Last year’s pandemic, recession and racial strife pushed more people to see therapists, though fewer people of color sought treatment than their white counterparts. Cost, social norms and a lack of nonwhite therapists tempered demand, though there are efforts to overcome those barriers—efforts that are increasingly important amid a crisis that’s taking an especially enormous toll on people of color.

People of color are dying from COVID-19 at a higher percentage than white individuals, says the Centers for Disease Control and Prevention. They also have higher pandemic unemployment rates, according to the U.S. Bureau of Labor Statistics.

In addition to the pandemic, the Black community last year endured the high-profile killing of George Floyd while in police custody and the fatal shooting of Breonna Taylor by police during a botched raid at her apartment. Meanwhile, some Asian-Americans were harassed by those who blamed them for the public health crisis, as former President Donald Trump and others called COVID-19 “the China flu,” a reference to Wuhan, China, where the coronavirus infection was first identified.

Experts say the reluctance of people of color to seek professional help to address their mental health issues is a long-standing problem. Only one-third of Black Americans endeavor to get the mental health care they need, according to the American Psychological Association (APA), a Washington, D.C.-based professional and scientific organization.

“Traditional counseling is a Western European construction, and how it is applied to people of color can be inappropriate,” says Derald Wing Sue, a professor of psychology and education at New York City-based Teachers College, Columbia University. He notes that most approaches to therapy were developed by white European men decades ago.

“Many white therapists unknowingly commit microaggressions,” Sue says. “A number of them make the client feel like they are misunderstood.”

Mental health care also carries a stigma among many people of color. “The sense of shame is humongous,” says Eric Coly, founder and CEO of Los Angeles-based Ayana Therapy, which created an app that matches clients and therapists based on factors such as race and ethnicity. That aversion to mental health care is common in various communities of color despite other differences, according to Coly.

Many white therapists may not appreciate cultural variations. For example, Sue says Latino and Asian individuals highly value family bonds and will seek relatives’ advice when confronting problems. He adds that white therapists who don’t understand such relationships may view their patients as weak or immature. “If that is communicated to a client of color, they may leave counseling feeling worse off,” he says.

Some research has shown that patients of color prefer and benefit more from therapists of the same ethnic or racial background. “In general, a therapist of color is more likely to understand a patient of color,” Sue says, adding that doesn’t mean a white therapist can’t be helpful to a person of color.

Coly notes, however, that people of color lose valuable therapy time if they must educate their white therapists about their backgrounds. “Healing can’t start,” he says.

Finding therapists of color is a major problem. The overwhelming number of therapists—86 percent—are white, according to the APA. Five percent are Asian, 5 percent are Hispanic, and 4 percent are Black/African-American. So the profession has less diversity than the U.S. population, which is 62 percent white and 38 percent racial/ethnic minority.

There are numerous reasons for the disparity, according to Karen Stamm, director of workforce studies at the APA. People of color don’t often consider becoming counselors because they don’t typically seek therapy. The cost of education is another stumbling block. “You can get into a lot of debt without making the money of other medical professions,” she says.

Cost also keeps people of color from seeking therapy. It can be pricey, even with health insurance—and prohibitively expensive without it.

Still, more people of color are seeking therapy. White psychologists said the number of Black patients they’re seeing rose 10 percent and the number of Asian patients jumped 7 percent during the pandemic, according to the APA. The number of white patients rose 19 percent.

Therapists of color said the number of Black patients increased 14 percent, while the number of Asian and Hispanic patients rose 15 percent and 13 percent, respectively. The number of white patients jumped 21 percent.

Coly says the idea for Ayana, which means “mirror” in Bengali, sprang from the difficulties he encountered when trying to help a Black friend find a Black therapist.

The app launched last September after Coly spent years developing a slate of 300 counselors of diverse races, ethnicities and sexual orientations. Interest from companies jumped in 2020 as HR sought more ways to help employees cope with the year’s traumatic events.

The treatment is virtual, eliminating transportation costs and time. That has been especially important during the COVID-19 crisis. Licensing laws that make it difficult for therapists to practice in different states have been loosened during the pandemic, which has also helped fill demand.

Coly adds that he himself has experience dealing with depression, and that developing Ayana has been a boon for him. “The more I worked,” he says, “the more healed I became.” —T.A.