Documentation Wizard stands in solidarity with those who are opposed to the senseless violence and oppression of Black people in this country.
As I witness the horrors of what is happening, I see how it is increasing people’s sense of alienation, hopelessness, and helplessness. The 21st century lynchings of George Floyd, Breonna Taylor, Ahmaud Arbery, Eric Garner, Tony McDade, and countless others are not new. They are the result of systemic racism that can and do affect the mental health and safety of people of color, as well as the emotional health of White people. It is our responsibility as therapists to address racism and its effects on our clients’ mental health.
This is the first of two blog posts (and potentially more) addressing issues of social justice in the therapy room.
What is the link between systemic racial oppression and mental health care?
There is a Disparity in Access to Quality Care
Unfortunately, there is still a stigma against mental illness and mental health care. If we, as therapists, want to reduce the stigma and increase access to care, we need to first address the disparity of access to and quality of mental health care. Black people in America are less likely to receive mental health services and when they do, it often lacks cultural competency and is a poorer quality of care.
Racism Deeply Affects the Mental Health of People of Color
Black Americans are unfairly burdened with the responsibility of coping with oppressive and racist experiences on their own. Race-based trauma and stress associated with racial discrimination often go untreated because there are not enough therapists qualified to address these issues. As mental health providers, we need to be able to better treat mental health issues that are a result of racism.
Are you qualified as a therapist to help or treat someone whose mental health has been affected by racism? Here are some questions to ask yourself:
- Are you a person of color?
- Do you have colleagues who are of a different race?
- If the answer is yes, have you ever had conversations with them about the effects of racism on mental health care and mental illness?
- If the answer is no, why not?
- Was racism addressed in your education or training to become a therapist?
- If not, did you seek out any specialized training or workshops that could better help you understand race-based trauma or the effects of racism on mental health?
- Have you read any scholarly articles or books on race and mental health?
- Do you follow any therapists of a different race on social media?
- Would you define yourself as a culturally competent therapist?
Therapists have an obligation to be anti-racist.
We’ve all heard that “prevention is the best medicine,” so how do you prevent your client from experiencing intentional and systemic racism and oppression? Increasing access to care and cultural competency is not enough. The only way to prevent yourself or your clients from experiencing racism, is to be anti-racist and actively work to dismantle the system of racial oppression in this country.
It is an uncomfortable necessity as a (white) therapist to be an agent of change. But confronting my own white privilege and unconscious racism does not compare to the experiences of people of color in America. We have an obligation to advocate for any individuals or group of people whose mental health is suffering. We also have an obligation to challenge the racism of white clients we work with because silence is violence. Our silence harms our clients, their safety, and their mental health. If we really want to make a difference in the mental health of people in this country, we need to be able to treat mental health issues that are a result of racism and fight against systemic racism.
I believe in equality and I am an agent of change.
This is a frightening time that is leaving many people feeling hopeless, helpless, and exhausted. But I’m also seeing how people are coming together to stand up for what is right and demand justice and positive change. We are seeing people coming together and creating connection and community.
I believe in equality. And I believe in looking at myself as an agent of change so I can be a better ally to Black people and people of color. As a therapist, I pledge to do my part to end racial injustice. The personal is political. The political can be therapeutic.
Michael Castaldi says
Dear Beth,
Thank you for your timely blog reminding me of my obligation to my clients and to my self.
How easy to read the news, shake your head and huff.
You have helped keep me on track to be aware of racist language and my own biases and of course …not stay silent!!!
Misti Bryan says
Race, whether we choose to believe it or not, plays a significant role in our individual identities and the way we move through the world. It shapes our experiences and how we’re treated. To leave it out of the discussion as it pertains to mental health, when it can be one of the most significant factors, is a tremendous loss. One felt primarily by Black people, who are often the most overlooked and under treated. Let’s start with the numbers. Despite common misconceptions, rates of mental illnesses for Blacks are similar with those of the general population. But the outcomes are not the same. Black people often receive inadequate quality of care, and overall lack access to practitioners who are culturally competent. Speaking of lack of access I identify as lesbian and as mixed race and as a therapist I can tell you we lack therapist from the Black LGBTQ+ community. Clients have to sometimes search for months to find a clinician they can work with. My question to is Why? I know they are out there because I have friends who are Black LGBTQ therapist are listed. And I’m sorry but these clinicians that say they will work will all populations but don’t understand our community this is what a client said to me “When you work with clinician not from your racial background or sexual identity, sometimes you encounter racism, transphobia, homophobia, or the pathologizing of Black and LGBTQ people,” “That drives people away.” WOW!!! I still hear about clinicians who insist on using the clients legal name instead of their preferred name or their preferred pronouns or even fail to ask them their preferred pronouns.
Maybe I got off track here but racism isn’t just for straight cis gender Blacks.
Beth Rontal says
Misti, thank you for taking the time to share your thoughts. I agree with you on many points and have learned from you on others. This blog was written in response to George Floyd’s murder. Not mentioning LBGTQ in the blop does not negate the needs others who should not have to struggle to be included. I am doing my best to learn and to demonstrate my commitment to justice. I recently updated my clinical forms to include a much broader definition of trauma when taking a history. It includes racial profiling, LBGTQ discrimination and other issues. So many therapists do not think to ask these questions that those who have suffered do not think to share their experience or even think it’s legitimage. So thank you again for sharing. Your voice is important.
Misti Bryan says
Beth
Let just say I’m so sorry I got off track. Racism of any kind boils my blood! I also want to thank you for your courage. Not many as you said “white” therapist would have the courage or the integrity to admit to their white privilege or that they may possibly be racists or bias. Just reading this blop was such a source of hope that we as change makers no matter our skin color are in this together and if we are going to make a change we cannot be silent and we cannot let those around us be silent. Silence in this sense is not only an expression of passive violence but also to a concealed strategy of psychological abuse. That is to say, it can profoundly damage the person or people on the receiving end.
“The worst sin to our fellow creatures is not to hate them, but to be indifferent to them: that is the essence of inhumanity”
~George Benard Shaw~
Beth A. Rontal says
Thank you, Misti, for your acknowledgment and courage to post. This is not easy for any of us. But it is necessary. Also, thank you to George Bernard Shaw, one of my favorite old white male playwrights.