The Digital Issue

Marginalized Mental Health Matters: What Experts Want You to Know

In a welcome change of behavior and social progress, individuals are now more willing to promote mental health in the same way that physical health has long been prioritized. Despite this advancement, society still has a long way to go regarding the discourse on how oppression impacts mental health. Thankfully, BIPOC experts personally understand the harmful psychological effects of white supremacy, which informs their work as doctors, counselors, and therapists.

Seven professionals from across the US sat down with Verywell Mind to share insights about how they are improving the mental health discourse to better address the needs of marginalized groups. Their therapeutic approaches are largely influenced by their lived experience surviving such oppression as white supremacy, anti-Blackness, sexism, ageism, ableism, poverty, homophobia, xenophobia, transphobia, etc. Here's what they had to say.

Brittany A. Johnson, LMHC

Licensed therapist, strategic consultant, and best-selling author, Brittany A. Johnson, LMHC, says, "As a Black woman and a high achiever who has spent most of my career in predominantly white spaces, I was often told I was too much for them and not enough for Black people. I also see how family and friends who are Black and queer, fat, etc. are treated negatively, which has increased my ability to empathize with any client who comes into my office. Seeing and experiencing the different intersections pushed me to create a protocol to treat racial trauma in high achievers."

Johnson reflects that the first time she saw a Black woman who had similar experiences was later in her career at a conference, who spoke about her experiences "being in a category of one for most of her career," which prompted and pushed her to learn more so that she could open doors for other clinicians who had similar experiences.

"Using the Racial Trauma protocol has allowed my clients to discuss, process, and heal from past experiences. Part of the work teaches clients how to live, work and thrive in spaces where they are the only one," she says.

Ariel Landrum, MA, LMFT

Ariel Landrum, MA, LMFT, licensed marriage and family therapist, and certified art therapist at Guidance Teletherapy, says, "As a member of the AAPI community, my experience of oppression is subtle, because people treat me with the model minority myth in mind."

Ariel Landrum, MA, LMFT

Viewing me in this [model minority] myth caused me to internalize the message that I should be able to perform certain skills at a level that I wasn't able to.

— Ariel Landrum, MA, LMFT

Landrum explains, "A model minority myth creates a stereotypical narrative that individuals of my community are polite, law-abiding, high-level achievers, that do not create disruptions and do not attempt to actualize themselves through leadership positions. Viewing me in this myth caused me to internalize the message that I should be able to perform certain skills at a level that I wasn't able to."

Landrum explains how she grew up overcoming a learning disability around visual processing and reading comprehension known as hyperlexia III, but the model minority myth had rendered her learning disorder invisible.

"The assumption was that I was not motivated enough to reach my full potential and not that I had something organic to overcome. Sharpening my listening comprehension skills has been a saving grace, as my career involves listening to others, but a system designed to support me in learning had oppressed me by refusing to see my disorder as real, and believing their own assumptions about my ethnic and racial background," she says.

Lydia X.Z. Brown, Esq.

Disability justice advocate, organizer, educator, attorney, strategist, and writer, Lydia X.Z. Brown, Esq., says, "It is a lot when I am teaching as an openly marginalized person, and students feel that we are the only safe people to talk to, so they spill all their traumas on us. We care so we are empathetic and validating, but they also need a marginalized therapist." In this way, Brown explains how there are fewer marginalized people working in fields like therapy, especially in academia, and are unlikely to offer a sliding scale, so it can be difficult to find a therapist who understands their experiences of oppression.

Brown says, "Intense stigma can be attached to seeking therapy as if it means that you are broken in a way that people do not want to conceive of themselves as being. There can also be the perception that doing therapy means functionally accepting the colonizer's view, which is not necessarily true, but it can be a barrier." While Brown acknowledges that there are plenty of therapists who operate in an inherently white-supremacist manner, they clarify that there can still be resistance to engaging if individuals associate therapy with acceptance of a settler-colonialist perspective.

Lydia X.Z. Brown

There can also be the perception that doing therapy means functionally accepting the colonizer's view, which is not necessarily true, but it can be a barrier.

— Lydia X.Z. Brown

Furthermore, Brown illuminates how mental health and disability are often only viewed through a very specific privileged lens, based on the framework developed by Talila A. Lewis, who calls very direct attention to the problem of a colonized, white supremacist perspective. Brown explains how there can be an underlying assumption that there is a bigger stigma in communities of color, which is not necessarily true, although it may apply to a particular family or smaller community, but clarify that the way that these topics are discussed is simply different, which can pose an additional barrier to accessing mental health support.

What is psychology

Verywell / Bailey Mariner

Brown says, "Mental health and disability have always been part of our experiences, especially because of the impact of colonialism and trauma, so we may say that 'someone is not feeling well' or 'going through it' or 'really needed time off.'" It is why Brown practices from an explicitly anti-racist and BIPOC-centric perspective, as any understanding that does not take white supremacy into consideration is going to lead to failure.

Unfortunately, many mental health professionals are not remotely mindful of the impact of historic and current oppression on people's lives, which cannot exist in a vacuum, nor has it ever.

Despite their marginalization, Brown highlights that they also hold a number of privileged and resourced experiences as an East Asian person of color who works in an academic position. They highlighted how even an adjunct faculty role at a university comes with substantial class privilege. "Understanding these nuances has really shaped how I approach my work, as I have an imperative to uplift and amplify the experiences and demands of more marginalized individuals in the communities that I belong to, and redistribute and return resources when I have access to institutional privilege," says Brown.

Sabrina Sarro, LMSW, C-DBT, CTP

Clinical social worker and therapist, Sabrina Sarro, LMSW, C-DBT, CTP (they/them) says, "I identify as a chronically ill person. This not only affects my mental health, but being someone that experiences auto-immune disorders, I am constantly paving a way to receive equity in my occupation, in my health care, and in my peer circles. On top of already being Black, queer, and trans, these identities are undoubtedly linked to my mental health and how the world quite literally makes it difficult for me to remain alive and thriving."

Sabrina Sarro, LMSW

We cannot talk about our emotional bodies without contextualizing the identities that inform them.

— Sabrina Sarro, LMSW

Sarro reflects on their first experience with an OB-GYN appointment as a young child as when they first knew acutely that they were being mistreated and mishandled, due to the perception of their gender and their Blackness, as their intuition let them know that something was deeply amiss. "That experience was harrowing. I knew then that I would need to advocate for myself harder because no one was going to do it on my behalf," they say.

In their practice, Sarro highlights how many patients share how incredible it is to finally be able to cultivate sacred space with a provider that can relate to them on an identity level, as every facet of your identity can impact mental health. "This changes things at a molecular level and allows for witnessing to happen on a cosmic level. We cannot talk about our emotional bodies without contextualizing the identities that inform them," they say. 

Howard Pratt, DO

Behavioral health medical director at Community Health of South Florida, Inc., psychiatrist Howard Pratt, DO, says, “Racial and economic disparities have blighted the ability to not only function but at times to just exist. Any person that has to reconcile this moral injury will have their mental health burdened. As a physician and a Black man, I have been in hospitals where I have worked for a significant period of time in my white coat, and once I remove it, I have often been immediately associated with the custodial staff, including in the eyes of other physicians I have worked with."

Given the assumptions made of him, Dr. Pratt illuminates why he takes diagnoses with a grain of salt, as marginalized groups are more subject to misdiagnoses and inappropriate treatment. He shared the most obvious example of that in his opinion, which was a five-year-old that he encountered who had been misdiagnosed with conduct disorder, which is often termed antisocial disorder as an adult and carries negative associations.

"When somebody misdiagnosed that five-year-old, they were writing their future off and suggesting this was a person likely to grow up to commit crimes, but what really happened to this patient is that they lost both of their parents and were severely depressed as a result," he says.

Renato (Rainier) M. Liboro, PhD

Assistant professor of psychology at the University of Nevada, Las Vegas, Renato (Rainier) M. Liboro, PhD, agrees, as he says, "I am both a racial and a sexual minority who immigrated to North America as an older adult. In addition to this, I am also a highly educated person with considerable familiarity with North American culture, fluency in the (American) English language, and training and work experiences as a healthcare practitioner and clinician. All these intersecting aspects of my identity as an individual have impacted and helped shape my personal experiences, life decisions, and ongoing work as a researcher, educator, and scholar."

As an older, racial, and sexual minority immigrant, Liboro understands the challenges that can come with ageism, racism, heterosexism, homophobia, xenophobia, etc. "This personal knowledge and my experiences of oppression are collectively referred to by scholars as my epistemic privilege; a privilege that informs my work in a profound way that another scholar without these aspects of my identity will not (and never) have. However, apart from my epistemic privilege, I also have an epistemic responsibility to conduct work, whether as a researcher, educator, or scholar, in a manner that gives justice to my epistemic privilege," he says.

Juliette McClendon, PhD

Mental health equity research, psychologist, and director of medical affairs at Big Health, Juliette McClendon, PhD, says, "As a Black queer woman, I grew up in predominantly white educational spaces—from elementary school to post-doctoral studies—and thus, my experiences with oppression have occurred throughout my entire life. In my professional life, I have worked in settings where I felt like an outsider. These experiences had a huge impact on my mental health, but I often hesitate to share them because I fear they may seem minor to some. However, this is what oppression often looks like—especially for professionals of color."

McClendon explains that small subtle insults, exclusion, and comments are easily explained away as something other than "racism" or "sexism" when she is certain that it is the reality of her experience. She shared how often she has also been subject to gaslighting, as her experiences of oppression are questioned or pushed aside. "I have experienced exclusion and tokenization, such as being the only Black psychologist in a setting and being ignored until my work on racial disparities became a "hot topic." After which I have been paraded around as the "expert" while being asked to do additional, unpaid work," she says. 

drawing of women waiting in an office lobby with resumes

Verywell / Bailey Mariner

Despite the challenges that come with doing this work, McClendon acknowledges that her intersectional identities enable her to see the world from multiple viewpoints, so she understands that oppression is often occurring on multiple levels and in multiple ways to one individual. "Because of this, I am able to be a validating presence for my patients, colleagues, and friends. I also understand the dynamics of inter-group oppression (e.g., oppressing Black LGBTQ+ individuals within Black communities), which enables me to take a more nuanced look at all the various ways in which individuals can be oppressed," she says.

Juliette McClendon, PhD

I have experienced exclusion and tokenization, such as being the only Black psychologist in a setting and being ignored until my work on racial disparities became a "hot topic.

— Juliette McClendon, PhD

In her work, McClendon's lived experience, along with her education enables her to effectively describe intersectional oppression to others, and to develop and refine strategies and tactics for addressing the harmful effects of oppression on mental health. "These experiences also have shaped how I view mental health problems—as consequences not just of internal genetics or thinking patterns—but also a consequence of the contexts within which people live, the resources they have access to, and other ways in which oppression extends to one's environment; and how contexts, relationships, traumas, cultural norms and expectations, and internalized oppression all intersect to shape mental health,” she says.

Although McClendon has only had a few role models that were Black queer women in psychology and equally scarce in tech, it has helped her to feel less alone in doing this work. "I have gotten feedback from dozens of my patients that working with someone who shares one or more of their oppressed identities is life-changing because they feel that finally, their provider will get it and can connect with them on a cultural level. Unfortunately, it’s common for marginalized identities to experience microaggressions in in-person therapy. If this does happen, it can deter people of color from seeking mental health support at all,” she says.

McClendon emphasizes that mental health provider pipelines need to be considered to create a more equitable system of care. While the option to work with someone who shares one or more of your identities is a privilege right now, McClendon believes that it is a basic human right. "Beyond in-person therapy, there are digital options that can reach communities of color in a more discrete, destigmatized, and consistent manner. Research has shown that 55% of patients prefer digital tools, but to reach and effectively support people of color, important solutions like digital therapeutics need to be built on the foundation of culturally sensitive frameworks and be clinically proven through research,” she says.  

Where Do We Go Next?

If these insights from BIPOC professionals have not yet been on your radar, it may be overwhelming to consider, but these takeaways can help:

  • Oppression can contribute to unique mental health challenges when marginalized in multiple ways, such as Asian and autistic and trans, or Black and poor, or Asian and immigrant and queer.
  • BIPOC communities are often assumed to have more stigma regarding mental illness, but when individuals seek support, they are more subject to misdiagnoses and inappropriate treatment.
  • BIPOC mental health professionals can be tokenized and gaslit at work, but their experience of oppression can inform responsive practices to meet the needs of their communities.