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Does a Black Woman need a Black Therapist? Lack of Representation In the Healthcare System

The decision to seek professional help for your mental health and well-being is never an easy decision and it is not one that is made overnight. As a black woman my identity is a personal evolution, one that is formed from my experiences with the world and with others. Like many black women I wear my scars like medal of honour, that display what I have been through and my strength. So, it is understandable why there is so much anxiety and fear centred around seeking professional help because you are entering into a state of complete vulnerability and transparency.

What is Racial Trauma?

A particularly pivotal moment for many was the Black Lives Matter movement which reopened a psychological wound for people and revealed unique challenges and barriers within mental health services. In the face of racial inequalities and injustice black people are facing anxiety, anger, and exhaustion. Many experienced racism in the form micro-aggressions, directly and indirectly, leading to racial trauma. Racial trauma is defined as the mental and emotional injury caused by encounters with racial bias and ethnic discrimination, racism and hate crime (Mental Health America, 2010). Racial trauma can lead to other mental illness such as depression, chronic stress, and post-traumatic stress disorder. After this there was a surge of individuals from ethnic minority backgrounds requiring psychological help, and the call for an ethnically diverse and representative mental health service became apparent and imperative.

Healing takes time, and asking for help is a courageous step- Mariska Hargitay

Essentially the UK healthcare service should mirror the diversity of the population it seeks to serve. Whether or not your therapist will “get it”, speaks more to the larger issue and need for cultural competency in the healthcare service. The structure of the current mental healthcare system needs to do more for ethnic minorities. According to an independent review of the UK’s Mental Health Act in 2018, profound inequalities were found to exist, with black British people four times more likely to be sectioned than white people and more likely to be given psychoactive medication instead of being offered talking therapy as an effective treatment. In addition to this there is a lack of psychiatrists and psychologists of ethnic backgrounds within the mental health professions. Black, Asian and Minority Ethnic individuals make up only 9.6% of qualified clinical psychologists in England and Wales, in contrast to 13% of the population (Office of National Statistics, 2018). The gross underrepresentation in the mental health profession has led to a lack of cultural competence within the service and the clinical practice.

Cultural Competency and Clinical Practice

So, does this mean that Black people need to have black therapists? The answer is no. It is important to understand that just because a therapist looks like you doesn’t mean that they will have a significant level of cultural competency or understand what cultural competency looks like in clinical practice.

Cultural competency is the defined as the ability to understand and relate with people from different cultures, whilst being mindful of both verbal and non-verbal interaction. To have multicultural competence, you need:

  • A basic understanding of your own culture.

  • A willingness to learn about the cultural practices and worldview of others.

  • A positive attitude toward cultural differences and a readiness to accept and respect those differences.

The race of your therapist shouldn’t be an issue unless they fail to understand the complex role that race and culture play in your interaction with the world, and vice versa. A good therapist should be able to listen effectively, communicate and validate one’s experiences and trauma. The simple act of empathising can open so many doors for healing. We are taught to recognise our individual unconscious biases and immediately dispel or deal with these biases. One side of the argument is that it is very important that the client feels like they identify with their therapist, whilst the other argument suggests that it does not matter what the therapist looks like, but rather what is important is the connection made through empathy, trust and understanding. This is first established by identifying differences and celebrating them.

Action and Change

A recent attempt to promote equality in clinical practice has been implemented through colour-blind racial ideologies, however sociologist have argued that this causes more harm than good. When a white therapist states they “don’t see colour”, it denies the client’s race and exposes a lack of awareness regarding the therapist’s own power and privilege. For this reason, it is also important to have people of ethnic minority backgrounds in positions of power to implement changes to policies and regulations. 43% of the NHS workface in London is from black minority (BME) ethnic backgrounds, yet only 14% of board-level positions are held by people from this group.

The aim of this blog post is to not only educate the community but to encourage any future Black, Asian and ethnic minority female psychology students to take the clinical route and be the change that the mental health service needs. If you are interested in joining the Several Seats Mentorship Scheme as a Mentor or Mentee for aspiring mental health professional, please click on the link below

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