I am a black woman, and yes, I have a therapist.
I recommend therapy for anyone able and willing to access it. A good therapist can help you deal with trauma or difficult situations, assess and improve interpersonal relationships, or teach valuable coping skills that make the day to day grind a bit easier. Although the African American community has historically been wary of mental health care, anecdotal evidence suggests that the number of African Americans seeking treatment is on the rise. Seeking care for the first time can feel overwhelming, so here are a few things to consider when choosing a psychiatrist or therapist.
1. Know who’s who
- Psychiatrists are medical doctors who prescribe medications.
- “Therapists” can be one of a number of alphabet soup buddies: a Ph.D./Psy.D. (psychologist), LCSW (licensed clinical social worker), LPC (licensed professional counselor), LMHC (licensed mental health counselor), or MFT (marriage and family therapist).
Many people have two mental health providers: a psychiatrist to manage their medications and a therapist that handles the counseling or the “talk therapy” portion of treatment.
2. How should you choose providers
Speak with your primary care provider about your issues and ask for referrals. You can also try getting recommendations from friends and family, choosing from among your insurance company’s list of approved providers, or even calling a local university or large clinic to request a recommendation.
3. Ask questions
Your providers will spend the first few sessions getting to know you and trying to understand your situation. This is a period when it is perfectly fine, and even encouraged, to ask questions. Ask what you might ask any healthcare provider: about their experience, approaches to treatment, expected outcomes for you, appointment and billing policies, etc. You can be casual and conversational about it, but the more questions you ask, the easier it will be to determine if the provider is a good fit for you.
4. Yes, race matters
When it comes to mental health care, race still matters. According to a 2001 U.S. Surgeon General’s report on mental health, African Americans are more likely to be misdiagnosed and less likely to receive appropriate care than white Americans — partly due to clinician bias. The study also found that a greater proportion of African Americans than whites metabolize some medications slowly, which could affect proper dosing.
Your psychiatrist or therapist doesn’t have to be African American, but you do want to find someone capable of providing culturally competent care. It’s perfectly reasonable to ask whether they have treated African Americans in the past. Their comfort level when discussing this can be indicative of their ability to discuss race, culture, and other aspects of your background over the course of your treatment.
For those that might prefer an African-American provider, the bad news is that only 2 percent of psychiatrists are African American. The good news is that we comprise more than 20 percent of social workers, so you have a decent chance of finding at least one black provider.
5. Don’t sleep on low-cost options
When it comes to mental health, pricier isn’t always better. Many private practices don’t accept insurance and can be unaffordable, however, the Affordable Care Act has expanded mental health coverage requirements, so treatment is now more accessible than ever. Most urban areas have accessible nonprofit or state-run mental health clinics that accept common insurance carriers. You can also look for offices that provide sliding scale fees, or try a university training program that might offer discounted services. Your quality of care will depend largely on the quality of your specific providers, and quality practitioners can be found in all types of institutions. Your goal should be to find a highly-competent provider with whom you feel comfortable, and whose fees are affordable for you so that you can see them often enough to complete your treatment plan and see results.
6. You can break up with your therapist
Finally, if the first (or second or third…) therapist you try is not a good fit, don’t be afraid to “fire” them and find another.
The relationship between you and your therapist is key to your success, so bring it up if you two are just not clicking. Your therapist might even have some good recommendations for other providers that could be a better match.
Although there’s still some stigma attached to accessing mental health care, I’m a firm believer that there is nothing wrong with being proactive about one’s health. A healthy mind, healthy emotions and healthy relationships are just as important as physical health to your overall well-being. If you have annual well checks and seek care when experiencing physical ailments, why wouldn’t you do the same for your mental health?
For more information or for assistance locating local resources, contact NAMI or Mental Health America.
