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Q&A: Therapy Stigma
Understanding why some communities discourage therapy
Erica Pierre

—Erica Pierre

Q: In general, what does the black community think about therapy?

A: There’s a stigma attached to mental illness in America as a whole, among people of all ethnicities. There’s a joke that psychologists and psychiatrists are crazy themselves. Ridiculing the people who are delivering the care is a way of avoiding facing up to their own mental problems.

The stigma seems to be a little bit higher among African Americans because they tend to view mental illness as something to hide. Some of that is because of history. In the past, blacks were more likely to be sent to state hospitals and locked up against their will. They can’t do that anymore, but I think there’s still some fear of being put away without your permission.

Q: Why do some people see mental illness as shameful?

A: Instead of seeing it as an illness that you can get because of a chemical imbalance or from stress, they tend to see it as a defect in themselves. They feel that other people will see them as weak.

Q: Does the stigma exist in black communities in other countries (like Haiti, where I’m from) or only in the American black community?

A: In most cultures there’s some stigma about “going crazy.” I’ve traveled in Africa, China and the Caribbean and I think there’s a stigma there as well.

But what is seen as mental illness may vary in different cultures. If you’re in Haiti and you hear voices, some people might not think that’s a problem, if those people practice voodoo. But if you’re hearing voices in the U.S., people might consider that a mental illness.

image by YC-Art Dept

Q: I once heard someone say that “black people don’t go to therapists, they go to church.” What do you think about that?

A: That’s not entirely true. There are a lot of blacks now who go to therapy. But a large portion of the black community will seek out ministers and the church to deal with emotional problems. A lot of the time it probably helps because they’re talking about it and seeking help. But ministers have to know when to refer certain people who are very ill to psychologists or psychiatrists.

Q: I’ve heard that black people usually don’t trust white therapists. Is that true?

A: It varies. Some black people don’t trust that a white therapist is going to be able to help them, and they’d prefer to go to a black therapist. White patients are the same way. A lot of patients prefer to go to a psychologist or psychiatrist who comes from the same culture. But black patients may fear not just that they won’t be understood, but that a white therapist may be prejudiced and they won’t get good care.

Q: Do we need more black therapists in the U.S.?

A: Absolutely. Black patients are likely to have a therapist of a different background than them. Even in a city like Boston, where I live, there are very few black therapists.

A black psychiatrist can make black patients feel a greater trust and feel more welcome. The other thing a black psychologist or psychiatrist can do is help educate and give a cultural perspective to the non-black therapists at their clinic who are treating black patients.

Q: What can be done to eliminate the therapy stigma?

A: People in medicine, public health associations, and the U.S. Surgeon General all have to keep saying that there shouldn’t be a stigma associated with being mentally ill. Mental illness is a disease like diabetes or hypertension. It’s treatable with therapy and medication, and there’s no need to suffer or not seek help because people feel it’s a weakness. We have to encourage people not to stigmatize the mentally ill, not to make fun of them, not to abuse them, but to treat everyone with dignity and respect.

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