African Americans and Mental Health
Welcome to February, Black History Month. This month is an important time to celebrate Black and African American culture and contributions. It’s also a valuable time to look at the challenges Black people experience in the U.S. Among these is getting mental health care when needed.
Barriers to mental health care
People of all races and ethnicities experience mental health issues. Overall, Black Americans are about as likely as other Americans to have a mental health condition. However Black Americans experience unique individual and societal pressures that affect their mental health and make them less likely to seek treatment. In fact, statistics show that about 25% of Black Americans seek mental health treatment when needed, compared to 40% of White Americans. There are several factors, or “barriers”, that affect African Americans’ willingness or ability to seek mental health care, including: are stigma, lack of access, and discrimination.
- Stigma. Stigma is a reaction to negative attitudes and beliefs about mental health that makes people feel ashamed for something that is out of their control. Mental health stigma is common in the U.S., and especially within the Black community. For example, many African Americans fear that their friends and peers would think they were weak or “crazy” if they saw a therapist, or believe that discussing mental illness is inappropriate, even within the family. Unfortunately, the belief that seeking help is a personal weakness and fearing the judgement of others can keep people from getting the help they need.
- Poverty and Health Insurance Coverage. In the U.S., Black people are less likely to have access to healthcare, including mental health care. The poverty within a community can limit healthcare options in that community, and an individual’s insurance coverage also plays a role. While the number of people without insurance has declined since the Affordable Care Act took effect, 11% of Black Americans were uninsured in 2021, compared to 7% of whites. Another 15 million African Americans are underinsured, meaning they have coverage, but the cost of treatment is still too high to seek care.
- Lack of Cultural Competency. The culture we’re born, raised, and live in affects our attitudes and beliefs, and can even affect how we describe our mental health. Providers who understand a person’s culture – who are “culturally competent” – are more likely to make an accurate diagnosis.
Tips to help you find mental health care
Many African American people talk to their primary care doctor about mental health concerns. This may be because they know their primary care doctor, or because many Black people describe their symptoms in a physical way – as tiredness, nervousness, or headaches, for example. This can lead to “underdiagnosis” or even misdiagnosis. While primary care doctors can often provide an initial assessment, it’s best to go to a mental health professional for treatment. But how do you find the right therapist for you?
- Personal characteristics. Think about who you might work best with. Is gender important to you? Age? Therapy is about building a relationship and talking about difficult things. If you don’t feel comfortable talking with someone, therapy won’t be as effective.
- Ask questions. Don’t be afraid to ask questions of a provider. Think of your first visit as an interview – you want to make sure they’re the right person for the job. Ask if they’ve helped other Black people, whether they have special training in cultural competence for Black mental health, and any other questions you might have.
- Think about how you feel. Therapy isn’t always easy, but you should always feel heard and respected. If a provider doesn’t make you feel like you’re important, they’re not the therapist for you.
- Other factors. There are other things to consider when looking for a therapist. One is the cost—does the therapist take your insurance, or charge a rate you can afford? Another is their specialty – some therapists specialize in marital or family problems, others in working with young people, others in issues such as PTSD. There may be other issues that are important to you as well.
Your EAP can help
If you are having a hard time accessing care because of cost or other factors, contact your EAP. We can help you find a therapist who understands the problems you face, at no charge to you.
 Understanding Mental Health in Black Communities | McLean Hospital
 RISE Blog | Black History Month: Discussing Mental Health Disparities | Blog | RISE | TTU
 9 Ways to Fight Mental Health Stigma | NAMI: National Alliance on Mental Illness
 Black and African American Communities and Mental Health | Mental Health America (mhanational.org)
 Health Coverage by Race and Ethnicity, 2010-2021 | KFF
 Racism, Inequality, and Health Care for African Americans (tcf.org)
 How to Find a Therapist (verywellmind.com)