Recently, I was having a conversation with someone close to me, and we got on the subject of mental health and therapy. She tensed at the subject as it came up, but to my surprise she then shared about a particularly tough time she was having a few years ago. She told me that she shared with her doctor some personal details of the struggles she was having, and her doctor’s response was to tell her she was likely depressed, and prescribe her an antidepressant. I’m sure the doctor believed she was acting in the best interest of her patient, but that response communicated something, and the message that was received discouraged this woman from ever wanting to open up about her troubles again.
Some of you may be able to imagine the message my loved one perceived from that interaction with her doctor, and it was a single word- “Crazy.” But even more than that, she took away “don’t open up about your problems, or someone will think you’re crazy.”
For many people, particularly Black people, the connotation associated with medication or labels like “depression” is that dreaded word crazy. Often times the response to anything related to mental health is to become defensive or shut down on the grounds of “but I’m not crazy. Only crazy people…” insert “see therapists,” or “take medication,” or “have diagnoses,” etc. The fear of being crazy can keep us away from seeking, and therefore receiving the help we may truly need. 
There are a number of reasons that have kept Black people away from services like therapy over the years, including a historical distrust for the health care system, a reliance on the church or religion during trying times, and an attitude of keeping personal matters personal. None of these reasons are inherently wrong, nor can they be invalidated.
But the question that must be asked is: are they effective?Are these methods keeping our people safe and healthy?
With studies suggesting that Black people with mental illness receive treatment about half as often as their white counterparts, and with undiagnosed/ untreated mental health problems contributing to the risks of things like becoming incarcerated or homeless (issues that disproportionately affect the Black community), we can’t overlook the detrimental effect that may result from not receiving treatment. Unfortunately, we also can’t overlook that systemic barriers can often limit the access many Black people have to mental health care.
So with all of these challenges, what are we to do? There is no single answer, or maybe even a simple answer. But something I believe that may go a long way is that amongst ourselves we must work to continue to normalize not only mental illness and seeking treatment for it, but seeking therapy period; whether you’re ill, or just need support during a tough time. We’ve got to shift from a culture of stigmatizing mental illness and seeking help (i.e. mental illness = crazy) to one that embraces taking care of ourselves, wholly. And as we become more comfortable seeking the help, here are some tips that may make accessing care more easy or comfortable:
-
If talking to your Primary Care Physician, let them know you’re looking for a referral for a mental health practitioner specifically (many PCP’s aren’t trained in mental health, and may not be sensitive to the discomfort the topic may cause).
-
Speak up if you are strongly against the idea of medication (though with more severe mental health diagnoses medication may be needed for improved functioning).
-
Contact your insurance company for a list of in-network mental health providers.
-
Look for local graduate schools with therapy/ counseling training programs; they may have an on-site clinic that offers lower rates per session than licensed professionals.
-
Look for a therapist with a similar cultural background as you if it makes you more comfortable.
-
Ask if the licensed professional offers pro-rated fees, or does any Pro-Bono work.
-
Seek a faith-based therapist (i.e. Christian therapist) if that is in-line with your beliefs.
