Where Are All the Black Mental Health Professionals?

There is a shortage of mental health professionals in the United States. Many areas of the country have between 20-40% of the therapists needed to meet demand. But North Carolina, for example, can only accommodate 12% of patients who need it. The Commonwealth Fund says, “Nearly half of the people in the United States will have behavioral issues in their lifetime from a mood disorder to a substance abuse problem.” And 160 million Americans live in areas with mental health shortages.

You know the saying that when America gets a cold, our people get pneumonia? The lack of Black mental health professionals poses a significant risk to the wellness of our community. According to the National Alliance on Mental Illness, only 1 in 3 Black adults with mental health issues receive proper care.

Black patients seeking support are forced to face barriers regarding the accessibility of mental health services. Additionally, patients can become lost as they try to navigate the lack of representation, making it even more difficult for Black patients to find practitioners who can understand their unique experiences with cultural competence.

According to the American Psychology Association,  only 5.08% of U.S. psychologists were Black. In 2022, the Association of Black Psychologists (ABPSI) teamed up with the Black Psychiatrists of America and the National Association of Black Social Workers to create a Black Mental Health Workforce Survey. They found:

• 2% of psychiatrists are Black.
• 22% of social workers are Black.
• 7% of marriage and family counselors are Black.
• 11% of professional counselors are Black.

Those who participated in the study shared how this impacts us nationwide:

• 67% reported working in urban cities.
• 16% reported working in suburban locations.
• 6% reported working in rural locations.
• 9% reported that they work in other types of locations.

Economically distressed cities and rural areas have the most significant deficit in trained professionals. Other barriers to care include low reimbursement rates, lack of coverage by employers, and private health insurance programs. Then there are the challenges faced by those covered by Medicare and Medicaid to find providers, The Commonwealth Fund points out.

Black Health Matters spoke with two women on the front lines of this crisis. Arlene Edwards, MA, a Licensed Professional Counselor (LPC) and an International Certified Advanced Alcohol and Drug Counselor. (ICAADC), about the mental health care shortage. And Diane Prosper, an LP, discusses solutions for this systematic issue.

BHM: What impact does the lack of representation have on Black patients seeking mental health care?

Arlene Edwards: Many clients prefer to work with clinicians and mental health professionals who look like them, who they can relate to, and who they feel would advocate for them. The lack of representation of Black mental health professionals often results in individuals not seeking services, cycling through various professionals to find one whom they feel comfortable with, and a distrust of their treatment team, resulting in disengagement and premature discharge from services. In addition, clients may not be as forthcoming with their symptoms and mental health needs.

BHM: What health disparities are most apparent to you regarding mental health care for Black patients?

Arlene Edwards: I have noticed several disparities in the treatment of Black patients, including continued stigmatization around substance use and the use of Medicated Assisted Treatment. Withdrawal and post-acute withdrawal symptoms reported by Black patients tend to be minimized and overlooked, resulting in inadequate treatment and less favorable treatment outcomes.

Due to a lack of cultural competency and sensitivity, I have observed Black patients being committed to psychiatric treatment at a disproportion rate compared to non-black patients, misdiagnoses due to inadequate evaluations, and ineffective medication due to patients’ inability to self-advocate and a lack of mental health professionals advocating for their needs.

BHM: How can we address the underrepresentation of Black mental health professionals in the field?

Diane Prosper: I would say by promoting the field more and presenting the notion that there are options other than being a therapist or counselor who does one-on-one therapy. There are so many avenues that a mental health professional can take. The more we know about the options, the more we can broaden our scope.

BHM: What motivated you to pursue a career in mental health?

Diane Prosper: I was motivated by my culture. I have a Caribbean background, so mental health typically is not addressed. I wanted to show others of the Caribbean diaspora that there are professionals who understand their struggle, their values, and motivations. It is a different kind of relating that can help build rapport and distribute information and tools.

There is a critical need for more Black mental health professionals nationwide; mental health care must be more diverse and equitable. Black patients need the opportunity to find a practitioner that makes them feel safe, supported, and free to be vulnerable regarding their experiences. We hope that soon, our community can receive the care it deserves.