A guide to getting quality mental health care as a person of color

Everyone deserves access to compassionate, science-backed mental health care. But getting that support isn’t always easy. And it can be especially difficult if you’re Black, Indigenous, or a Person of Color (BIPOC).

Research shows that BIPOC adults face a range of barriers to care that their white counterparts simply don’t. In 2023, a Kaiser Family Foundation (KFF) surveyed more than 6,000 adults.¹ The results revealed several common hurdles:

• More than half of Black adults surveyed (52%) said racism is a major problem in health care.
• Asian (55%) and Black (46%) adults are more likely to have trouble finding a provider who understands their background and experiences.
• Hispanic adults are more likely than their white counterparts (24% vs. 11%) to say the main reason they didn’t seek care was they didn’t know how to find a provider and/or that they were afraid or embarrassed (30% vs. 18%).
• Roughly 40% of Hispanic adults and 30% of Black adults thought finding care would be too expensive.

“It’s not right that you have to work harder to get quality support,” says licensed therapist Donay Butler Ernest, LMFT, manager of clinical program development at AbleTo. “But with the right knowledge, you can empower yourself as you navigate the process.”

Below, we’ll unpack challenges you might encounter if you’re part of the BIPOC community seeking mental health care. We’ll also share tips for how you can be your own best advocate.

Common barriers to care — and how to tackle them

The first step to breaking barriers is identifying what they are. Some exist within your community. Others may stem from larger systems. Let’s dig into 5 big ones.

Stigma

The barrier: Negative views of mental health care are changing for the better overall. But research shows that stigma persists across a range of cultures. It can make people less likely to seek care and less likely to adhere to recommended treatment.²

BIPOC individuals may think that their ancestors went through greater hardships without support. So they should be able to manage whatever they’re facing on their own. Or they might worry they’ll be rejected by friends or family. Or they might feel like mental health challenges are a sign of moral or spiritual weakness. Research backs this up.²

How to tackle it: Talking about mental health can be tough. But the more these kinds of struggles are discussed, the more everyone realizes how common they are. Explore groups like Barbershop Therapy, which fosters conversation and provides resources to community hubs where BIPOC patrons already feel at ease.

Using different words, especially with older generations who are more hesitant to broach the subject, can also help. For example, you might try asking a loved one to share what’s on their heart today. It can also help to use physical symptoms, like a racing heart or headache, as a segue to discuss your feelings.

Lack of cultural awareness

The barrier: A person’s cultural identity informs how they view the world and their place in it. “When it comes to mental health, it can also impact how someone understands themselves and their experiences,” says Butler. “It gives them more frames of reference to help them move through whatever they might be going through. But if a provider isn’t well-versed in a patient’s culture, or one that’s similar, they may miss important context.”

She gives the example of female patient who says she gets a headache every time her husband comes into the bedroom. If that patient comes from a culture where wives feel like they have to put their partner’s desires above their own, the headaches may be a physical sign of anxiety.

How to tackle it: The majority of behavioral health providers identify as white and female, according to the most recent data from the United States Health Resources and Services Administration.³ In big cities, you may have a larger and more diverse pool of providers to choose from. But it may be tougher to find someone who fits your needs if you live in a rural area. Virtual support, like AbleTo, can be a way to bridge the access gap. Check to see if you have access.

Bias

The barrier: Conscious and unconscious bias in health care is all too common. A provider might use outdated or inappropriate language to talk about your identity. Or make assumptions about your culture. Or dismiss discrimination you’ve experienced.

“Someone might downplay the importance of race and ethnicity,” says Butler. “Or they might say things like, ‘I treat everyone the same’ or ‘I don’t see color.’ Those kinds of blanket statements don’t honor the distinct lived experiences of BIPOC patients.” And it’s not okay.

How to tackle it: Most providers have profiles online, and their bios can tell you a lot. “They may have expertise with certain groups or subjects,” says Butler. “Or their bios may talk about their approach to racial identity or stigma.” Many people also list language skills. As Butler points out, some symptoms don’t translate well, so finding someone who speaks your first language can make a big impact on care.

Ask for a short intro call to meet a potential provider. At AbleTo, we call this an initial consultation. Ask questions about their approach to care. Ask what types of people they’ve worked with in the past. This will help you get a sense of whether someone fits your needs.

That said, if something happens later and you want to find someone new, say so. “Be honest,” says Butler. “Explain what they may have done or said that made you uncomfortable. Even if it’s too late to apply the lesson to you, hopefully they’ll apply it to their other patients.”

Mistrust

The barrier: Historical wrongs, like forced sterilization of Indigenous women and the Tuskegee experiments, have left some BIPOC patients wary of the medical system. That’s understandable. You might also have had experiences of your own that make you question whether you can find a provider who sees you, believes you, and has your best interests in mind.

How to tackle it: Building trust with a provider starts during the search process. Know a friend or family member who has gotten support? Ask if they liked the person they worked with. If not, those online provider listings can tell you a lot. So can that initial introductory call. Ask what to expect from the process and cost. And don’t be afraid to ask specific questions related to your personal history or concerns. “You deserve someone who will lift you up and address your concerns,” says Butler.

Lack of access

The barrier: Health care access comes in many forms, including location and cost. If you live in a rural area, you may not have clinics or providers nearby. Public transit may be unavailable. Insurance may not cover the cost of care or it may limit the number of sessions allowed. And out-of-pocket costs can be high.

How to tackle it: Online support from companies like AbleTo can make it easier to access care no matter where you live. “As long as you’re physically in the state in which the provider is licensed, you can be seen virtually,” says Butler.

For payments, some providers offer a sliding scale. (You can ask if it’s not stated on their profile.) You may also be able to find low- or no-cost options through the National Association of Free and Charitable Clinics.

How to make sure your concerns are heard

Everyone deserves to be understood by their provider. It helps to come into your sessions with notes about what you want to discuss and any questions you have. Writing in a journal is one way to sort through your thoughts and feelings. It can also help you keep track of when symptoms began. (The AbleTo Freewrite Journal is a great space to do this.) Bring any notes you make with you.

“Refer back to your notes as needed,” says Butler. “Ask follow-up questions. And speak up if you feel they misunderstood you.”

When you’re in sessions, you can push back if you think the provider is distorting a situation. Or if they’re playing into a stereotype. One example Butler gives is the unconscious bias that Black women are strong and don’t need as much support. “You shouldn’t have to call out things like this,” she says. “But you have every right to.”

More ways to feel empowered

Not ready to work with a provider? That’s okay. You can also lean on your people. Friends, family and peer support groups can help bolster your confidence. They can also encourage you to speak up for your needs when it feels tough. There’s also power in shared experience. The Mental Health Coalition Resource Library is a great place to find groups related to your community.

The most important thing to remember is that you deserve support for your well-being. And you can get it in whatever form works best for you.