Between the pandemic, national politics and social unrest, many people are experiencing mental health concerns, such as depression and anxiety.
But as Dr. LaShaunda Poindexter Massey says, race plays a role in who gets therapy and who doesn’t.
The American Psychiatric Association reports that only about one of three black people who need mental healthcare receives it today. There’s a wide range of reasons, says Dr. Massey, the most obvious having to do with the cost of mental health care.
Now more than ever, she believes it’s time to remove the stigma of therapy so people can get the help they need.
Q: In a recent column, you pointed out that there are very few Black therapists. Why is it important to have more?
Dr. Massey: It’s important because there is a connection that is necessary in the therapeutic environment. Many people of color, African Americans in particular, have found it difficult to connect across racial bounds when they're seeking therapists, and sometimes that's a barrier to even trying.
I want to point out: this is not to say that non-clinicians-of-color are poor at connecting, but sometimes the perception or the fear that the connection may not be there becomes a barrier for the African American seeking help in the beginning.
Q: You mentioned in your column that one difference between Black patients and white patients is that a white patient doesn't come in with the baseline social “weariness” that people get from being a minority, facing racism day to day. How do you address that weariness -- that most people learn to just live with -- as maybe a main source of a crisis?
I actually feel that the current climate is making it an easier discussion, because it's one of the things that they are now finding it more necessary to talk about. Over time, Blacks have learned to just deal with: it’s there, you experience it, you work through it, or you expect it and it’s a part of surviving, a part of the resilience that’s expected.
But people are now recognizing that that really weighs you down. I say to clients often, “just because you can carry it, doesn't mean it isn't heavy.”
So they're starting to learn that this load that I've been carrying, some of these experiences that I have, really are heavy! So I think the current situation is bringing it to the forefront-- that it’s something they need to talk about and deal with, and actively resolve as opposed to feel like you just push through it.
Q: Recently at the Emmy Awards, the Black writer Cord Jefferson publicly thanked his therapist in an acceptance speech. Later when he was asked about it, he said he wanted to address the problem of the stigma that Black men have about therapy. Is that still a major problem?
Oh, yes! That is, in general, a problem for mental health and not just clients of color. We know that there's a stigma with mental health in general, then when you add on top of that Black and male, these add more and more layers to those things that will keep you out of therapy.
To say I'm going to go somewhere and talk about my feelings, it's like the most unmasculine thing you could do in our society, unfortunately. (I’m talking about that in stereotypical kinds of ways.)
So we are really trying to spend some time helping people understand that seeking therapy and having that in your corner is not about weakness. It’s actually about strength, it’s understanding that I’ve got to maximize resources.
So many people are struggling with the acceptance of a mental illness -- it's just that: it's an illness. It's actually one of the reasons that I've tried to be more vocal as a mental health provider to really normalize that we've got to get this professional help just like we seek help for other illnesses.
Q: Dr. Massey, have you found that the pandemic has pushed people to being more proactive about their mental health? They’re stuck at home (sometimes with children), churches don’t feel safe, there’s nowhere to blow off steam. Maybe if you didn’t consider it before, now’s the time.
I think it is the increasing amount of pressure, as you just described, There are so many things [now] that it's easier for people to say, “You know what? This really is too much. When I was going to work and I had to deal with a couple of racist acts, or I had to deal with some microaggressions, I could come home to where home is my castle and my quiet space.”
But when all of those things collapsed together and people didn't have access to some usual distractions or pleasantries -- “I'm going to go out to a bar and a happy hour, or I'm going to go to the gym and work out” -- once we were home alone with our own stuff, it was stripped down to me, myself, and I. And I've got to do something different if I'm going to survive this heaviness.”
Q: Aside from the social taboos, there’s also an economic barrier to getting therapy. It’s expensive! What do you think needs to change so more people can access professional help?
One of the main places we’ve got to change, like I mentioned in the column, is when we think about copays and office visits. A $25 copay is okay when you're seeing your doctor once every three months for something that happened to come up. But you establish a problem in the mental health arena that's requiring a weekly session for at least four or five months. That becomes another $100 bill for a family. And when we’re seeing people get access [in the form of] one free session -- I’m appalled, to say the least, as a clinician.
What am I going to do with one session with someone so that they step in and get their feet wet, and then they can’t come back?
So, I think one of the main things that we have to look at is how are we changing healthcare so that we are able to help make it a priority -- that people are accessing mental health and that they’re understanding the consistency with which you need to be involved in those services.
