Researchers found that Black patients were less likely to even receive a call back from potential therapists to schedule an appointment.
Your location impacts mental health care
We know there are barriers to mental healthcare for BIPOC (Black, Indigenous, and people of color)—there have been numerous studies sharing the many different ways Black and brown women miss out on crucial care. But when you stop and think about it, even something as seemingly innocuous as an address makes a difference. To Charmaine Williams, PhD, Vice-Dean of Students at the School of Graduate Studies, University of Toronto, location could be a deterrent for Black women accessing care. “I did a study and the travel times that people [Black women and women of color] were undertaking to get to help were astonishing,” says Dr. Williams. In a 2018 study, 46 percent of respondents had to drive an hour round trip or more to access mental health services. Systematically racist policies such as gerrymandering and redlining negatively impact access to mental health services for people of color. Additionally, Dr. Williams says we have to look at the professions of potential patients and how restrictive traditional therapist’s office hours are. A potential patient may be unable to leave work and meet a practitioner in the middle of the day; and many offices close at 5 p.m.
These obstacles can make the case for telemedicine, says Tichianaa Armah, MD, Medical Director and Vice President of Behavioral Health at Community Health Center, Inc. “I've been very much a proponent of telehealth, even before Covid-19 happened,” Dr. Armah says. “Some of my patients would have to take two or three buses before they can get here, so we [the Community Health Center] had actually been piloting this for several months already.”
Due to Coronavirus, there may be more opportunities to engage with telehealth, or some of the digital mental health providers, like Talkspace or Cerebral. These services are also significantly less expensive than traditional therapy, which can be anywhere between $50 to $250+ per private session.
The Black community still has stigmas we need to break through
There is this idea that millennials are the “therapy generation,” and that we’re more open about attending therapy, but that’s not necessarily the case for BIPOC millennials. “We need more black people sharing their [mental health] experience,” Dr. Armah laments. “People are suffering and they get care and then they feel better—while all of that's happening, largely people don't know about it. You never find that with my white patients—they’re sharing that info with each other.” Talking about therapy and mental health remains a taboo in so many BIPOC communities, and the National Alliance on Mental Illness (NAMI) says this stigma may stem from personal shame, and can even be familial stigma passed down through generations. Black people in particular are hesitant to “air family business,” aka share these issues with an outside party, and you may carry that notion with you far into adulthood.
Breaking away from those beliefs can be a major turning point for Black women seeking mental health care. In turn, you may be helping others. "Being open [about mental health care], can help you relate to a friend or family member; that really speaks volumes that we can be more open about pursuing help, “ says Dr. Armah.
How can Black women start a mental health care journey?
“I typically tell folks to start with their primary care physician,” says Dr. Armah. “If you start there [with the recommendation], then it’s someone you already have a relationship with and that person may be a good fit.” That relationship can break through another huge barrier that is present in BIPOC communities: a fear and mistrust of doctors and medical institutions. This fear isn't entirely unfounded, as history has shown us. The Tuskegee experiment saw medical professionals purposefully withhold syphilis mediation from African American male patients. There was also J. Marion Sims, the “father of modern gynecology” who experimented on enslaved Black women without anesthesia. The scars of historical wrongs may be stopping us from getting the care we need.
To Dr. Williams, Black women may need to take a step back and stop being our own barrier. “I think in some ways it starts with yourself; what I find is a lot of black women are very oriented to caring for others over caring for themselves, and taking time to do this kind of work for themselves feels kind of self-indulgent,"Dr. Williams says. She urges Black women to make the investment in emotional well-being and to give yourself the “permission to take this space and energy.”
She urges Black women to make the investment in emotional well-being and to give yourself the “permission to take this space and energy.”
Dr. Williams also cautions new patients to let go of the notion that therapy is a quick, one-stop fix. “We'd love to think that we're going to find a therapist that is going to meet all our needs but maybe this is a person who can help you with one part, who can give you some coping skills and way of dealing with things that help you continue to function.”
So where do we find these mental health-care professionals? There are resources out there that could be a great starting point for Black women who want to embark on this journey. There is Therapy for Black Girls (which has a directory of Black therapists) and several other digital spaces. Dr. Armah also suggests looking into “Federally Qualified Care Centers,” if you are in an underserved area. These centers have a variety of care options available, some include mental and emotional counseling or therapy.
If accessing therapy simply isn’t an option at the moment, Dr. Armah shares that there may still be ways to positively contribute to your mental and emotional health. “I ask women, 'what are your outlets?' Are they giving themselves any time to read, maybe wake up at an earlier hour than they usually do so that they can get a moment of peace from all the noise of the world, or are they doing self-reflective practices,” she says. The hope is that something you do for yourself resonates with your emotional health, that you can recognize if you do this one thing then the day is a bit better.
We’re far off from a truly equitable solution for all Black women who want to access mental health care, but we can continue to push forward and tap into what’s out there. Your health depends on it.
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