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  • The Stigma of Therapy in the Black Community

    As Black History Month has just wrapped up, I thought I’d offer some quick reflections on unique issues affecting mental health in the African American community. Mental health concerns like depression and anxiety can of course impact all populations. However, there are specific historical, sociological, and cultural issues that influence the rates of both mental health concerns, and the seeking of relevant treatment ​among African American​s​.

    Photo credit: Jessica Fellicio

    A CDC report showed that African Americans have among the highest rates of stress-related illness and disease with diagnoses including heart disease and hypertension and other by proxy health-related outcomes such as obesity, diabetes, adverse birth outcomes for expectant mothers, and ultimately premature mortality. (Woods-Giscombe, 2010;

    Yet, Mental health statistics from the National Alliance on Mental Illness in 2018 indicate that African American use mental health services at about half the rate of their Caucasian American counterparts.

    What accounts for such a wide disparity in seeking services?

    Here are a few factors to consider:

    – Stigma and Misinformation: In the African American community, there is a lack of information and education about mental illness, which can perpetuate fears of being misunderstood and misdiagnosed by mental health professionals. There is also fear of being stigmatized by our own community for needing or desiring the assistance of ​therapists, counselors, or psychologists.

     History of Mistreatment: African Americans have experienced extensive violations of trust, privacy, and unjust treatment at the hands of systems such as the police, social services, the government, medical doctors, and psychologists. These adverse experiences in treatment serve as a deterrent to further engagement with services​ that require disclosure of intimate personal or familial details for fear of further mistreatment​.​

     Stereotypes of Black Women: Expectations of Black women to be strong, and hide any sign of ​emotional ​weakness originates from the Black Superwoman Schema, which has its roots in North American chattel slavery (Abrams, 2014). Popular culture and persistent oppression has fed the enduring image of Black women as always prioritizing the caregiving of others to their own personal detriment and neglect of self-care.

    – Internalized Stress and PressureJohn Henryism is a stereotype which articulates the idea that Black people have to work twice as hard, over-function, and embody strength despite the significant impact of this stress on the body. This cultural norm is so deeply embedded in the subconscious of the Black community, and can make it hard not only to know when you need help, but also, how to reach out and ask for help.

    These factors are some of the very real barriers for African Americans to consider therapy as an option and get very much needed help.

    Fortunately, there are ways that you can support your mental health and decrease the stigma about mental health services. For example:

    • Black persons can consider sharing more openly about mental health challenges to normalize them for others in the community.
    • Follow Black therapists on social media who are talking about a variety of mental health challenges impacting the black community and provide resources to support black mental health (e.g.  @therapyforblackgirls@melaninandmentalhealth@nedratawwab@drthema@decolonizingtherapy, etc.)
    • Talk to trusted friends and family about your positive experiences in therapy
    • Understand that therapists are bound to confidentiality, which means the things you discuss with your therapist will remain between the two of you.
    • Remember that prioritizing one’s own needs and self-care is NOT selfish. Exercise, recreation, and other positive hobbies and social activities are essential for managing stress – especially for individuals who are used to being told that their own emotional and health needs are not important.


    Abrams, J. A., Maxwell, M., Pope, M., & Belgrave, F. Z. (2014). Carrying the world with the grace of a lady and the grit of a warrior: Deepening our understanding of the “Strong Black Woman” schema. Psychology of Women Quarterly38(4), 503-518.

    Woods-Giscombe, C.L. (2010). Superwoman Schema: African American women’s view on stress, strength, and health. Qualitative Heath Research, 20(5) 668-683.

    Seanita Scott, M.A. is passionate about supporting individuals struggling to manage stress, anxiety, and OCD, family systems impacted by separation and divorce, teenagers struggling to develop positive coping strategies, and couples working to restore their relationships. She is also passionate about working with clients facing religious and spiritual concerns.