The phrase I hear most often when a new Black service users who log into my telehealth platform is: “I’m so glad I finally found you.”That relief, that exhale, says everything. For so many Black and Brown clients living and working in spaces that are more than 75% white, finding a therapist who gets it feels almost impossible. It feels like a miracle.

The Needle in the Haystack

Let’s be real: the numbers tell a story.

Between 2019 and 2020, the percentage of adults reporting symptoms of anxiety and depression jumped from 11% to about 40% (U.S. Census Household Pulse Survey). Meanwhile, according to Mental Health America’s 2023 report, there are 350 people for every one mental health provider.

And when you zoom in on racial representation, the gaps are glaring. Out of roughly 720,000 social workers in the U.S., only:

• 17% are Black or African American
• 11% are Hispanic/Latino
• 3% are Asian
• 65% are White

At the same time, nearly 4.8 million Black people reported living with a mental illness (SAMSHA, 2018). That means there simply aren’t enough of us to meet the need.

By the time Black consumer land on my schedule, they’ve often been through a draining search: asking friends and family, scrolling through directories, contacting local organizations, reading provider bios line by line—only to come up empty. Finding a Black therapist in these spaces really does feel like searching for a needle in a haystack.

Cultural Mistrust Is Real

Layered on top of the shortage is something we don’t talk about enough: cultural mistrust.

In a nation where polarization over race, gender, reproductive rights, and equity is sharper than ever, many Black clients walk into therapy carrying the weight of past harm from institutions and providers. We can’t ignore the history: discrimination, inequities in treatment, and even medical experimentation.

As NAMI points out, provider bias—whether conscious or unconscious—can lead to misdiagnosis and inadequate treatment. So it’s no surprise that many BIPOC clients want racial and cultural representation in therapy. It’s not just about comfort—it’s about safety.

Representation as Health and Safety

Here’s the truth: discrimination, exclusion, and racial isolation don’t just hurt feelings. They impact the body. They’re linked to higher rates of heart disease, diabetes, depression, anxiety, and substance use.

When clients see themselves reflected in their therapist, something shifts. They feel belonging. They feel safety. And neuroscience shows us that social exclusion lights up the brain the same way physical pain does. That’s why representation isn’t optional—it’s health, it’s safety, it’s healing.

Being a Good Fit

Representation matters, but it’s not everything.

Being the right fit for people seeking services means more than having a shared lived experience. It means showing up with cultural humility, reliability, compassion, and nonjudgment. It means committing to ongoing training, to practices rooted in anti-oppression, and to inclusivity that honors intersecting identities—Black, woman, Muslim, immigrant, neurodivergent, queer, and beyond.

Clients want more than a therapist who looks like them. They want one who sees them.

Increasing Our Visibility

One reason the gap feels so wide is that too often, we’re simply not visible. And if clients can’t find us, we can’t help them.

Mental Health America reports that more than half of adults with a mental illness—28 million people—received no treatment. Visibility matters.

Here are some ways we can bridge the gap right now:

1. Share clear descriptions of the communities you serve—including intersecting identities.
2. Show up on social media.
3. Participate in local panels and discussions.
4. Facilitate community workshops.
5. Write articles (like this one).
6. Be a guest on podcasts.

Every touchpoint helps someone say, “Finally, I found you.”

Providing Culturally Attuned Care

Culturally attuned care extends beyond awareness—it involves actively tailoring treatment to cultural values, practices, and beliefs. It’s about asking the right questions, making space for spiritual or indigenous practices, and recognizing the role race, gender, and culture play in someone’s mental wellness.

Clients come to me not just because of my clinical expertise, but because of my social location—my race, gender, cultural affiliation, and my commitment to anti-oppressive, holistic practices like hypnotherapy and body-based healing. My assessment forms even include questions about cultural and spiritual practices, because that’s part of who my clients are.

When clients choose me, they’re choosing a therapist, coach or hypnotist who doesn’t just accept their whole identity—I celebrate it.

Representation and visability saves lives.  For so many Black consumers of services navigating predominantly white spaces, finally finding a therapist who understands their world is the first step to healing.