Breaking Barriers: Why BIPOC Communities Struggle to Access Mental Health Care—and How We Can Change That

By Tim Scudder

Mental health is a universal human experience, yet the journey to seeking help is far from equal. For many Black, Indigenous, and People of Color (BIPOC) in the United States, systemic barriers, cultural stigma, and historical trauma create a complex web of challenges that make accessing mental health care daunting. As a BIPOC mental health therapist, I want to shed light on these barriers, explore their roots, and offer culturally sensitive ways to address mental health concerns in today’s climate.

The Numbers Tell a Story: Mental Health Disparities Across Cultures

Mental health struggles are widespread, but prevalence and access differ sharply between minority and majority populations:

• Nearly 1 in 5 adults in the U.S. experience mental illness annually (NIMH). (National Institute of Mental Health, 2021).

• Among BIPOC communities:

  • Black adults report similar rates of mental illness as White adults but are less likely to receive treatment—only about 33% of Black adults with mental illness receive care, compared to 48% of White adults.

  • Latinx individuals experience depression at comparable rates but face language barriers and lower insurance coverage.

  • Indigenous populations have some of the highest suicide rates among all racial groups, particularly among youth (rtor.org).

  • Asian Americans often report lower rates of mental illness, but this is partly due to underreporting and cultural stigma.

Historical Roots of Distrust: Why Many Communities Hesitate to Look for Therapy

Distrust in the healthcare system among BIPOC communities is not imagined—it is earned through centuries of exploitation and neglect.

Here are some examples:

• The Tuskegee Syphilis Study (1932–1972): For 40 years, Black men with syphilis were misled and denied treatment so researchers could study the disease’s progression. This violation of ethics left deep scars and fostered generational mistrust of medical institutions. (Washington, 2006).

• The Myth of Black Women’s “Pain Tolerance”: Historically, Black women were falsely believed to feel less pain than White women. This led to inadequate pain management and continues to influence disparities in maternal health and emergency care today. (Hoffman et al., 2016).

• Grave Robbing for Medical Study: In the 19th and early 20th centuries, bodies of Black individuals and Indigenous people were often stolen from graves for dissection and research without consent. This dehumanizing practice reinforced the perception that BIPOC lives were disposable. (Lawrence, 2000).

• Native American communities endured forced sterilizations and unethical medical experiments well into the 20th century. (Lawrence, 2000).

• Latinx farmworkers were historically exposed to harmful pesticides without adequate health protections, fostering mistrust of health authorities. (Holmes, 2013).

• Asian immigrants faced discriminatory health screenings and quarantines during immigration waves, reinforcing stigma and fear of medical systems. (Shah, 2001).

• Although these examples are medical and do not fall under the umbrella of mental health, the deep erosion of trust in institutional authority still shapes how these communities view mental health care today. 

Cultural Expressions of Mental Health: Why Symptoms Go Unrecognized (Message to BIPOC Readers)

If you’ve ever felt “off” but couldn’t name it, you’re not alone. Mental health symptoms often look different across cultures, and Western medicine doesn’t always recognize these variations. Here’s what that means for you:

• Depression May Not Feel Like Sadness: In Latinx communities, depression often shows up as physical symptoms—headaches, stomach pain, fatigue—rather than expressing “sadness” (psychologytoday.com).

• Anger Can Mask Pain: In Black communities, anger or irritability may actually be signs of depression. If you feel constantly on edge, exhausted, or hopeless, it’s worth exploring (psycix.com).

• Withdrawal Isn’t Always Laziness: In collectivist cultures like Asian or Indigenous communities, pulling away from family or overcommitting to obligations can signal distress (wjarr.com).

What You Can Do:

• If you notice these patterns, write down what you feel and how it affects your daily life—even if it doesn’t sound like “depression” or “anxiety.”

• When speaking to a provider, use clear examples: “I’ve been having headaches every day and can’t sleep. I feel angry all the time.” This helps providers understand the full picture.

Culturally Significant Ways to Talk About Mental Health

For Mental Health Providers

• Use Community-Centered Language: Frame mental health as “wellness” or “balance” rather than clinical terms (damorementalhealth.com).

• Incorporate Spirituality: Collaborate with faith leaders or integrate spiritual practices like prayer or meditation (resilient-mind.com).

• Normalize Collective Healing: Offer group therapy, community circles, and storytelling sessions that align with cultural traditions (resilient-mind.com).

For BIPOC Community Members: How to Advocate for Yourself

• Ask for Culturally Competent Care: It’s okay to request a therapist who understands your cultural background or speaks your language (mentalwellnesscenter.org).

• Bring Your Own Language: If “mental health” feels foreign, use words like “stress,” “balance,” or “well-being.”

• Know Your Rights: You have the right to ask questions, seek second opinions, and refuse treatment that doesn’t feel right.

• Leverage Community Resources: Support groups, cultural organizations, and faith communities can help bridge gaps in care (theprojectheal.org).

Addressing Anger and Social Injustice in Today’s Climate

The current political climate—marked by racial violence, immigration debates, and systemic inequities—fuels anger and fear. These emotions are valid, but they need healthy outlets:

• Therapeutic Activism: Channel anger into advocacy, art, or community organizing.

• Safe Spaces for Dialogue: Seek therapy environments where discussing racism and discrimination is encouraged (groundedconnectionscounseling.com).

• Mind-Body Practices: Yoga, breathwork, and mindfulness can help regulate the nervous system, especially for those living in constant vigilance.

Moving Forward: Building Trust and Access

To dismantle barriers, we need systemic change and cultural humility:

• Increase Representation: More BIPOC therapists mean more culturally competent care.

• Affordable and Accessible Services: Sliding-scale fees, telehealth options, and community-based clinics can bridge gaps.

• Education and Advocacy: Normalize mental health conversations in schools, workplaces, and faith communities (mentalwellnesscenter.org).

Seeking mental health care is an act of courage, but it is also a basic right. For BIPOC communities, the journey is layered with historical trauma, cultural stigma, and systemic inequities. But by acknowledging these barriers and embracing culturally informed approaches, we can create pathways to healing that honor identity and lived experience.

References

Damore Mental Health. (n.d.). Damore Mental Health resources. https://damorementalhealth.com

Grounded Connections Counseling. (n.d.). Advocacy and mental health. https://www.groundedconnectionscounseling.com

Hoffman, K. M., Trawalter, S., Axt, J. R., & Oliver, M. N. (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between Blacks and Whites. Proceedings of the National Academy of Sciences, 113(16), 4296-4301. https://doi.org/10.1073/pnas.1516047113

Holmes, S. M. (2013). Fresh fruit, broken bodies: Migrant farmworkers in the United States. University of California Press.

Lawrence, C. R. (2000). The origins and legacy of grave robbing in America. Journal of Medical Ethics, 26(1), 1-6.

Mental Wellness Center. (n.d.). Mental health advocacy. https://mentalwellnesscenter.org

National Institute of Mental Health. (2021). Mental illness. https://www.nimh.nih.gov/health/statistics/mental-illness

Project Heal. (n.d.). Community mental health resources. https://www.theprojectheal.org

Psychology Today. (n.d.). Mental health articles. https://www.psychologytoday.com

Psycix. (n.d.). Mental health insights. https://www.psycix.com

Resilient Mind. (n.d.). Mental health strategies. https://resilient-mind.com

RTOR. (n.d.). Resources to Recover. https://rtor.org

Shah, N. (2001). Contagious divides: Epidemics and race in San Francisco’s Chinatown. University of California Press.

Washington, H. A. (2006). Medical apartheid: The dark history of medical experimentation on Black Americans from colonial times to the present. Doubleday.

WJARR. (n.d.). Cultural mental health research. https://wjarr.co