Research from the Columbia University Department of Psychiatry reveals that the adult Black community is 20% more likely to experience serious mental health issues. However, only one in three African Americans who need help actually receive it. For comparison, about 25% of Black people seek mental health care, compared to 40% of white individuals.
Several barriers contribute to this disparity, making it harder for Blacks to access professional mental health care. These include a lack of Black therapists, cultural stigma within the community, and high costs.
1. High costs of care
Despite the Affordable Care Act, around 12% of African Americans are uninsured. Dr. Nettie Jones says that even those with insurance often face high co-pays or deductibles for mental health services.
“Deductibles can somewhat be high. Some people don’t have insurance and a lot of the providers are now getting off of these insurance panels, so people are finding themselves unable to afford care,” Jones said.
- Finding care
Even those with insurance can find their search for care stymied by the inability to locate a provider.
“Not only do you have to find a provider who is accepting new patients, but you also have to find one that will accept your insurance,” Jones said. “Or you may have a clinic that does sliding scales, but you can’t get in for several weeks. Or if you can get in, then it’s very limited on the services that you receive. Getting an appointment for a psychiatrist for a new patient may be anywhere from two to three weeks to a month. If there are no resources available, what ends up happening is people kind of give up.”
3. Family shame
When 23-year-old Kristian Smith first started therapy ten years ago, she faced her family’s dismissiveness of mental health.
“When I told my mother I needed to see a therapist, you would’ve thought I told her I was going to be a prostitute. She had a fit about me spilling ‘family business.’ And that’s the way it’s always been in my family,” Smith said.
For many in the Black community, it’s still taboo to admit suffering from depression, anxiety, and other mental illnesses.
“Many of us have grown up with ‘what goes on in our house stays in our house’. And I’m sure many of us have a story about an uncle or an aunt who just wasn’t quite like everybody else.”
- Cultural stigma
Familial shame often stems from a broader cultural stigma within the Black community. Therapy is viewed as a sign of weakness and something to be ashamed of.
“A lot of Black people don’t think of therapy as a realistic option,” says Jones, adding that they often turn to “safer” avenues like church, friends, and healing circles.
5. Lack of diverse professionals
Blacks often prefer therapists who share their racial background for better understanding. However, in 2023, only about 2% of American Psychological Association members identified as Black. This lack of representation makes it challenging to find appropriate therapists.
6. Whiteness as a foundation
Most psychological training is based on white norms, values, and beliefs, which can affect the competency of non-Black therapists.
7. Distrust of the medical industry
Historical mistreatment and misdiagnosis have fostered a deep mistrust of the medical system among Black people.
8. Wording choice
Black folks hate to be labeled “crazy,” which some mental illnesses are often unjustly labeled. Jones suggests using words like “Emotional wellness” instead of “Mental health.”
“When you use the word emotional wellness, people are a little bit more accepting,” she said. “When you say words like mental and psychological, it kind of shuts people down because they immediately think of the C word.”
- Emotional hesitation
Blacks are often taught to keep their feelings to themselves. Even after finding a therapist, opening up can be challenging.
“Talking about emotions is something many of us are not directly taught,” says Smith. “Sharing that process with a stranger can be daunting.”
10. Negative past experiences
Many Blacks have had negative experiences with counselors, often due to a lack of cultural awareness and competence. These experiences can discourage them from seeking further help.
