HealthPotential Barriers to Mental Health Care for Black Americans: How to Get...

Potential Barriers to Mental Health Care for Black Americans: How to Get Help


“The field of psychology has a sordid history of pathologizing Blacks’ resistance and protest, and of attempting to justify racist stereotypes about Blacks.

Although we are not at fault for the racism we experience, we are still met with the burden of coping with these experiences. Experiences of racism can be traumatic, and like with other trauma, it is often the victims, not the perpetrators, who are left dealing with the mental health impacts of the trauma. Therapy can be beneficial for reducing anxiety, reconnecting with values, accepting our emotional responses to racism, increasing self-compassion, and more. However, there are real barriers, particularly for Black individuals, that can make it difficult to receive or even seek therapy.


The mental health system is, in some ways, reflective of the racism that exists in society generally. The field of psychology has a sordid history of pathologizing Blacks’ resistance and protest, and of attempting to justify racist stereotypes about Blacks. These factors may, understandably, result in mistrust of the counselors and therapists that are part of this larger system and can be a hindrance to seeking mental health treatment. It is certainly true that there are therapists who may not be understanding or validating of experiences with racism, or who may not feel comfortable discussing race or racism at all. However, there are also many excellent therapists who are not afraid to broach the topic of race and work effectively with clients to heal from and cope with experiences of racism.

      • Finding a provider who is a good match for you, understands you, and who you feel comfortable talking to is critical.
      • It’s important to know that it is okay to switch therapists. Huge changes after just a session or two of therapy are uncommon. However, after a few sessions, you should feel like you and your therapist are establishing a connection, and that you both have a sense of what your goals for therapy are and how you two will work towards them. If you do not feel heard or something feels off, it can be helpful to bring your concerns up to the therapist.
      • If you have given it several sessions and things just are not working with your therapist, look for someone else. Be sure to talk to your new therapist about what did not work for you in your previous therapy experiences.
      • Ask for therapist recommendations from people you trust. Friends, your pastor/imam, and your physician can be a good place to start. If you are specifically looking for a therapist who is Black, reaching out to your local Association of Black Psychologists (ABPsi) chapter or using ABPsi’s online Therapist Directory may be helpful.
      • You can also look for therapists through your insurance website and other online directories like the American Psychological Association Psychologist Locator or Psychology Today Find a Therapist.


Cost and other factors that limit access to services can also prevent individuals from seeking therapy. Therapy is often expensive. However, there are some options to consider when seeking therapy that can help defray the cost.

      • Some mental health providers have a sliding fee scale, which means that the amount you pay per session is based on your income. If you are not sure if a counselor/therapist offers this, it is okay to ask.
      • Check to see if your physician/primary care provider’s office also offers mental health services.
      • Consider seeking services at a training clinic associated with a university clinical or counseling psychology program. Providers at such clinics are usually doctoral students who are not yet licensed, but receive a great deal of supervision from licensed psychologists. Training clinics typically offer quality services at a much lower rate than private practitioners. You can find a list of training clinics at
      • If you are a student, your college or university may have a Counseling Center that offers free or low-cost counseling.
      • Check to see if your employer has an Employee Assistance Program (EAP). Some EAPs offer free or reduced rate counseling or referrals for counseling services.
      • Your health insurance may include mental health benefits. Contact your insurer to find out about your mental health (sometimes called behavioral health) benefits, deductible, and co-pay. Your insurance company should also be able to provide you with a list of in-network providers.
      • If you have a flexible spending account (FSA), you may be able to use it to pay for mental health care expenses that are not covered by your insurance.


Although the stigma associated with seeing a therapist or having a mental health concern is not unique to Black Americans, research has indicated that it has notable effects on Blacks’ likelihood to seek treatment for mental health concerns (Alvidrez, Snowden, & Kaiser, 2008; Mishra, Lucksted, Giola, Barnet, & Baquet, 2009). Alvidrez, Snowden, and Kaiser (2008) found that that Black individuals in their study indicated that because of stigma, they did not pursue more information to help with recognizing mental health problems and did not pursue mental health services despite knowing they needed them. Some of the stigma surrounding mental health concerns may relate to seeing mental health issues as a sign of weakness and as inconsistent with the ideals of strength that are valued by many of us in the Black community. Beginning to reduce our own stigmatizing beliefs and encouraging the same of those around us can enable individuals to get mental health care.

      • Consider that seeking mental health services can actually allow you to be stronger. The additional support and strategies for managing the anxiety and stress associated with experiencing racism can allow for renewed strength and increased emotional endurance.
      • Acknowledging the existence of mental health concerns, encouraging those who may benefit from mental health services to seek them, and supporting people who disclose a mental health concern or disclose seeking counseling or other mental health treatment are good first steps for reducing this stigma.
      • Although silence around mental health concerns and therapy can at times perpetuate stigma, silence can also be protective. It is up to you who you tell about seeking therapy. Your therapist/counselor is required to maintain confidentiality. This means that therapists/counselors do not disclose the identity of their clients (there are some exceptions to this that your therapist should discuss with you at the first session). Privacy is your right, and if you do not want to tell anyone else you are going to therapy, no one has to know!
Professor of Psychology at University of Massachusetts Boston

Dr. Tahirah Abdullah is an Assistant Professor at the University of Massachusetts Boston and received her M.S. and Ph.D. in Clinical Psychology from the University of Kentucky. Her research focuses on the impact of racism and discrimination on mental health, ethnocultural factors, barriers to help-seeking, and stigma of mental health treatment among Blacks in the U.S., with the goal of improving mental health services and reducing stigma in the Black community.

Assistant Professor of Psychology at Salem State University

Dr. Jessica Graham-LoPresti, an Assistant Professor at Salem State University, holds a B.A. in Psychology and American Studies from Williams College, and M.A. and Ph.D. degrees in Clinical Psychology from the University of Massachusetts Boston. She's a recipient of the American Psychological Association Minority Fellowship and has expertise in barriers to care for marginalized populations and the effects of racism on stress and anxiety in individuals of color. Dr. Graham-LoPresti is also the co-chair for the multicultural special interest group at the Anxiety and Depression Association of America.

Doctoral Student at University of Massachusetts Boston

Amber Calloway is a doctoral candidate in Clinical Psychology at the University of Massachusetts Boston. Her research focuses on understanding the effectiveness of therapy, particularly cognitive-behavioral and mindfulness-based approaches, for adults with anxiety disorders. She is also working with Dr. Tahirah Abdullah's Black Mental Health Advocacy and Research Team to examine the mental health treatment experiences of Black individuals in the U.S. with the goal of improving existing treatments for diverse populations. Amber is also a student member of the Anxiety and Depression Association of America.

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