Diminished access to mental health care is one of the many ways systemic racism has affected the Black community — but things are starting to change.

An abstract illustration of two black people in a cozy therapy setting. Share on Pinterest
Illustration by Brittany England

Even in discussions about the effects of healthcare inequity and inequality on Black communities, the topic of Black mental health is often overlooked.

Not only is it overlooked, but when Black folks do speak up and seek help, there are significant barriers that prevent them from accessing the mental health care they need.

So, how can we bring more awareness to something so vital to the health and happiness of Black communities in this country and around the world? And what can we do to change the narrative around Black mental health — to identify those barriers and promote equity in mental health care for people everywhere?

Ahead, we speak with experts on the importance of Black mental health, including how to prompt real change that benefits everyone in Black communities.

Our “health” encompasses everything about us — from the well-being of our bodies to our emotional state and so much more. But even though we often view health through a primarily physical lens, the reality is that our mental health is just as integral to our overall sense of wellness.

“Mental health is an incredibly important factor for a fulfilling life. And having good mental health means having a better quality of life and satisfaction with your overall being,” Dr. Francesca K. Owoo, LCPC, LMHC, a licensed therapist who specializes in helping BIPOC couples and families navigate chronic illness, tells Healthline.

“Mental well-being should always be prioritized to ensure that everyone can experience stability and wellness in their lives,” Owoo says.

But in BIPOC communities in the United States, especially in Black communities, factors like racism, oppression, and trauma can severely affect a person’s mental well-being and contribute to huge disparities in mental illness rates.

“Mental illness is a pervasive issue in the African American community, with many negative social and economic impacts,” explains Owoo. She states that factors driving mental health disparities among African Americans include:

  • distrust of the medical system
  • institutionalized racism and oppression
  • trauma caused by racism and violence
  • healthcare inequities
  • lack of access to quality mental health care
  • cultural competency gaps among providers
  • the lack of diverse mental health professionals
  • the common stigma of seeking help within the Black community

While all these elements can compound mental health factors for the Black community, we should be clear that Black people experience mental health conditions at similar rates to other racial groups. However, when they do, Black people tend to have a much harder time accessing resources to treat them.

What is cultural competency?

Dr. Owoo mentions a lack of cultural competency as one of the many factors fueling disparities in mental health care. But what is cultural competency, exactly?

Cultural competency in medical care is the idea of medical professionals providing effective care within cross-cultural situations. Cross-cultural situations are interactions that involve components such as different languages, communication styles, beliefs, and values.

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While recognizing the factors that contribute to healthcare disparities is important, it’s also just as important to understand how these issues can affect access to mental health treatment.

“These issues create significant barriers to necessary mental health services for African Americans,” Owoo says.

In fact, research has shown that these factors can affect everything from perceived stigma during visits to overall treatment satisfaction in Black folks who access healthcare services.

In one study from 2019, researchers pinpointed four significant factors that affected healthcare experiences in Black adults with unmet mental health needs:

  • Interconnected oppression: This is when oppression outside of healthcare systems affects the way someone expects they will be treated during healthcare-related experiences.
  • Double discrimination: This happens when people experience multiple forms of discrimination (such as being Black and having a mental health condition) that result in significant barriers to care.
  • Institutional mistrust: Developing from both personal and historical experiences, this causes mistrust of the medical system and fear of the potential consequences of seeking mental health care.
  • Microaggressions: Subtle interactions or behaviors that contribute toward stigma against marginalized communities, which can appear in healthcare experiences and deter people from getting proper care.

Many of these factors make it difficult (if not impossible) for Black community members to seek out treatment or receive the level of care that they need.

Data from the American Psychological Association (APA) in 2021 showed that only 5.08% of the psychology workforce was Black — as opposed to 80.85% being white.

According to Owoo, this disparity is likely due to the same factors that prevent Black community members from accessing mental health care.

“With mental illness having a profound impact on the Black community, yet lacking access to therapists that understand their culture, history, and experiences, it’s important to break down the stigma surrounding mental health and increase the visibility of Black professionals in the field,” says Owoo.

“By having more Black therapists available, clients are empowered to open up about their concerns in an environment that feels safe and familiar,” she adds.

“In order to provide culturally competent care, measures must be taken to address racism and discrimination within academia, as well as increased outreach to the field so that more African Americans are exposed and able to choose a career in therapy,” she continues.

In addition to this, the high costs of attaining a graduate degree can leave students burdened with massive amounts of debt. The process of getting licensed to practice therapy also takes an extended period of time and may require you to work an unpaid internship.

This prevents many people from pursuing therapeutic professions and for those that do, it can limit their choices of employment afterward because they’ll need to pay off student loans.

How to find a culturally competent therapist

As a BIPOC, one of the most important aspects of effective mental health treatment is having a culturally competent therapist — one who understands not only how to treat your condition but also the impact that social and historical factors can have on your mental health.

If you’re a BIPOC looking for a Black therapist for mental health treatment, here are some resources that can help you on your search:

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“When considering the impact of mental illness on African Americans, you cannot overlook how centuries of systemic racism and oppression have exacerbated the effects of mental illness in the population,” says Owoo.

And we only have to look as far as the recent COVID-19 pandemic — and the social situations that presented and still continue to present themselves — to see the effects.

“COVID-19 has further increased rates of anxiety and depression amongst African Americans, while racial trauma is leading to an alarming increase in cases of PTSD,” she explains.

In a recent study from 2022, researchers found that not only did the levels of fatigue, stress, anxiety, and depression increase in Black communities during COVID-19, but so did the barriers to proper treatment — barriers like inaccessibility to services and increased discrimination, for example.

“This intersection between race and mental health is having a further social, economic, and psychological impact on Black communities as well, with higher rates of suicide, particularly among African American youth,” Owoo says.

Because the Black community is often let down by clinical care, many social and religious groups have stepped in to attempt to bridge the gap for their friends and family members.

Black communities have long felt the psychological, social, and economic effects of healthcare disparities — disparities that continue to exist in every corner of the healthcare experience, including mental health treatment.

As we continue to address these disparities and work toward healthcare equity for all, it’s crucial that we don’t overlook the importance of equity within Black mental health care, too.