As the end of the semester and exam week approaches, it brings with it a slew of new fears and anxieties for all students. Some are dealing with the stress of finals and studying while graduates look toward the future and their post-college careers. For everyone, it can be a difficult time for their mental and emotional wellbeing, and recommendations for how to approach this are everywhere, a very common one being to seek counseling or therapy.
However, much of the traditional treatment for mental distress and disorders may fall short for some or even be inaccessible. Those individuals in marginalized and minority communities, especially LGBTQ+ individuals and people of color, often face a more complicated and difficult battle to find effective counseling.
“I told the therapist that I can't make friends here with people from back home because I would have to hide my queerness around them," said Sam, a senior international student attending school in the U.S. "And I can't make American friends because they have zero understanding of my experience. The therapist didn’t give me any validation."
Sam, who chose not to disclose her real name or school for safety reasons, said that her attempts at seeking professional help were unsuccessful. During the pandemic, while struggling with loneliness and isolation, she saw multiple therapists looking for support.
However, she said the counselors she saw did not understand her cultural upbringing, and she would have to spend much of her sessions educating them about her background.
“It would take three to four sessions to explain to the therapist how different the way you were raised was from Westerners,” Sam said.
Neal Holmes, a licensed counselor and the current deputy director for OUTMemphis, said that it's important for counselors to take a patient's cultural and racial background into consideration when treating them.
He explained that, sometimes, clinical diagnoses can be symptomatic of deeper environmental and generational traumas. He also said that counselors shouldn't forget about external factors when discussing solutions.
“What if those behaviors you need to change are not your behaviors but the behaviors of those around you?” Holmes said.
Holmes himself often includes his patients' backgrounds when developing treatment plans. He said for Black patients in particular, there is a lot of stigma around mental health. A study in the journal Psychological Services found Black youth are less likely to seek out mental health services and receive treatment than their white peers.
“It’s changing, but there’s still a huge stigma about people of color engaging in mental health services,” Holmes said.
Religion can be one source of stigma for those who grew up in religious households. Holmes said some of his patients feel shame or guilt for seeking professional help outside of religion. In order to combat this, Holmes said he works with these patients to see how they can include their faith to help in a clinical setting.
However, ethnic and cultural barriers against accepting help can be a powerful deterrent.
“I delayed seeking psychiatric help or a therapist or even talking about my mental state with friends and family because of the cultural stigma surrounding it all," said Rin, a junior at Vanderbilt University.
Rin struggled with coming to terms with their queer identity and the acceptance of their Egyptian family.
"I was concerned with hiding it, whether I could ever come out and still be part of my family and community," they said. "It really took a toll on me."
After pursuing health services at their school, Rin was able to start seeing a therapist which they said helped them a bit. However, given that Rin is part of the LGBTQ+ community, they said their therapist is unable to fully bridge that gap with them. Rin is not alone. A study in the American Journal of Public Health found that more than twice as many LGBTQ+ individuals expressed dissatisfaction with mental health services as the control group.
For Rin and other members of marginalized communities, connecting with people who understand their own experiences and struggles can help provide extra support, whether that be in-person or online.
"My Twitter friends that are also queer and Egyptian, in a way we face the same problems," they said. "Just knowing they exist is very helpful."