Why Black People Avoid Therapy


depressionIt is obviously not fair to generalize about any group of people but it is hard to ignore the number of people that avoid psychotherapy in the Black community. While there are many Black people who are smart, educated and accomplished and have no problem affording therapy, you still find that many people will avoid it like the plague!

When asked, some people will joke that they believe that if you need to see a “shrink, ” then it must be because you’re “crazy”. Some people will say that therapy just feels like sitting around complaining about your problems instead of getting up and solving them.

According to Monnica Williams, Ph.D., an Assistant Professor in the Department of Psychological & Brain Sciences at the University of Louisville, the following are the issues behind  African Americans being reluctant to make use of psychology’s solutions to emotional hurdles:

Stigma and judgment

In places like Los Angeles and New York, everyone and their pet has a therapist, yet even among the wealthy and elite, many African Americans continue to hold stigmatizing beliefs about mental illness. For example, a qualitative study by Alvidrez et al., (2008) found that among Blacks who were already mental health consumers, over a third felt that mild depression or anxiety would be considered “crazy” in their social circles. Talking about problems with an outsider (i.e., therapist) may be viewed as airing one’s “dirty laundry,” and even more telling is the fact that over a quarter of those consumers felt that discussions about mental illness would not be appropriate even among family.

In a study I recently completed, one African American gentleman noted, “I was just embarrassed. Getting this type of help has, and continues to be, like a sore thumb in the African American community. Unfortunately, I don’t have insurance, so my fear was that if I sought help, it would not be good because I couldn’t afford it.”

Likewise, African Americans may be resistant to seek treatment because they fear it may reflect badly on their families–an outward admission of the family’s failure to handle problems internally. Something I found in my own studies, is that even among African Americans who suffered greatly from mental disorders, many held negative attitudes about people who obtain mental health care. No matter how impaired they were, they didn’t want to be one of “those people.”

Many African Americans with mental disorders are unaware that they have a diagnosable illness at all, and are even less aware that effective psychological treatments exist for their specific problem. Because of the taboo surrounding open discussion about mental illness, African Americans often have little knowledge of mental health problems and their treatments.

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  1. This is very true regarding our community, many social ills that plague our community are oftentimes contributed to mental health, however, we feel ashamed to seek help because therapy is considered “for white people”. We need to do better as a community.

  2. I think age is also important. Younger people are less aware of stigmas. I was 12 yrs old when I realized that I could no longer cope with life. I picked up a telephone book and dialed the first female child psychiatrist I saw. This action began a journey that would change my life for the better and eventually distance myself from my closest family members. I was an inpatient for a month and an outpatient until I graduated from high school. I agree with the author about gaining new insight and self-efficacy. It was through re-framing that I saw the world around me differently – a world where I had no control over as a kid.

    Therapy is expensive and as an adult I often sought therapy to deal with traumas from my childhood. Also, by dealing openly with emotional pain I have been able to confront issues that plague my family members who are unwilling or unable to seek help. Instead they self-medicate with drugs, alcohol and gratuitous sex. It’s been a lonely road but I have no regrets. I’m still here!

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  5. Othermore reasons for our reluctance to get help
    The external society’s looking upon one of our failures as a reflection upon all of us has much to do with our reluctance to get therapy. If one of us is even perceived as culpable for anything, all of us have been required to assume responsibility for it. Thus when one suffers from a mental illness, we are reluctant to discuss it with outsiders as we feel that it not only reflects on our family’s failure to settle matters but also a reflection on the entire community.
    Even veterans with PTSD, whose mental health issues are perceived to be understandable and justifiable are reluctant to seek help in the “be strong” warrior culture of the milit’ry as well as in our community. Nobody wants to be seen as a “punk.”
    Moreover, there is an often justified fear that what we share in confidence will be used against us later.
    Moreover, therapists outside our community lack the training and experience to deal with our issues and therapists from within our communities like the rest of us live and work under a presumption of incompetence.

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