New Study: Religious Counseling Underserves Suicidal Black Lesbians, Gays and Bisexuals

by Dr. Herukhuti

Black people don’t do therapy. It’s an often held belief rooted in reality. For many reasons, people of African descent consume mental health services from psychologists, psychiatrists and other psychotherapists at lower rates than white folks i.e., people of European descent.

Because we disproportionately experience greater levels of economic violence and inequality, we have less money to buy  mental health services. Mental health services are not subsidized by health insurance plans to the same degree as medical health services. As a consequence of  economic violence and the lack of funding subsidies, mental health services are a luxury we can not afford.

Despite the African roots of certain psychological traditions, paradigms and practices, the history of Western psychology and psychiatry contains reasons for our skepticism. Dr. Samuel R. Cartwright in the 19th century introduced the concept of drapetomania to pathologize the desire of African people to liberate themselves from the European chattel slavery system and dysaesthesia aethiopica to pathologize the resistance of African people held in the European chattel slavery system to work, which from the point of view of the Europeans who were exploiting their labor was an act of laziness.

The Eurocentric and white supremacist forces and tendencies of the fields of psychology and psychiatry are not so far removed from the contemporary moment. Dr. Jonathan Metzl in his book, The Protest Psychosis: How Schizophrenia Became a Black Disease, describes how mental health professionals in a hospital in 1960s used the schizophrenia diagnosis of people of African descent to express their anxieties regarding the latter’s hostility toward white supremacy and racial inequality i.e., you got to be crazy for wanting to equal rights under the law and challenging our power.

The spiritual and communal nature of our communities has also provided us with resources for sustaining mental health that we have held as valid since before Europeans brought us here in bondage or we emigrated here. Ironically, in an act of unexamined cultural appropriation and exploitation, some in the West are seeking to draw upon African wisdom to understand and respond to mental illness. So it is no wonder that we draw upon our religious, spiritual and communal resources to sustain and realign our mental health.

A new study of “388 LGB participants who were sampled between February 2004 and January 2005 from venues [including business establishments (e.g., bookstores, cafes), social groups, and outdoor areas (e.g, parks)] in New York City” by the Williams Institute found that lesbians, gays and bisexuals of African descent  (24%) were three times more likely to seek treatment from a religious or spiritual advisor before attempting suicide than lesbians, gays and bisexuals of European descent (8%) and nearly four times more likely than lesbians, gays and bisexuals who identified as Latino (7%). The study also found “that seeking treatment from a mental health or medical provider did not reduce the odds of a suicide attempt…. However, counseling from a religious or spiritual advisor was associated with worse outcomes. Compared with individuals who did not seek help at all, those who sought help from a religious or spiritual advisor were more likely later to attempt suicide.”

Dr. Ilan Meyer, the principal investigator of the study and first author of its article published in The Journal of Suicide and Life-Threatening Behavior, said, “More studies are needed to assess the efficacy of treatment for LGB people with suicidal ideation in preventing future suicide attempts. But, even without further study, public health officials and health service providers ought to ensure that LGB individuals who seek mental health treatment, whether it is in medical or religious settings, receive competent mental health services that is relevant to their needs.”

One critical flaw of the study is how it lumps all religious and spiritual traditions together and does not provide us with an understanding of what traditions they assessed and captured in the study. We don’t know what forms of religious and spiritual counseling the participants sought. We don’t know if the services were from traditions that are sex-positive, affirming of sexual diversity, Eurocentric, etc. But the study does invite us to look at the need for cultural competence training for religious, spiritual and pastoral advisors and counselors who knowingly or unknowingly provide services to lesbian, gay and bisexual people of African descent.