We Need To Talk About Black Women & Therapy

It's no secret that, as common as mental health issues can be, sadly, not everyone gets the care that they need. According to the National Alliance on Mental Illness, while Black Americans are 20% more likely than the general population to develop mental health problems (and Black women are more likely to experience and mention physical symptoms related to mental health problems), only a quarter of Black Americans seek care, compared to 40% of white people.

We've often discussed how the shame associated with mental illness can stop people from getting help — and while that can definitely be the case, stigma isn't the only barrier to seeking help.

A 2014 report from the Association of American Medical Colleges found that Black and African-American doctors only made up 4% of the physician workforce. And Chirlane McCray, New York City's first lady, who last year launched Sisters Thrive, a mental health program for Black communities, says that has a huge impact on how comfortable people feel in seeking help, especially for mental health issues.

"All of our medical professionals are not necessarily people that we can identify with and trust," McCray tells Refinery29. "That makes it harder to want to go for help, especially because mental health is such a personal issue. You really want to feel comfortable, that you’re talking to someone who’s not going to be patronizing, or not treat you well. I think it’s really hard for Black women to even think about this topic and then to think about getting help when it’s necessary."

Joy Harden Bradford, PhD, an Atlanta-based therapist who runs the podcast Therapy for Black Girls, adds that getting care can be crucial for Black women.

"I think Black women tend to be so involved in a lot of groundbreaking important work," she says, citing the Black Lives Matter movement and other movements across the country. "Even if we’re just talking about who’s running our community organizations, who’s making sure their families are taken care of, who’s taking care of their elders, that typically is Black women. I feel like we shoulder a lot of responsibility, but you can’t keep doing that if you're not taking care of yourself."

But, according to Dr. Bradford, the lack of diversity in the mental healthcare field can be discouraging for those who are seeking treatment.

"There aren't enough Black women therapists to go around, but it has been my experience that Black women typically want another Black woman as a therapist," Dr. Bradford says. "The field is still predominantly white, so even if all Black women said, 'I want to go see a therapist,' there would not be enough of us to speak to."

In fact, a 2016 study involving 320 New York City therapists found that therapists in the study were more likely to call back new potential patients who they thought to be white and middle-class than patients they thought to be Black. While this is just one small study (and more research needs to be done), it does point to a disturbing suggestion: Some therapists may be racially discriminating against patients.

Overt racism aside, it's not hard to understand why someone would feel more comfortable speaking to a therapist who can more directly relate to what they're coming up against. In an ideal world, even if you're not seeing a therapist who you personally can relate to, you should still be able to have a good experience. But Dr. Bradford says that, too often, she hears stories from Black women who go to therapy and experience unconscious, subtle racism from their own doctors.

"If you go in and talk about how you might be paranoid about people following you around in the store, and then the therapist comes back with, 'Well what might you be doing to cause people to be suspicious?' — that’s not going to make you feel like therapy is a safe space," she says.

To begin offering better resources for all patients, "there needs to be a conversation around non-Black therapists and non-people of color therapists about looking at their own relationship to white privilege," Dr. Bradford says.

"There still needs to be a conversation around how non-Black therapists can make sure that they are operating in a culturally competent way, and making sure that therapy is a safe place for Black women," she adds.

Until then, she advises any Black woman thinking about getting therapy to think about what they want out of treatment.

"An important part of it is sitting down and being honest with yourself about what’s going to be important to you in a therapist," she says. "If you think that talking to another Black woman is going to be important to you, then start there. If you think your insurance is going to be important, call your company and get a list of who’s in your network. Prioritize what’s going to be important to you to do that work to take care of yourself, and then go from there."