Page 295 - Microaggressions in Everyday Live Race, Gender, and Sexual Orientation

Underutilization of Mental Health Services 269

is reinforced because most mental health providers are White (environmental
microaggression). The lack of providers of color may send a loud microaggres-
sive message to the minority community that they are not welcome, or that
the help they seek will not be appropriate to them (Burkard & Knox, 2004).
Second, the services provided may be perceived as antagonistic or incompatible
to their cultural perceptions of helping. The reliance on a one - to - one in the
office “ talk therapy ” aimed at insight may not be valued by people of color

who desire concrete advice and information (Parham, 1999). Third, potential
stigma may also diminish service utilization. Among Asian Americans, for
example, psychological problems may be viewed as weaknesses bringing
shame and disgrace not only to the client but his/her family as well (Kearney,
Draper, & Baron, 2005). Fourth, culturally appropriate forms of “ healing ” or
reliance on indigenous community resources may be the preferred choice of
persons of color (Leong, Wagner, & Tata, 1995). In this respect, people of color
may prefer seeking support, advice, and suggestions from community agencies
such as their churches or indigenous, informal healing networks.
Last, it is possible, but improbable, that people of color are “ mentally
healthier ” and do not require as many mental health services as their counter-
parts. While all the other reasons just cited contain validity, this last one is
not supported by indirect data. Although the manifestation of psychological
disorders is culturally determined, their rates appear similar across all groups
(Sue & Sue, 2008). If true, people of color are likely to seek help from traditional
European American sources only when more culturally appropriate means
have failed to give them relief. Thus, we might conjecture that those who seek
mental health services would be more likely to be severely disturbed than
their White counterparts. In other words, clients of color are more likely to be
in greater distress and evidence greater pathology. Indeed, in a nationwide
sample of 1,166 clients of African American, Asian American, White, and
Latino students across 40 university counseling centers, it was found that
clients of color had higher levels of distress than Whites before and after
their sessions: Asian Americans, followed by Latinos, African Americans, and
then Whites (Kearney et al., 2005).

Premature Termination
While stigma plays an important role in keeping certain groups of color from
utilizing mental health services, beliefs that services are irrelevant to their
needs and operate from a biased White Western European perspective consti-
tute a major racial microaggression that discourages traditional mental health

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