“Depression” was not a word Sally Yue Lin ever learned in Mandarin.
There were euphemisms for things like anxiety, abuse or trauma, but Lin, 28, never thought about seeing a therapist.
She saw her first one at the age of 20, when she was living in Montreal with roommates.
“The therapist I saw was an older, white woman who gave me pamphlets on breathing exercises; there was no follow-up and I felt even more isolated and misunderstood.”
Lin spent years trying to find a therapist who was a person of colour (POC). Like many, it was important for the now-Victoria, B.C., resident to find someone who she could trust, but also, and more importantly, someone who would be able to recognize some of her lived experiences.
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“My experience as a racialized Asian femme person made me more vulnerable to sexual violence and harassment,” she continued. “My Chinese culture and identity as a diasporic person is both a treasure and a burden.”
To complicate matters, Lin was estranged from her father, which was simultaneously difficult and liberating. For her, respecting one’s elders was a common belief in her household, something one of her white male therapists didn’t understand.
“It is a very sensitive topic for me and brings up a lot of memories of domestic abuse and trauma,” she said. “Despite my reluctance, the therapist asked me to imagine that my dad was sitting next to me in the room.”
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It was the last time she saw that particular therapist.
“I wanted a therapist who was at least willing to acknowledge and learn, not… from me, their client, having to teach them,” she said. “I don’t need them to have the same experience, just the willingness to recognize my lived experience, my culture, and my heritage — both the good, the bad, and the grey.”
A mountain of hurdles
There are mountains of barriers for POC to find therapists of colour. Sometimes it’s about location; people like Lin who live in predominantly white Canadian cities have an especially hard time. Others have a hard time accessing therapists or paying for it.
Sometimes there are language barriers for immigrants who don’t speak English as their first language, so it can even be difficult to describe what you’re going through in your mother tongue.
For some, conversations around depression, anxiety or abuse don’t happen in the households, and the thought of telling a stranger can seem overwhelming. Some POC also fear that if they tell someone in their community their most personal traumas, it may somehow get back to their family members or friends.
There’s a larger problem within the profession itself with a lack of representation of POC — whether it’s in counselling, psychological or social services, said psychologist and educator Dr. Jeffrey Ansloos of the University of Toronto.
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Stigma and stereotypes follow people who pursue psychotherapy in the first place, and the added weight of being a POC contributes to the difficulty.
In his work with the Indigenous community, Ansloos is a firm believer that therapy is often rooted in most communities of colour, but it doesn’t look like what we typically picture as “therapy.”
“It may not all look like psychotherapy, but I think there are natural helping roles that exist within every culture,” Ansloos explained. “We can do a lot even on the level of promoting mental health by really supporting diverse communities in elevating the value of these different roles that people hold.”
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The end goal is to find a therapist you can connect with. For example, some young South Asian women may face greater pressure to get married, or Indigenous youth may experience inter-generational trauma or verbal abuse — these specific things impact mental health, and a therapist with the same experiences may be more understanding.
Ansloos said the good news is that POC’s perception of mental health and seeking help is shifting, and more want to openly discuss it.
The struggle to find one
But talking about it is hard when you can’t find a person to talk to. Sarp Kizir, 39, looked for a therapist of colour for nearly a decade. “I was checking names and last names. Sometimes I gave up and just went with whoever was available and accepting new clients,” he told Global News.
The Ottawa native, who is a child of immigrants, often felt vulnerable when he had to explain his experiences to a therapist. Today, he works with one who is nurturing. “There are things that I don’t feel pressured to over-explain because she just gets it.”
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Emile Wickham, 32, of Markham, Ont., is still searching for a black therapist. In and out of therapy for 10 years, all of his therapists have been non-black. Paying for therapy has been his biggest hurdle.
“Even with that rate, I’ve been on and off for long periods because I simply couldn’t afford it.”
Jason Ip, 30, was looking for a queer POC therapist, and even in a city like Toronto, he found one person through a friend who fit the criteria. Today, he sees a white therapist who he feels comfortable with.
Credit: Getty Images
“I speak to him about my lived experience, he listens and empathizes, which is the best I can ask for, given the restrictions I had when I was originally doing my search.”
And even when POC find therapists who fit their needs, it’s often expensive or hard to schedule an appointment. Navi Gill of Vancouver tells Global News private practices range from $100 to $300 an hour, and psychologists in the past told her their practices were incredibly busy.
“There is a big shortage of Punjabi-speaking therapists out there.” She said South Asians in B.C. often turn to more community-based groups like the South Asian Mental Health Alliance and sometimes Gurdwaras (temples).
Tackling the problems
These are all struggles and loopholes that therapist Premala Matthen is familiar with. As a queer therapist of colour in Vancouver, she said clients often come to her seeking POC. She said there’s a larger problem of racism not being understood as a traumatic experience.
“When I went through counselling school, there was a little bit on multiculturalism, but not nearly enough,” she said. “I’ve had clients who tried to talk to white therapists about racism and not be understood or their experiences [were] minimized.”
Ansloos sees this problem within the educational system and added psychotherapy has predominately been developed by white mental-health experts and continues to be taught today. On top of this, there is an underrepresented number of POCs in graduate-level programs and this translates through a range of professions like social work, counselling and medicine.
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Professional training needs to more broadly reflect people’s lived experiences, beyond white culture, he said. “That means when we have conversations about family, mental illness, identity, religion, spirituality or culture, people need to see their life more fully in what’s being taught.”
There’s also merit to further educate POC who may have unconventional roles in mental health. For example, Ansloos worked on a study that showed conservative Muslim women from countries like Jordan or Iraq were going to midwives for mental health-life services. “Does it make more sense to train the midwives? We need to be thinking more creatively.”
There’s often the criticism that any therapist, white or a POC, should be able to sit and speak with a POC seeking guidance — often as a blank slate. But he argued there are still valid reasons for POC to want therapists of colour.
Solutions for POC seeking help
But change like this takes time and funding from bodies of government plays a huge role. Plenty of organizations across Canada are doing the groundwork to promote mental health and support in their communities and larger organizations like Mental Health Commission of Canada recognize diversity in therapy is needed.
But these are all larger picture solutions. Sometimes, the biggest struggle is an isolated POC in a small city who is desperately needing the support of someone who looks like them. These are often the people that can’t afford therapy or talk to others about their mental health. So how do they get help?
Credit: Getty Images
Ansloos said it starts with recognizing you’re not trying to find someone who is exactly like you (he argued this type of therapy won’t be effective), but someone you can trust. “Trust doesn’t require sameness, but a relationship.” And even if you see a therapist who is white or a POC, be honest with them about what you are looking for.
“I encourage clients to tell me about their expectations and their concerns of beginning therapy — make that part of the process.”
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He, along with Matthen, believe in the importance of POC speaking with other POC about their search. Share information about the therapists you find and for therapists of colour, create a reference list for other people in the community you can refer to. Ansloos said for clients, doing research through Psychology Today, colleges of social workers, therapists of psychologists and even more grassroots organizations is helpful.
Matthen said for people in more remote communities, plenty of therapists of colour offer sessions over video. Apps, forums or groups on social media can be beneficial (and less expensive). Sometimes, just speaking with family and friends is a start.
But both experts recognize finances are the biggest reason people don’t seek help and one of the main reasons therapy is so inaccessible to POC. Therapy can start at $80 and can shoot up to $250 depending on the profession. Many Canadians also have insurance that covers forms of therapy, but this is often limited.
Credit: Getty Images
Ansloos said for people on tight budgets, group therapy or low-fee clinics with trainees may be options. “But we need to be thinking more broadly. How do we integrate mental health practices in an everyday setting?” While he understands these options may not be available for all POCs, it’s the ongoing open conversations about mental health at places like work, school or home that need to continue.
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But for some, the wait is worth it. Today, Lin sees a therapist of colour who works with the LGBTQ+ community. “I always leave the session feeling supported, understood, seen, and like I have tangible steps forward towards improved mental health.”
Where to get help
If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help.
The Canadian Association for Suicide Prevention, Depression Hurts and Kids Help Phone 1-800-668-6868 all offer ways of getting help if you, or someone you know, may be suffering from mental health issues.
arti.patel@globalnews.ca