Access to therapy has exploded over the past couple of years, with online companies developing new paths to providing flexible and affordable options, and platforms like Therapy for Black Girls making it easier to find therapists in certain underserved areas. Even still, many people in the Black community don’t seek treatment despite being 20% more likely to experience serious mental health problems. The resistance is due to a number of factors; prominent among them is the dearth of Black therapists.
63% of Black people surveyed believe that mental health conditions are signs of weakness
What percent of therapists are Black?
In 2015, only 4% of psychologists working in the U.S. were African-American, versus 86% White, 5% Asian, and 1% Multiracial. But Black people make up 13% of the population. This means that not only are there far too few Black therapists in the field, but those who are certified are often stretched thin.
So why aren’t there more Black therapists? What are some of the barriers they’re facing?
Lack of realistic exposure
The first issue that Dr. Latoya Gaines, a clinical psychologist who focuses on multicultural issues, points to is the stigmatization of therapy within the Black community. Conversations about mental health are few and far between, and asking for help with mental health is often viewed as an admission of failure. In fact, one study found that 63% of Black people surveyed believe that mental health conditions are signs of weakness.
This may be because the understanding of mental wellness support is largely informed by popular culture, which can negatively sensationalize both mental health conditions and their treatment. “The only depiction people see of therapists and the work we do is through movies or television and that is most often not an accurate portrayal of what therapy is and what therapists do,” Dr. Gaines says. “Because of this lack of knowledge, a lot of Black people do not seek out careers as therapists.”
It’s no secret that, historically, Black families have had substantially less wealth than their White counterparts. One study found that in 2016, the average White family had an income ten times that of the average Black family. Another analysis shows that Black men make $0.87 for every dollar a White man makes.
This income gap means that, in general, Black people have fewer opportunities to pursue higher education than others. Though the price of obtaining a master’s degree in clinical psychology varies depending on the school and program you choose, it usually costs between $25,000-$60,000.
As Dr. Gaines points out, there’s also usually an internship or fieldwork component to training programs, “which in most cases do not allow students to have a regular paying job.” She adds: “This may mean taking out additional loans to cover living expenses beyond tuition. The financial burden can become overwhelming, causing students to leave the program.”
Once training is complete, the next step is to become licensed by the state you wish to practice in. These exams and licensing fees can cost up to $1,000, Dr. Gaines says.
This is especially burdensome on those who intend to practice in a different state than they attend school in, as requirements for licensure vary state by state.
As Dr. Gaines explains: “If you attend a school in Maryland and complete all the requirements within your program and within the state of Maryland to become licensed, it does not mean that when you move back to New York you are automatically eligible for licensure there. New York may have stricter guidelines and may require you to do more unpaid clinical hours to obtain a license in that state.”
With the adaptation of telehealth therapy appointments, having the ability to see clients in more than one state is more and more crucial.
Dr. Racine Henry, a licensed marriage and family therapist, advocates for one centralized licensing exam. “This way, clinicians who pass a national exam can be available for clients across the country rather than just in the state they are licensed in,” she says.
Studies cater to the white experience
“We live in a society that centers a white worldview,” Jardin Dogan, therapist and founder of @blkfolkxtherapy says, and that worldview extends to the education system. “The founding fathers of psychology were white men; therefore, the majority of psychological theories and assessments make white voices the norm, rendering voices of Color inaudible and our experiences unimportant.” Dogan notes that she had to take a specialized course in her doctoral program to learn more about Black psychologists and theorists.
Dr. Gaines echoes that point, noting that most counseling programs are taught from a Eurocentric perspective. “Diversity is relegated to one course or one class on the syllabus,” she says. “Counseling theories do not take into account the racial, cultural, social, political factors that intersect to contribute to the mental health issues of Black people.”
“We live in a society that centers a white worldview”
Standardized test biases
The white-centric slant is also evident in the standardized tests that are requisites of becoming licensed. “Research suggests the likelihood of passing these exams is related to race and ethnicity, indicating racial gaps in testing outcomes,” Dogan says. “These tests, like many other standardized tests such as the SAT, ACT, GRE, are not free of racial bias.”
Further, there have been reports that white psychologists found the Examination for Professional Practice in Psychology (EPPP) course and test preparation materials more helpful than psychologists of color.” This is likely because white people are more able to purchase expensive exam prep programs and study materials than people of color.
Discrimination in hiring practices
Workplace and hiring discrimination is rampant across many industries and fields. A study conducted by the Harvard Business Review found that, since 1990, white applicants have received about 36% more callbacks than Black applicants with identical résumés—and that number hasn’t changed in the 30 years since.
Dr. Candice Nicole says that she hasn’t experienced discrimination herself, but she stresses that that’s in large part because there were Black people already in the department when she applied. “They advocated for me when it was perceived that I was not qualified enough for the job,” she says. “After five years, all of my colleagues are highly impressed with my success and accomplishments, but it took a Black woman professor advocating that I be invited to interview.”
Few Black mentors
This brings us to the importance of having Black professionals who can advocate for and lift up one another. “There is not a strong pipeline of psychologists of color that teach, train, and mentor younger mental health professionals,” Dogan says. Dr. Nicole further points out that non-Black professors can be uninterested in studying what Black students would like to research. “Even when they are, they may be inadequately trained to mentor Black students,” she says.
More Black psychology faculty means more Black therapists—which could mean more Black mental wellness.
This leads to a lack of retention, Dr. Gaines says. “It increases the likelihood that many students of color will experience microaggressions and racism, which are difficult to deal with at baseline but without the support of faculty of color,” she notes. “It can cause some students to withdraw from programs.”
She reiterates that “If more Black people enter the mental health profession, it increases the potential for them to become faculty and provide more mentorship to trainees.” More Black psychology faculty means more Black therapists—which could mean more Black mental wellness.
It is unquestionably important that there be more Black psychologists. For one thing, studies have shown that people, in general, are more likely to listen to and trust their doctor if they have a similar background. For Black people, who deal with extra nuanced burdens and often come into therapy with a distrust of the healthcare industry, having someone they can trust holds extra importance.
But furthermore, there is some research that suggests it’s harder for Black therapy seekers to find help at all, regardless of the race of that clinician.
One study found that Black middle-class “help seekers” only secured appointments 17% of the time, while their White counterparts managed to get appointments 28% of the time. (Both Black and White working-class help seekers only secured appointments 5-8% of the time.) If the field were more populated with Black therapists, perhaps this statistic would look different.
It comes down to this: The lack of Black therapists harms not only the Black community but it undermines healthcare as a whole.
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