The Mental Health Barriers People of Color Still Face

In this episode of Skills & Pills, Dr. Jo and Dr. Mo explore the unique mental health challenges many people of color face and the stigmas that often keep them from seeking help. Together, they unpack how culture, faith, and lived experiences influence the way we view therapy, while highlighting the emotional weight of navigating spaces where your story isn't always understood. 

The conversation dives into the impact of microaggressions, the importance of finding culturally competent providers, and why representation in mental health care can make such a meaningful difference. They also reflect on what it looks like to embrace both your faith and your cultural identity without feeling pressured to minimize either one. 

Healing doesn't require leaving any part of who God created you to be behind, and this episode offers encouragement for anyone searching for care that truly sees, understands, and values their whole story.

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Transcript

SPEAKER_02 0:00

Find yourself a therapist and a doctor that is culturally competent. Somebody who wants to know what impacts your world, what shapes your world. You don't want to erase your blackness in order to be healed. We are so excited to have you here on the Skills and Pills podcast. We are breaking into a new segment this month. The month of July is BIPOC Mental Health Awareness Month. So we're gonna be talking all things mental health barriers, stigma, and what are we gonna do from here? We're excited to have this conversation. And it also kind of goes back into our previous episode about the myths of mental health that you could check out a few weeks ago. Dr. Joe.

SPEAKER_01 0:51

As mental health professionals, we look at different observances for m months. This one, of course, is important to us as African American women and being a part of the BIPOC community, which is black, indigenous, and people of color.

SPEAKER_02 1:08

Absolutely. Honestly, I don't think that we pay enough attention to what the communities need. Um there's not I think not a big focus on stigma and how much stigma there is attached to it. People don't often consider that um where you come from, your ethnic background, your religious backgrounds, how these things impact your ability or your desires or your um readiness to go into therapeutic work, therapy, medication management, right? And we can only really speak from our experience. We can speak from research across the board. But I think as black women, it's so important that we have these conversations because um, in full disclosure, only about eight percent of the population of psychiatric mental health nurse practitioners, um, actually a little bit less than eight percent are black or African American. And same with licensed therapists, it is very difficult to find a black provider. And so um what's interesting is just like in any other healthcare space, like with OBGYNs or your primary care doctor, a lot of times when you find um a provider of color, you find safety. Yeah. Because there's an understanding into the cultural nuances that impact your physical, mental, and emotional health. And being seen in your care is so important. Find yourself a therapist and a doctor that is culturally competent, yeah. Somebody who wants to know what impacts your world, what shapes your worlds, the way that you live, the way that you feel, the way that you breathe, those things matter, right? You don't want to erase your blackness in order to be healed.

SPEAKER_01 2:56

Yeah. I did research on um African American counselor educators, and I was just really blown away in that research, like you said, 8% for medication management. When you think about the BIPOC community when when it comes to representation in therapy and counseling, it is less than 20%. And we're talking all minorities put together, not just African American, but all minorities are less than 20%. African Americans are less than 15%, and then African American males. So as you break it out, it would seem like there's a a large representation, but really if you look at the profession as a whole, it is not. And through that research, we found out that we have lived experiences that really shape how we come in the field, shape how we what we call bracket. When we say bracket, we mean how do I set aside my lived experience, right? To be able to sit with someone in their healing journey when my experience mirrors it so much. Like it doesn't matter. I was talking to some of my students about this just this week. It does not matter how many PhDs that I have. Right. It doesn't matter how much how educated I am when I walk. And we're gonna let me put a pin here and say that we're gonna talk and lean in to some of the um more uncomfortable.

SPEAKER_02 4:38

I was gonna say controversial a little bit because I was like, I have a slight controversial take um on therapy for us that I was gonna say after you went. Yeah. Um but we're gonna have to touch on some things.

SPEAKER_01 4:49

It's some uncomfortable things. Uh, but when I was telling my students, when I but still on site, because of my melanated skin, when I walk in a major department store, I'm deduced to from all of the trainings, all of the things that I have accomplished when it comes to social mobility, down to someone who is targeted to be followed, you know? And so it's m in moments like that that I'm reminded that it is not because I walk through the world looking to be different or looking for something, I walk through the world and almost daily the world reminds me uh through a microaggression or through. So, how do you keep the whole part of your heart soft when you walk through that part of the world? So I lean into these conversations with my students, first of all, because I teach multicultural. Second of all, I think um I do the profession of service by being authentic, being genuine about my lived experience when I realize that I may have a student or I may have a colleague that just does not have a framework for what it is that I walk through that or that we walk through as behavioral professionals. And to top all that off in the research, I think I had a minute of catching my breath when I realized that a lot of institutions, churches, schools, um, universities, they are a microcosm of the larger society around them. Right. So if um oppressive behaviors or um minimizations, marginalizations, if that is the daily environment or presence, if you will, in an area and you pop a church in that area or you pop a university in that area, that institution on certain levels is going to mirror um that community. Right.

SPEAKER_02 7:19

So and I would honestly say that like one thing that I would say is it's not really controversial, I feel like, because it's true, but when you really look back at like the history of therapy itself or specific types of medicine, it wasn't made for us. Right. Does that make sense? Like when therapy, outpatient therapy first started, it was not heavily being used by black, brown, indigenous people. Um, it was for a specific tax bracket, it was for a specific group of people, and there wasn't a lot of representation of doctors, nurses, therapists that could come in and help. And I think what you say, the reason why it is important when you talk about the more larger systemic issues is because if I'm sitting in front of a client and they're black or brown, there is a lens in which they see the world or how they're impacted by the world that I could minimize their pain or I can minimize the things that they're going through if I don't have an understanding of their general culture. Like, for example, um we had this amazing conversation with Dr. Crystal Holbert um a couple episodes ago on trauma. Go check them out. They were amazing. Um, and in that she was talking about church hurt and trauma and how we navigate that through the Lord. Well, that may look a little bit different for a black client that has complex trauma that may be in a church space that isn't having that multicultural lens. The way that they process through that could be very different because they are seeing the same systemic pressures in different environments. Yeah. Right. And it's always kind of very subtle in ways. And so the way that you process with that client may be different than you the way that you process with a client that hasn't experienced systemic racism, that hasn't experienced any level of oppressive behaviors, that hasn't experienced hate speech, microaggressions, microcosms. So when you think about the idea in the psyche for me, as a black woman, if I go to work because I'm in less than 8% of um, there's less than 8% of nurse practitioners that are black, and then I specialize in psych, which is even less so. It's like 2% of us across the United States. And so I often find myself being the only one in the room. And so I may go from my work space to my church space to my everywhere to the grocery store and may find myself being in spaces where people can't identify with the experiences that I have, which then not intentionally, they may invalidate them because they don't experience them. So when you bring up that concern or your clients bring up that concern, they'll say, I'm feeling this way, but nobody else in the environment is seeing it because I'm the only person in the environment like me. Right. Does that make sense? And so it does matter. It matters in how we process because it also matters because there are some aspects of the that that we can't change for them. So, how do I teach this client to have more resilience in the spaces that they're in? How do I teach them how to navigate relational strain and the difficulties of walking through life without being able to change a certain portion of what they're experiencing in those environments? Does that make sense?

SPEAKER_01 10:44

I I think not just the clients, but even our colleagues.

SPEAKER_02 10:48

Yeah.

SPEAKER_01 10:49

Right? Um, I'll I'll never forget the backdrop of when was it? It was 2020.

SPEAKER_02 10:56

2020 was just like an interesting year for, I mean, that's a really nice way of saying the world was on fire. Like it was just we were standing by the dunker like dash of water.

SPEAKER_01 11:12

Right. You had you had the vents of COVID going out there, which a lot uh there were higher uh rates of um, you know, of fatal incidents, things like that in a community where there was disparities, right? You had all that going on, but then you had the incident with George Floyd that happened then. And I will never ever forget that. I was um teaching a class that the day after it happened, and I remember, you know, it was like a synchronous class, like we were on the camera together, students on the camera, I'm on the camera, and I remember uh because counseling is so much about, and there's so much communication, you would be shocked at how much communication is nonverbal. We have we give more nonverbal cues in our communication than verbal. And so when I cued that class up, I could just see, and I, you know, and in that moment, I'm like, okay, we've got I've got to teach you about research tonight. Right. Oh, well, let's go into qualitative and quantitative. There was a piece of me that um that I believe was birthed from the transatlantic slave trade, honestly. That's like, let's move. We we go, no matter what the atrocity we go. And I just in a moment, in a couple of seconds, I decided, no, I'm not gonna pretend like this is not happening. But in that period, um, I remember again I did research around it, right? And that year brought back racial tensions, right? And racial overtures that had not been seen since the 1960s, between 1963 and 1967. And so I was like, as a let's go into our intersectionality, as an African-American woman, as a believer in Christ, as a professor, how do I bring all of myself into that moment? So I think when it comes to um the training of behavioral health prof uh professionals, I believe that you're kind of ticked the clock on how we begin to lean into conversations, right?

SPEAKER_02 13:43

It was, and it was a conversation, um, a big conversation for me, especially as a black Christian woman. There's a lot of calls for us um as black people to be Christian first before black. And I've heard this in sermons, I've heard this, I've heard this all my life. And as a mental health professional, um, I'm like, I can't choose to not be who the Lord made me be. Does that make sense? It makes absolute sense. I understand that I'm always I'm a part of the body of Christ, and my Christianity is always above that. But to say that I need to choose Christianity to and forsake my blackness uh puts me in a position where I begin to ignore the intersectionality. I am a both Christian and black. And I'm I could be persecuted for being Christian in certain environments and around the world, and I can also be um discriminated against for being black, and I can be discriminated for both at the same time. So I think that there's a both and conversation that we as licensed professionals sit in the balance of. Just because you're Christian doesn't mean it erases the very human realities of racial tension and all of the history that we have that still that impacts people generationally. Yeah. Right? So my grandmother, my great-grandmother, my great-great-grandmother, my right, like it goes back and back and back. And when you think about that, to ask me to suppress that portion of me. What you're asking me to do is to suppress it away. To say, because that makes us uncomfortable as a conversation in the church, we're going to tell you that you can't be that. You really need to be Christian first and kind of put that put that part away. We don't want to talk about that part. But that leaves a lot of like our clients and people like that coming in and saying, I don't know what to do with suppression leads to increased anxiety, depression, you know, and it leads to constant stress. Um, and so it's not something that we can recommend. We say, well, you have to come to terms with the fact that you're gonna need to process these things, whether or not you can't just say, I I can't say that. And I actually think that in some ways, and I that please don't go to town on me on the in the comments, but you might, it's okay. But in some ways, it's almost a divine privilege for you to be able to even tell me that.

SPEAKER_01 16:22

Right.

SPEAKER_02 16:23

Because the fact that you can tell me to forsake that part of myself is because you're not impacted by that part.

SPEAKER_01 16:30

Yeah. Does that make sense? It makes total sense. And and we're gonna have to pick this up, right? This is hard. I know we're don't eat us up. I know. They're gonna eat you up, girl. They're gonna eat us up. I don't know why you say don't eat me up. They've been eating you up since it's okay. Well I was about to say Plymouth Frog, but I mean they've been eating me. It's just a topic that, you know, even in this moment. Research-based. Even in this moment, I feel kind of you like, I don't want to have to be the one to bring this forward, but I don't want to be the one that doesn't bring it forward. But to speak to your point, um, I got down into it, you know, in some of the teaching that I do, and I begin to say, Line, Lord, how do I explain to somebody that I know that you receive us all? Heaven looks like all of us, but at the same time, make them see me, right? Right. And I was reminded of that uh the scripture when I was for when I formed you in your mother's womb, I knew you, I set you apart. So if he knew me, he that means he kissed my melanin in the womb. I got a melanated kiss. Does that make sense? What it looks like now. So that means he sees my color, he designed and made my color. And then if you go through different stories in the Bible, he names culture, the Samaritan. Sometimes you won't even get a person's name, right? You will get their culture. Does that make sense?

SPEAKER_02 18:05

Yes, and so he actually does see him as an example of something culture. He was not colorblind, culture blind, like he cared for people that he shouldn't have even been caring for. Yeah. And you even see that in the the parable with the Samaritan, um, with the good Samaritan, right? Where he kind of, you know, is the only one to stop on the side of the road and help somebody that he was not supposed to be helping based off of cultural norms.

SPEAKER_01 18:36

Absolutely. If you look at that part of the world, he looks more like you and I than uh one would think. Does that make sense? Or one I should say would realize. And so there is something uh to be said, and we don't want to take away from the fact we're gonna kind of put a pen in here, pick up the conversation, a little bit on lived experience, right? But we don't want to put a pen in the fact. I teach some classes and I teach, I'm teaching some classes right now where I'm teaching cultural humility, cultural competence, and I am the only minority in the room.

SPEAKER_02 19:15

Right.

SPEAKER_01 19:16

So when I get sat in those situations, I am like grabbing from everything from my knowledge base on multiculturalism and social justice, right? And I'm grabbing everything from the heart of the Lord and putting them together. And I'm saying, how can I teach? I know a couple of uh quite a few actually, but personally a couple of colleagues that are not minorities, right? That are some of the most multicultural counselors that I know. So it's not to take away from um the fact that, or it's not to say that you have to be a minority to be culturally competent.

SPEAKER_02 20:02

And I think that goes the same way because we've uh of course framed this conversation mostly from our perspective as black women, but like when I have clients that sit in front of me from other religions, other cultures, other spaces, I have to lead with understanding. I don't understand that. Can you help me? Um explain that to me, right? I I wasn't grown from raised in an immigrant family of a Latino background or from, you know, an Asian family background. So when I'm trying to understand how I can help them on their healing journey, I've got to kind of understand the layers of what is this culturally for you? Um, oh, this isn't just something that's a part of your personality. Right. This is something that's taught. This is something that you caught. This is something, right? This is something that's not just a part of your family system, but a part of a larger cultural system. Does that make sense? And so that can help you to know, like, for example, for me as an African-American Pentecostal-raised Christian, I'm not going to be looking at my client sideways when they say that they've heard a voice or they've heard a voice of God. Or you know what I'm saying? Like, I understand a word of knowledge and I understand what it looks like. Um I get it when they talk about the laying of hands or when they had the altar moment. I'm not coming to them and saying that those things were not valid or appropriate or that the psychosis. Right. Or can't be a part of their um their treatment planning, too. Like, how are we going to include your pastoral time, your altered time, your growth group, your how are we going to include that into your care, right? Because for me, that's been a part of my care. And it's been a part of the care for every person that's been in my walk of life, right? And so it's a God first mentality, it's a prayer first mentality, it's a read your word, that's what's feeding you. And so now, does that mean that if somebody from a different religion sits in front of me that I'm not able to say, I don't always get it, but I want to seek understanding so I can help you the best that I can? And I think when we're talking about the therapeutic space, it's so important when we walk into these therapy rooms that we're seeking providers either that do understand our culture, whether they look like us or not, or are willing to learn about our culture. Because you don't have to know it, but I do want you as a therapist, as a doctor, as a nurse practitioner to be willing to ask me about it.

SPEAKER_01 22:32

I was I was thinking as you were saying that too, and um we're gonna pick it up. We're gonna pick it up. We're talking like on from the perspective of being the provider, but when we pick up the conversation, I totally want to talk about what it's like being just a person and a human. Um, but even with that in mind, one of the things and the major things I have learned as a provider is that if you want to know how to treat people or how to be with someone who's of a minority culture, allow them to teach you. If you listen, they will teach you. And I think that is really, really important. No, it's like it's the thing. It's the thing, it's the thing thing.