Three Reasons Why It Can Be Harder for Black Women To Get Mental Health Treatment

Depressed While Black
5 min readNov 13, 2018

Black women are making their presence known everywhere. Our fashion, slang, and approach to what we do shapes and define mainstream culture.

But there are still moments when I feel invisible as a black woman. In 2013, I was told by an inpatient psychiatrist that I’m bipolar because I was laughing with my friends and writing in a journal. (“She’s a writer!” my mom and best friend shouted in unison.) I would have accepted the diagnosis if the reasons weren’t so comical.

In another instance a year later, a white university psychiatrist said I’m fulfilling a stereotype if I drop out of grad school due to a long list of microaggressions.

In these moments, I felt seen no further than the parts of myself that can be used, stereotyped, and exploited. This is why I believe getting mental health treatment as a black woman can be more difficult than for our white counterparts. Just 10.3% of African American women used mental health services in the past year compared to 21.5% of white women, according to the SAMSHA National Survey on Substance Abuse and Health from 2008 to 2012.

Wealth inequality can also restrict treatment. Black women make around 62 cents for every dollar a white, non-Hispanic man makes. If you’re on a limited income, you can be left with overworked social workers and inexperienced interns as therapy options.

Learning what you’re up against as a black woman is key to advocating for yourself, and finding advocates who will fight for you.

Due to patriarchy, black women are at the bottom of the totem pole, even in our own communities.

Living in the shadow of the “endangered black man” is hard. There were moments when I felt all my older brother had to do was exist to get overwhelming attention and praise. Meanwhile, I was hungry for someone to affirm my accomplishments as something that isn’t expected but strenuously hard earned.

The concept that black men are endangered is an acknowledgment of their trauma and oppression. But the valid suffering of black men is sometimes used as an invalid reason for patriarchy.

This belief, that the oppressive status of white men should be emulated, comes with casualties. It can be extremely painful to be oppressed by cis hetero black men while your mental illness and trauma are just a footnote to theirs.

47% of black respondents to the 2015 U.S. Transgender Survey attempted suicide in their lifetimes, according to the National Center for Transgender Equality. But how often do we hear about the plight and resilience of black trans women during discussions of issues affecting the black community?

Depression can amplify the near-suffocating hatred of black women in our society. It’s easier to believe you’re worthless if the people in your community does.

For me, true mental health treatment is finding a safe space where the totality of my black womanhood can be seen. I feel more comfortable with therapists who are black women because their responses are shaped by both their training and lived experience.

This narrows my list down significantly. In 2013, just 5.3% of the active psychology workforce are black, according to the American Psychological Association. For every black man who is an active psychologist, there are 5.8 black women who are their counterparts. This reveals how far we need to go in terms of both racial and gender parity.

We’re expected to hurt, so we don’t know we’re hurting.

I didn’t know I needed serious mental health treatment until I was speeding on a Los Angeles highway wanting to die. I was a 25-year-old grad student in 2012, but by that point, I was unemployed off and on for 19 months. I was trying to follow in the footsteps of my mother and grandmother by working my way out of poverty and unemployment. But this sent me into a tailspin. Working without any regard for yourself can take you away from your dreams and amplify depression to dangerous levels.

Since slavery, our hurt has been seen as a mere backdrop to the labor that was extracted from us. Even as a grad student, I cared more about my work than my wellbeing.

According to the U.S. Office of Minority Mental Health, adult African Americans are 20% more likely to report being in serious mental distress than their white counterparts. A potential reason is that stress, overwork, and symptoms of mental illness are so normalized and expected, that we may not know there’s a problem until our bodies can no longer function. And with cultural norms that disparage conventional warning signs of depression like excessive crying, we may not see reflections of our mental illness in white-dominated representations. Our mental illness symptoms may manifest in more culturally acceptable ways like physical pain.

After years of disregarding how much I was hurting, I struggle with having an awareness of my body’s needs. I tend to thrive the most with therapists who employ mindfulness and other dialectical behavioral therapy exercises. The grounding of deep breathing and progressive muscle relaxation plants my consciousness in how I feel and not what I do.

Black women are not seen as an expert of our own lives.

In my experience, the most inflexible hurdle in the mental health system is a closed mind. When a mental health professional labels you as unintelligent or crazy, it can feel like there is nothing you can say or do to prove otherwise.

When I petitioned a judge to release me from a mental hospital where I felt unsafe, an inpatient psychiatrist said that I will jump out of the car if my mom drives me home to a treatment center closer to my family. Yes, this is the same psychiatrist who said I’m bipolar because I write in my journal.

I remember sitting in front of that judge, in a hospital gown I was forced to wear, feeling that I had no chance to be heard as a mentally ill black woman.

This feeling continued with one therapist I had whenever I tried to explain a racist incident that affected me. These discussions seemed to turn my therapist into a defense attorney. The barrage of questions I faced about whether I remembered the incident correctly carried a sting because the therapist was not black. With each inquisition, I could feel myself retreating inward. Racism became another topic I promised myself I would never mention again.

This sense of powerlessness can make people abandon the mental health system entirely. And when you struggle with depression, it can be difficult to believe there is a better therapist out there.

What I’ve learned through this is that your therapy sessions should not be a test of how many microagressions you can endure. As black women, we are the experts of our lived experiences. We have the right to have mental health support that acknowledges how our journey is different from others.

The ability to create new solutions in the face of discrimination is something black women have been doing for centuries. Organizations like Therapy for Black Girls and Harriet’s Apothecary are developing their own infrastructure for finding therapists and other forms of treatment. Despite systemic barriers, we still find a way to access healing in our communities.