Before George Floyd was killed in Minneapolis by police, the clients who came to the clinic Anissa Keyes runs on the city’s north side didn’t care if the clinician they saw was Black or white. But now, they do.
Keyes, who is an African American therapist, recently got a call from a potential new client looking for therapy for herself and her family, but also looking to support African American businesses. The woman, who was Black, expressed her desire for an African American therapist and asked if the clinic was Black-owned.
“I think this feels ... like ‘where can I feel safe?’” said Keyes, whose clinic can hardly keep up with demand in the aftermath of Floyd’s death. “The nation has showed me that as a Black person in this country, I'm not safe. So, I think the feeling of going into a therapy office with a white-bodied person might not really feel safe.”
Historically, many in the African American community have been hesitant to seek mental health care because of stigma, discrimination from some providers, and a lack of culturally competent care. But as more people are seeking mental health care to help them cope with grief and trauma after Floyd’s killing, they’re looking for therapists they can trust.
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In general, traditional therapy has not been the first answer in African American communities, said Willie Garrett, who heads the Minnesota Psychological Association.
“They tend to first talk to friends and family when they have an emotional issue then they’ll go to the church, maybe talk to their pastor then, and after all of that, then they’ll go to see a therapist,” said Garrett.
African Americans are often skeptical of mainstream mental health care, he added. Even as a clinician, Garrett said, he has faced racism. When he first started practicing, he said, white people would laugh when he went to retrieve them from the waiting room because they’d never heard of a Black psychologist.
When he was working on his master’s degree several decades ago, he said, the head of the clinical department called Garrett into his office to say that he wasn’t as qualified as other students, that he’d only been admitted because of affirmative action, and that he should really drop out. (Garrett ignored him. And he thinks things have gotten better since that time.)
There’s other discrimination, too, which is less blatant but no less insidious. African American men, for example, are often misdiagnosed with serious diseases like schizophrenia by white mental health care providers. And Garrett said he’s gotten countless referrals of young Black boys who have been diagnosed with attention deficit hyperactivity disorder, or ADHD; when Garrett administers an ADHD test, though, they rarely meet the criteria.
Garrett said Floyd’s killing was the last straw for a lot of people who are reacting to years — and generations — of racism and oppression.
“We’re talking about cumulative stress, cumulative anxiety, cumulative racism over the years, over the lifetime,” he said.
When a Black person goes to a Black mental health professional, he said, they often have a shared experience, cultural values and, even, social cues.
But there is a critical shortage of Black mental health professionals — both in Minnesota and nationally. A 2014 survey from the Minnesota Department of Health reported that 95 percent of mental health professionals in the state are white; just over 2 percent are Black.
While Keyes’ north Minneapolis clinic is bustling these days, just a few months ago, it was reeling from the economic fallout of the pandemic. The spread of COVID-19 forced the closure of Minnesota schools, where her clinic did a lot of work. Those sessions disappeared, and she lost nearly half her business.
The lack of Black mental health care providers means some white professionals who serve Black clients are trying to figure out how to connect in ways that are culturally sensitive.
Michelle Sherman, who is white, is a psychologist at the University of Minnesota and works in a family medicine clinic in north Minneapolis. She’s not sure how many people decide not to see her because she’s white. She also offers to refer clients to a Black therapist if they prefer.
Working with military veterans helped her learn humility in her practice, something she uses now with her clients, who are mostly African American.
“There was, ‘Well, doc, you don’t understand, you’ve never been there,’” she said her veteran clients would tell her. “And similar ideas, ‘You’ve never grown up in north Minneapolis or had some of the experiences we’ve had.’ And I very transparently say, ‘That’s right.’”