Diversity in Mental Health: Welcoming All in Counseling

By John Howard and Miranda Nadeau, Ph.D. – November 20, 2020

While mental health issues impact individuals from all walks of life, your unique concerns can vary widely based on your culture, race, ethnicity, gender and sexuality. Each of these factors of your personal background can shape your life experience, so it makes sense that, for counseling to be most helpful, you may want to see someone who understands your experiences, strengths, and struggles. Psychological care has not always been as culturally competent as it could be. As a result, many people have gone without the benefits of professional therapy. In this article, we will explore how diverse populations can find a counselor who will be supportive and affirming while effectively addressing mental health concerns.

People of Color

Many people of color carry stress and continue to experience discrimination and bias that affect their mental health. Broadly speaking, people of color have similar rates of mental health issues as white individuals, yet those concerns in communities of color tend to be more persistent, disabling, and under-treated. What’s more, less than one-third of adults of color who experience mental health concerns seek out counseling. One of the reasons why individuals of color may not seek out therapy is because as many as 86% of psychologists are white, according to the American Psychological Association, and would-be clients may fear that therapists will be discriminatory or just not understand their experience. A white therapist may not understand what it feels like to be marginalized or prejudiced against in overt and covert ways or understand those effects of institutionalized racism on one’s mental and emotional well-being.

 Though it can be helpful to receive care from a therapist of your own racial or ethnic background, many therapists work well with diverse populations. You can look for therapists who align themselves with causes related to racial justice and equality. Such therapists are more likely to have studied inclusive approaches and focus on creating a well-informed space for real conversation and connection in their work with diverse individuals.


Despite having higher rates of some mental health conditions, men are much less likely than women to seek out and engage in therapy. Many cultures teach that men are supposed to be “tough” and handle their concerns on their own. Generally, men are not socialized to talk about their emotions or seek emotional comfort, which can make the therapy space unfamiliar. Men may worry that issues such as aggression, porn use, affairs, and anger might be judged in therapy, There are also far less men working as therapists. Some men may perceive therapy as an unstructured exploration of emotions and prefer a more logical or practical approach to their concerns.

 In recent years, several factors are encouraging men to seek the help they need. Changing social norms are making it easier for men to talk about their feelings, develop emotional intelligence, and reach out for support. Therapists, regardless of gender, can take more emotion-focused or a more practical approach to their work. Just don’t rule out a counselor that can help you to develop a greater emotional range and help you connect with your tender side, as those skills can be immensely valuable in relationships. 


Gender and sexual minorities are more than twice as likely to experience a mental health issue as compared with the non-LGBTQ population, and that is especially true for transgender individuals. Between understanding oneself, coming out to others, and embracing their identities, LGBTQ+ individuals commonly face hardship, intense emotional stress, and struggle. Unfortunately, those in the LGBTQ+ community do not always get the affirmation and support they need from mental health professionals and may worry about discrimination in the counseling setting or about a therapist over-focusing on their gender or sexual identity. These days, though, increasing numbers of LGBTQ+ therapists and well-trained allies strive to provide informed and affirmative care.

LGBTQ+ individuals seeking therapy can benefit from contacting therapists who are homosexually-identified and allies who explicitly talk about gender and sexuality issues on their listings or webpages. Don’t be afraid to try a few therapists until you find the right one for you.

Other Underrepresented Groups

Immigrants may fear that therapists in the U.S. will not understand them, their culture, their religion, or other important aspects of their lives. Also, in some cultural and religious communities, people are accustomed to seeking mental and emotional support from community or religious leaders. This can ensure a more familiar experience that fits with one’s home culture, but there are some struggles that are best addressed with the help of a trained professional therapist. You might look for a therapist that has traveled widely, lived abroad, and is personally familiar with various cultures or religions. 

Our society can be judgmental of non-monogamous people and partnerships, even when the partners involved are self-aware and fully consenting. Due to this social stigma, many non-monogamous and polyamorous individuals and couples worry that a therapist may judge their lifestyle choices, tell them it’s unhealthy for their relationship, or have a negative personal reaction. Poly and open folks should seek out therapists that feel comfortable working with non-traditional relationship lifestyles. Feel free to ask a prospective therapist directly about their experience working with various relationship orientations.

Many groups within our larger community sometimes avoid counseling due to the factors mentioned above, but there are ample ways to protect against being othered and to find safe mental health support. As therapists are striving to provide a welcoming, affirming, and productive therapy for everyone, we hope we have encouraged you to reach out whenever you need support.

John Howard and Miranda Nadeau, Ph.D. are psychotherapists at PRESENCE, an integrative wellness center supporting your mental, physical, and relationship health so you can heal, grow, and thrive in life through science-based psychotherapy and medicine. Dr. Nadeau specializes in providing care for LGBTQ+ and POC communities.


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