Black Gay Mens Experiences with Racism in Therapy: Implications for Social Work Practice and Research

Background:

Racism and discrimination negatively impact the mental health of LGBTQ and BIPOC communities. Intersectional research on this topic has been recognized as an area of growth and importance for social work practice and education. With the increased attention to racism and proliferation of research in this area by a similarly predominately White social work academy, centering the knowledge production by BIPOC scholars alongside BIPOC communities is key. This study was inspired by Black gay community members who wanted their stories to change and improve access to culturally affirming mental health care for their community. The goal of this study is to understand the experiences of Black gay men seeking mental health treatment and the impact of racism when engaging with a predominantly White mental health workforce, in order to inform changes to social work education, practice and policy.

Methods:

Four semi-structured in-depth qualitative interviews were conducted between March of 2020 and June of 2020, interviews lasted between 45-60 minutes. Interpretative Phenomenological Analysis (IPA) was the method utilized alongside purposive sampling to recruit a homogenous sample of (N=4) Black gay men (ages 25-35) from a large city in the Northeast. In recognition of the ethical implications of over researching a community with lack of access to culturally affirming mental health care, recruitment and interviews stopped after saturation of themes across 4 participants (accepted study size for IPA studies: 3-6 participants). MaxQDA was utilized to analyze the transcripts using the hermeneutic cycle to read and re-read interviews to understand the participant’s experience and interpretation of these incidences of racism. Emergent themes were identified for each participant and superordinate themes were found across participants.

Results:

The phenomenon of interest was the experience of racism within mental health for Black gay men. Participants identified the following superordinate themes and related examples: 1) Impact of racism in the mental health system: long wait times, settling for White therapists, putting in extra work to find a therapist of color; 2) Harms in therapy: therapist ignores their racists acts, and the complexity of holding how the therapist has helped and harmed them; and 3) Urgency need to address racism in this system.

Conclusions:

The perpetuation of racism in the therapeutic dyad is not uncommon, just not well published. The participants’ experiences and behavioral responses to the racism, highlight the undue burden needed to avoid and deal with racism in the mental health system. As social workers mandated to address racism and anti-Blackness, it is important to: 1) Value the expertise from the community 2) Challenge existing policies that exacerbate mental health disparities and 3) Develop and implement intentional training and policies interventions based on community feedback. Research must be utilized to inform and change how we train social workers to address racism within intersectional communities and how we discuss and present this research. Accountability and ongoing training for how social work practitioners engage with diverse communities must be prioritized while the field works to diversify the workforce and recenter knowledge production from the global majority.