Angelique Brown is desperate for a therapist.
“I have been without a therapist for a year and a half. I’ve still been looking, but it's hard,” she said.
Brown lives in the suburbs of Detroit. She's a registered nurse, and the mother of two small children.
Brown also struggles with anxiety. Since college, she has gone through individual and couples therapy, teletherapy, and even leaned on some work resources to help manage her mental health. But she hasn’t been able to find a therapist she connects to.
“I want to talk to my therapist about the fact, like, I mean, I got a divorce because I came out” as a lesbian, she said. “I have kids. And now I’m leaving my career as a bedside nurse….. So, a lot of s— has shifted in my life.”
As a Black queer woman, Brown has found it really hard to find someone who “gets” her.
“I feel like I was so centered on finding someone that was a woman of color,” Brown said. “I was centered on that. But now I feel like my anxiety has gotten back to such a severe state, that now I'm willing to listen to or talk to anyone who can see me as a total person.”
And Brown is not alone in her search to find the “right” therapist.
According to the American Psychological Association, just four percent of psychologists in the U.S. in 2020 were Black. And among that group, only 21% were male – signaling that clients might have an even harder time finding a therapist in that particular demographic.
The APA data show that only about 1 in 5 clinical therapists identify as people of color.
A big chunk of the therapists of color are Hispanic. Those identifying as Black, Asian, and Indigenous come in at an smaller percentages. And there's been very little growth in the share of psychologists of color over the last decade.
Jessica Mayfield-Ashwood is a social worker and therapist in the Detroit Wayne Integrated Health Network, a state-funded “health care safety net organization that provides integrated services'' to the people of Wayne County.
Mayfield-Ashwood specializes in family, individual and group therapy. She said her clients have noticed the lack of diversity among therapists.
“I recently got a client and she's like 30-plus years old. She was like, I've had like five therapists in my life and you're my first Black female therapist. I was like, what? You've had five therapists that you've seen, and I'm the very first person that you've gotten access to as a Black female therapist?”
Her younger clients say they appreciate that she is closer in age to them, too.
Mayfield-Ashwood is also under the age of 30, which the APA data show is another population that only makes up 5% of therapists today.
“They're like ‘I like talking to you because you can understand me,'” Mayfield-Ashwood said. “'You can understand who I am, what I've been through.’”
Finding a therapist with the tools and background to understand who you are as a whole person is important.
Mental health professionals are increasingly aware of this; and some have started adding identifiers in response. Now you can sometimes find labels like “LGBTQ+ affirming” and “culturally responsive” in provider bios.
But some therapists say there are bigger problems within the profession than labels.
Dr. Amorie Robinson is a practicing psychologist at the Ruth Ellis Center in Highland Park. The social service agency serves LGBTQ youth, and is about to open its second health care clinic.
Robinson said it’s important for therapists, no matter their race or background, to acknowledge the history of race, identity and mental health.
“For so long, there's been a stigma right around mental health and people of color,” Robinson said. “It's … always been there, you know, kind of like a reluctance to see mental health professionals…. And some for legitimate reasons.”
She said there is a heavy burden put on minority groups struggling with mental health, racism, and often poverty.
“Oftentimes we forget that much of our mental health problems and challenges are a direct result of discrimination dealing with the stress, the minority stress,” she said, adding that while society is slowly becoming more informed and accepting of different cultures, there is still a need for those same values to be formally adopted within the mental health field.
“I like to use the word cultural humility,” Robinson said. “Having the mindset that the person, the individual in front of you, is the expert on their own lives.”
The idea of seeing the client as an expert of their own lives is a more modern, and some might even say radical, approach to therapy.
“Respecting the lens and the lived experiences of that person or those people that you are serving. You know, that's what I think about. And being responsive to that culture, not always depending on that individual to educate you,” she said.
Dr. Tahani Dari is a counselor, professor and researcher at University of Detroit Mercy. She studies how cultural humility isn’t just for the client’s benefit, but how it's a tool providers need to use for themselves as well.
“[T]he first part when I think of cultural humility is taking a real reflection on my own beliefs and values so I can compartmentalize that when I enter that room.”
Dari said therapists need to address their own cultural backgrounds and core beliefs, and take care to not project their own views onto their clients.
“If you don't take the time as a therapist, mental health professional and reflecting on your own values and beliefs, then the danger comes,” Dari said. “It could be dangerous going into that counseling room, thinking that your values and beliefs could work for everyone else.”
She said continuing education around culture and identity is one way mental health professionals can be better for people overall.
“I always say you get the training, but don't end there. Part of cultural competence is having that cultural humility of continuing to learn and to continue to reflect on your beliefs and having your own knowledge to continue to evolve.”
Both Dari and Robinson also acknowledge that you can’t responsibly talk about the mental health challenges of marginalized people without acknowledging the systemic reasons people need therapy in the first place.
“I know health care is just [one] area where systems of racism and sexism and transphobia and heterosexism have yet to be, you know, dismantled,” said Robinson.
In the meantime, she said, we should at least agree that access to safe and affordable health care is a fundamental human right.
