Focusing on Black mental health care

Black Americans can face many unique challenges when it comes to mental health, and research shows that only about one in three Black adults who need mental health care receive it. In addition to the mental toll of dynamics like racism, inequality, and discrimination, people in the Black community may also face added barriers to receiving the care and treatment they need to cope with mental health challenges. These barriers can include inequality of care, lack of cultural competency of providers, lack of health insurance, and the stigma of mental health in the Black community. Why do these barriers exist, and what can we do to make mental health care more available?

Here is a closer look at some of these barriers and what can be done to help get everyone the care they need.

Barriers to mental health care

A number of barriers exist that can make it difficult for Black individuals to receive adequate mental health care in the U.S., including: 

Inequality of care and distrust of the healthcare system

A lack of cultural competency in healthcare providers can mean that Black people receive an inaccurate diagnosis and inadequate treatment for their concerns—so even when they do seek help, they may not get the care they need. For example, Black people may be more likely to describe physical symptoms of depression, but a provider unfamiliar with treating members of this community may not recognize this during an initial mental health assessment. 

According to the Pew Research Center, when asked about their experiences with health care, 56% of Black Americans say they’ve had at least one negative experience, including “having to speak up to get the proper care and being treated with less respect than other patients.” These inequalities in care and negative experiences can contribute to justified distrust of the healthcare system.

Lack of health insurance

Another barrier to receiving mental health care is the lack of health insurance. Recent data shows that in 2021, 11% of Black Americans were uninsured, compared to 7% of white Americans. 

These disparities in health care coverage can make it difficult to start therapy, as the costs of paying for therapy sessions out of pocket can often be expensive. That said, even those with health insurance may have cost concerns regarding therapy, as many insurance plans don’t cover the full cost of sessions. 

Shortage of Black therapists

Data shows that only about 5% of the U.S. psychology workforce is Black compared to about 80% white. These low numbers of Black mental health professionals may also be a barrier to Black individuals receiving high-quality mental health care, as having providers from diverse racial backgrounds is important. As noted earlier, a lack of cultural competency among providers can mean Black patients do not get the care they need—having more Black therapists and better training of all therapists may help with this.

Having more Black therapists available could help individuals feel more comfortable seeking therapy. If Black patients could more easily find therapists who understood their culture, experiences, history, and the stigma surrounding mental health, they may feel more empowered to speak up and get help.

The stigma of mental health in the Black community

The stigma surrounding mental health in the Black community may also make it difficult to receive mental health care. Research has found that mental illness stigma is higher among racial minorities than among majorities, which can make it seem even more difficult for Black individuals to seek help for their mental health—on top of other structural barriers. 

What can be done? 

Addressing these mental health disparities and increasing availability of quality mental health care services requires a huge set of changes at various levels—such as reducing stigma around mental health, expanding health insurance coverage, and more.

One way to improve Black mental health care is to make it easier for people in this community to find Black therapists. Determining how to do this is complex, as it can involve attracting more Black people to the profession, and then making it simpler for individuals to find and connect with Black therapists for care. Currently, there are some Black-focused mental health resources available that can help locate Black mental health professionals.

In addition, it can be vital to improve cultural competency among all therapists, so that non-Black therapists can provide better care to Black patients. For instance, therapists can be educated on how to make the therapeutic environment welcoming, avoid microaggressions, and increase sensitivity to cultural differences. Making therapy a more productive and more positive experience for members of the Black community can help build trust in mental health care providers, which may help encourage more Black people to seek mental health services.

Other interventions are likely necessary on a systemic level. For example, public health organizations can ensure programs consider ideas, perspectives, and input from diverse groups and determine how racism affects not only the mental health of the Black community but also the delivery of care. Healthcare systems can start initiatives promoting mental health awareness and make efforts to recruit and fill positions to reflect the diversity of the populations they serve.

Online therapy is an option

If you are unable to find a suitable mental health care provider in your community or are looking for a more diverse selection of therapists from which to choose, you can consider an online platform like BetterHelp. With thousands of licensed therapists available through the platform, and the ability to select preferences that are important to you, it may be easier to find someone who understands your unique needs. 

Research has demonstrated the effectiveness of online therapy for a range of populations and concerns. One research study examined the effectiveness of computerized cognitive behavioral therapy (cCBT) on mental health outcomes among African American and white primary care patients. The study found that compared to usual care, the online program led to improvements in anxiety, depression, and mental health-related quality of life for African American patients. In this study, the online program was actually more effective for African American patients than for white patients.