looking for: Would you prefer if your therapist is honest and provides tough love? Or would you like it more if they’re kind and empathetic? Do you want advice, or do you want to be listened to? Make a list of some of the characteristics you’d like for your ideal therapist to have.
- Ask questions: Before you even make that first appointment, feel free to ask questions when you reach out and start chatting. Do they specialize in anything? What’s their experience like? What is their worldview like?
- Talk with people you trust: Take a look at your community, whether it be friends, coworkers you trust, family, or even local resources, like those at a university or community center. Does anyone have any recommendations? Have they had success finding a culturally competent therapist through a certain office?
- Use your resources: There’s a good network of resources that are specific to helping Black people finding mental health care, like:
It may not be the easiest process — you may meet with multiple therapists before you find the one you click with. But, if you’re able, having proper mental health care can make you feel less alone and more understood.