Opening the Door

How stigma prevents Black people from accessing mental health services.

Posted Dec 05, 2020

John Amachaab/Unsplash
Source: John Amachaab/Unsplash

"Yo, Steve, don't you realize the counseling industry is designed to create consumers? Some people are too smart to fall for it," said Jay. “Who pays someone to listen to them, anyways?” he forcefully continues without allowing me to speak.

I felt frustrated, dismissed, and defeated as my good friend rejected my pleas for him to seek help. Beyond this, I felt hopeless; it was as if Jay was deteriorating before my eyes and I could do nothing but watch.

I have known Jay for two decades. He is confident, charming, and charismatic with exceptional communication skills. He has what is referred to as "swag" in certain African American communities. If you do not know him well, it is hard to see that he is in the early stages of what appears to be psychosis. However, for the people he is close to, Jay is clearly losing touch with reality.

The first unusual thing I noticed was Jay’s reference to having an “out-of-body experience.” This came with a habit of looking deeply into normal occurrences that most people would ignore. Numbers had symbolic meanings and random objects were viewed as good or evil. I recall an instance of him comparing himself to Jesus, and another of him screaming, “All of you will be saved,” at the top of his lungs.

Though alarming, I did not probe too much. I understand that different cultures have their own religious and spiritual beliefs. I have known Jay to be moderately religious, but not to this extent. What happened in the weeks that followed cemented my view on his concerning behavior.

He began scribbling incoherent notes on how to become a millionaire on the back of my business cards (meanwhile being unemployed and having no source of income). He also started referring to me as “Sensei” and “Goku” (a fictional Anime character). Though flattering, I knew this was not like him.

In addition to his behavior, I noticed his pressured speech, as if he could not get all his thoughts out. He started neglecting his hygiene and sleeping either too much or too little.

When I shared my observations, he angrily urged me to stop repeating what I learned in “psychology textbooks.” When I mentioned how I felt, he reprimanded me for being “soft.” Both logic and emotions failed. I found that remaining silent was the only way to avoid agitating him.

"Oh, don’t worry, he's always been that way," friends replied dismissively. I have also heard the popular, “He doesn’t need counseling. He just needs more motivation,” as if sending him to a Tony Robbins seminar would be the appropriate solution.

For people of color—especially Black people—there are a plethora of negative feelings that arise whenever mental health treatment is discussed. Further, studies have shown that Black people expect life to be difficult (Thompson, Bazile, & Akbar, 2004), which may prevent them from seeking services. Other studies, over the course of history, have highlighted that Black people have a tough time trusting mental health professionals due to systemic mistreatment (Chandler, 2019).

As a Black male clinician, and concerned friend, I have felt conflicted about potentially coercing Jay into treatment. I acknowledge that symptoms—such as psychosis—have a chance of being ameliorated if caught early. However, Jay is adamant in his refusal. Meanwhile, his condition worsens daily.

We all know a person like Jay in our lives or may have suffered from similar experiences ourselves. We, too, should feel comfortable seeking the help that is available. It is unfortunate that we allow the stigma of mental health to act as a barrier to living our most happy, healthy, and rewarding lives.

Tim Mossholder/Unsplash
Source: Tim Mossholder/Unsplash

Moving forward we need to think about how our myopic view of mental health negatively impacts people’s attitude towards accessing help. At the end of the day, we are not in this industry to create consumers but to heal and transform lives.

LinkedIn Image Credit: Daniel M Ernst/Shutterstock


Thompson, V. L. S., Bazile, A., & Akbar, M. (2004). African Americans’ perceptions of psychotherapy and psychotherapists. Professional Psychology: Research & Practice, 35, 19–26.

Chandler, Q. S. (2019). The negative stereotypes about mental health, and African American College students’ willingness to seek counseling. Global Journal of Psychology Research: New Trends and Issues, 9(2), 32-42.