Mental health and racism

Musicians' Assistance Program

Volume 113, No. 2February, 2013

Janet Becker, LCSW, Ph.D.

The office of the Musicians’ Assistance Program is your one-stop shop for musicians’ health. We offer counseling – both one-on-one and in groups – as well as information on all kinds of social services, including health insurance, housing, food stamps and more. All services are free to Local 802 members. Contact us at or (212) 397-4802.

February is Black History Month, a time to contemplate past and current racial conditions for African-Americans in our society. Newspapers, magazines, television, radio and the Internet offer a variety of programming to document the history, oppression, struggles, victories, contributions and achievements of African-Americans, from colonial times through the Civil War, and up to today. Depending on the points of view of the writers, the emphases of these articles and programs vary, some focusing more on the progress that has been made in the movement toward equality of civil rights, and others more on the stubborn persistence of racism in our so-called “enlightened” times.

Having devoted the past 30 years of my life to the professions of social work and mental health, I have become painfully conscious of the many inequities of access and attitudes which African-Americans encounter when they are in need of psychological services. Despite the increasing emphasis on diversity training and cultural competence, much consciousness-raising remains to be done.

This is especially true when, as is often the case, the client is African-American, and the therapist is not. Each person, both therapist and client, may harbor attitudes, expectations and biases of which they are not fully aware. The extent to which these preconceptions remain unconscious may well determine the nature of the treatment experience that follows. And the outcomes of these encounters may be more pain and distress, rather than the solace which was originally sought.

Moreover, it is important to remember that most models of psychotherapy theory and treatment were developed by white European or white American therapists. Until relatively recently, it was assumed that cultural or ethnic differences among clients were inconsequential, ignoring the existence and impact of cultural and ethnic differences upon individuals’ lives. The tendency has been for many therapists to evaluate their clients’ mental health and functioning through a biased lens which does not understand or acknowledge the validity of alternative cultural values and experiences. And the conclusions reached by the professionals in their positions of power have at times been to misunderstand and therefore to pathologize that which was unknown or foreign to them.

Thus it should not be surprising that many African-Americans may have a “healthy cultural suspicion” of psychotherapy. According to Dr. Boyd-Franklin, professor of psychology at Rutgers University, “In African-American communities, therapy and psychopharmacology are often seen as the domain of sick people, crazy people, white people, or rich people,” and this belief “impacts the way black patients and their families interact with our system.” Furthermore, “all mental health clinicians should know that racism has absolutely impacted our African-American clients and continues to affect them, irrespective of class and education.”

How can this information inform and guide black individuals who find that they are in need of help with personal or family issues? If you are seeking a mental health professional, it will be important to ascertain the extent to which both client and therapist are aware of their own cultural biases, and are able to discuss, openly and with some degree of comfort, the impact of racism upon people of color. This is true regardless of the skin color of the therapist, as it is possible that some black professionals may not share the client’s background in terms of education, class, or life experience, and therefore may not be able to relate to them.

Whenever people of any race or ethnic identity ask me for advice in their search for a counselor or therapist, I always tell them to “trust their gut.” While it is important to be able to discuss and ask questions regarding racial and ethnic differences, it is most important to feel that the person with whom you might share your very personal thoughts and feelings is someone who is truly respectful of you, your culture, and your individual uniqueness. Also, most people really can tell if the person they are seeing is able to relate and connect to them in an empathic and nonjudgmental way. No amount of intellect or training can compensate for a lack of humanity.

This essay first appeared in the February 2007 issue of Allegro.