By Brian Delk

Mental health resources are a necessity for many New Yorkers. Yet access to the right therapists has proved challenging for many due to race, sex, insurance coverage, and many other factors.

One in every 5 New Yorkers experiences mental illness every year, or approximately the same number of people living in Manhattan, according to the Mayor’s Office of Community Mental Health.

However, white residents are more likely to use mental health resources than Black, Latinx, and Asian populations. Also, men across all races seek fewer mental health resources than women.

A study published in Counseling Psychology found that for every 1,002 Black, Indigenous, Person of Color (BIPOC) across the nation’s 45 largest cities, there is only 1 BIPOC therapist. When compared to the ratio of white individuals to white therapists, 307:1, white therapists are three times more accessible for white patients seeking white therapists.

One of the study’s researchers, Matt Zajechowski, collected thousands of individual profiles from Psychology Today‘s therapist directory to compare therapist availability with census data for different ethnicities and languages.

Mental health professionals have said speaking with a therapist with an equivalent ethnic background or shared lived experience benefits the clients’ comfort during their sessions — and can also save time.

Dr. Dana Crawford, a pediatric and clinical psychologist based in Manhattan, in her earlier experiences attending college and during her clinical practices in Philadelphia, Pennsylvania, said many of her mentors and professors were white, and while they cared for their patients and the community — they did not understand some of the cultural nuances of Black and brown people.

“It’s one thing to say, ‘I can’t imagine what you’ve gone through.’ Or to say, ‘I can only imagine what you’ve gone through,’ It’s another thing to say, ‘I know it,’” she said. “For example, ‘I know what it means to be afraid that your Black son might be harmed, cause I have a Black son, and I know that fear in my bones.’”

Crawford described the act of therapists projecting their unresolved problems onto the patient as countertransference. When she saw how her administrators treated her, she immediately thought of how they may affect their patients.

“There is such an honesty … of a vulnerability, as if, ‘I’m going to tell you my full truth and know that you’re not going to hurt me or judge me or evaluate me or think I’m ghetto or think any of those projections. You’re just going to see me. And I think that’s really powerful,’’ Crawford said.

She said it is hard for people to find Black mental health professionals, especially Black male therapists. Terrance Martin, a licensed Black male therapist in Harlem, said he agrees wholeheartedly. 

He said the negative portrayals of Black communities in media present an acute and pervasive trauma that affects many individuals. He said he believes mental health care is crucial in combating systemic inequities in healthcare and criminal justice systems. 

Also, Martin acknowledged the challenges of becoming a therapist, especially for Black individuals who often face barriers such as the school-to-prison pipeline in early childhood education and mental health stigmas. 

One thing you have to consider is therapy is very new for a lot of people of color. For a while, it was something that was ‘for white people’ or to go to when you’re crazy.

Roberta Jackson, licensed clinical social worker

Martin said he also struggles with internal battles as a Black therapist, balancing his desire to care for the community with the need for financial stability. He said the support of financially empowered clients can significantly impact his ability to help those in need.

Crawford and Martin agreed that there is a massive shortage of Black and brown therapists in NYC. They also said that the destigmatization, in recent years, of therapy in Black and brown communities may have aided this shortage. 

With fewer people associating therapy with “craziness” or severe mental illness, more people are open to the idea. For that reason, many of the therapists spoken to have extensive waitlists for patients seeking Black or brown therapists. 

Roberta Jackson, a licensed clinical social worker in Harlem, said she wants to break the stigma against therapy in the Black community. She said while she paid her education fees in full, she hopes the city government can financially help individuals seeking licenses in mental health practices.

Jackson explained that mental health resources are still mystifying for some people and are new to many. She said a black therapist can help people in their communities understand therapy from a familiar perspective.

“One thing you have to consider is therapy is very new for a lot of people of color. For a while, it was something that was ‘for white people’ or to go to when you’re crazy,” she said. “It’s not that at all.”

Jackson said that therapy can be a tool for people to process their traumas and change their lives as they see fit.

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