Mental Health Stigma Suicide

(Non-Pandemic Post) Racism in Mental HealthCare.

This has been digging at me for awhile. I collaborate with several therapists and prescribers of African American (also Jamaican and Haitian) descent.

There is one in particular who practices close to where I am located, and who is simply phenomenal. I refer practically everyone to her. She’s seasoned, she doesn’t get phased by high acuity, and she can take on complex families and cases, and she is always open to collaborate.

I’ve had more than one client come back to me after a couple sessions with her (often white parents of a white kid) who ask for another referral as they “don’t feel it’s the right fit.”

You can imagine my facial expression right now. It’s the one that smells and calls out bullshit.

I always pry to the Nth degree…exactly what is not the right fit? Yeah but exactly what didn’t go well for you/your child…I need to know precisely the issue because I don’t want the same issue to happen with the next person I refer you to. They usually smile because people tend to smile when they get uncomfortable. They squirm in their chairs, and make super vague statements about what went wrong.

I push until it is awkward to push any further.

I’ve then spoken to the therapist and we hash it out. We are comfortable enough with one another that she can say if she feels it is related to race or not and I agree or disagree. Most often I agree.

There was one case that the family just didn’t want to do therapy work. It was almost palpable relief to us both in that dialogue that there was one white family who wasn’t racist, just lazy. We laughed about it.

As I said, she is seasoned. I value her input and I value her clinical opinion. I don’t think I can put into words the enormous respect I have for her clinically. It’s hard to find good therapists. Especially forty years into a career when they can be burned out or a little crazy and not as invested in their clients. But she invests everything in her clients. I definitely have a top ten therapist list of who I would refer my own family members to. She’s on there. Probably at the very top.

To hear her question herself and her skills because of ignorant people who discontinue treatment abruptly because they are racist creates this anger and hurt that again is hard to put into words.

I’ve read “Me & White Supremacy” by Layla F Saad which helped me explore my own internalized racism and white privilege because I have Black clients who have made me do better and be better. Hearing experiences of African American women who have been abused and marginalized and ignored creates a space that cannot be ignored by any white person I would hope.

I’ve fired a client after they fired that therapist. One client admitted to me it was because of race. One client admitted to me it was because they didn’t feel they could benefit from treatment from a Black woman. I told them they likely then couldn’t benefit from treatment with a lesbian. So I’d provide them a referral and they could leave.

No one else has ever admitted to me that it was due to race. Though I have asked outright. I told her recently that I fired that person and she remembered them even though it was a few years ago. I didn’t tell her at the time. I didn’t know if it was right or wrong or what.

The older and more experience I gain the less tolerance I have for racism, hate, homophobia, bullshit.

It eats at me that a skilled clinician questions their skills because white people are ignorant.

I can’t apologize for other’s behaviors but I can ask white people to do better. Check your privilege at the door because there are plenty of brilliant Women of African American Descent who know so much more than you and who can support you and just do their jobs as clinicians. Skin color should not qualify a person to be or not be your therapist. That’s ridiculous.

I’ve lost clients because I’m out about being Queer. But I don’t wear it on my skin. I have it easier.

To all the clinicians of minority status whom I work with please know I’m challenging clients in my office. I’m not letting it go if they discontinue treatment abruptly and if they admit to discontinuing treatment due to the color of your skin I’m discharging them from care.

And Dear white people. Do Better.