James Donaldson on Mental Health – Black Parents and the Importance of Cultural Competence in Therapy

When Grace W.'s son Denzel began acting out in class, the New York City-based copy editor was immediately concerned. Denzel, then aged eight, had always been a stellar student. In the gifted program at school, he had never gotten into trouble.

When Grace contacted her company's Employee Assistance Program for a referral to a mental health provider, she had a few requirements. 'I wanted a child psychologist, someone with a practice near enough to go there after school easily, and I wanted them to be Black.'

Finding a Black therapist isn't easy. According to the 2022 Black Mental Health Workforce Survey, within the United States, only about 5% of psychologists, 7% of marriage and family counselors, 20% of social workers, and 11% of professional counselors are Black.

Despite the difficulty, recent research shows that many in the Black community have a strong preference for mental health professionals who look like them and share their cultural beliefs. Nearly half of participants in a Child Mind Institute study said that they trusted a Black mental health professional over one who is white or a non-Black person of color.

There are many in the Black community who still view health care with suspicion. From the Tuskegee syphilis study to the forced sterilization of Black women and girls, there's a long history of mistreatment and outright racism in the health care system.

Nearly half of the participants in the Child Mind Institute study stated that white and non-Black POC mental health professionals often misunderstand or underestimate the effects racism can have on mental health. Experiencing microaggressions and racism can lead to racial trauma which, in some people, can elicit symptoms that meet diagnostic criteria for PTSD.

Locating a Black therapist may feel challenging, but there are some resources and strategies you can use to simplify the process. Websites that provide directories of Black therapists include: The Association of Black Psychologists, Black Therapists Rock, Clinicians of Color, Inclusive Therapists, InnoPsych, Melanin & Mental Health, and Therapy for Black Girls.

Given the deficit in Black mental health professionals in the United States, the best option may be a carefully chosen non-Black therapist. 'I tell folks, do not let the color of your clinician's skin be the barrier that keeps you from getting the help that you or your child needs,' says Dr. Crawford.