How Your Race and Class Make It More (or Less) Likely to Find a Therapist


If you're a person of color or in the working class and have tried to find a psychotherapist, chances are you had a much harder time reaching one than an upper middle class, white person would have. At least that was the conclusion of one study from the Journal of Health and Social Behavior,

"She found 28 percent of white, middle-class callers were called back and offered any appointment, compared to just 17 percent of African-American, middle-class callers. Only eight percent of the working-class callers of either race were offered an appointment. When therapists offered appointments in the ideal time slot—weekday evenings—the wealthier, white callers prevailed once again.

Kugelmass also found subtle differences by gender, with the odds largely stacked against black men. If her experiment were to play out in the real world, an identifiably black, working-class man would have to call 80 therapists before he was offered a weekday evening appointment. A middle-class white woman would only have to call five."

If I were to be completely honest, none of this surprises me. I see the subtle discriminations in the way therapists talk about their business and clients. The notion of getting "high-paying" clients to fill slots so that they can make more is a conversation I hear all the time among therapists in private practice. In one respect, I understand it. Everyone wants to make a good living. At least that's what capitalism tells us. 

Of course, higher rates means higher socioeconomic class, which in New York City and most of America usually means white. It's all coded language, not that different than how white liberal parents discuss school desegregation. And if many of these therapists were to be honest, they'd admit that they self-select clients based on the voicemail greeting they receive from there the potential patient.

It's rather unfortunate because as the above article points out, lack of mental health services is a real problem in the United States. And that means that many working class people and people of color are not getting the help that they need, while more well-off whites are. 

What surprised me more is when I sent this article to a bunch of therapists who were mostly white, liberal and thoughtful people. There was a lot of resistance to the findings of the study. Many thought that the article overblew the impact of discrimination or got defensive and said they were inclusive or had to make a living. 

That defensiveness surprised. And it tells me that discrimination is an incredibly hard thing to parse out.  Like the oxygen we breathe, it's just a part of the fabric of American society. And to face it means to face your complicity in it.