Weeks after Vicky Musitongo was abused, she would wake at night in a pool of sweat unable to navigate the trauma, she says. “I had developed post-traumatic stress disorder.”
The stigma of seeking mental health aid and counselling runs high in some African communities, says Musitongo, who was born in the Democratic Republic of the Congo and moved to Ireland with her family when she was six.
But the experience had emotionally paralysed her. Going against the tide of tradition, she went to a therapist, she says.
Her therapist was a White woman. She seemed to be in her 50s, says Musitongo.
Musitongo says she tried to explain to the therapist that it was uncommon in cases such as this for Black women to challenge their abuser in court.
“But she couldn’t understand, she was just looking at me shocked. I feel like if I had a Black therapist, she would’ve understood me,” says Musitongo.
Musitongo may have been hard pressed to find a Black therapist in Ireland, though.
When Ejiro Ogbevoen set up Black Therapists Ireland, a directory of Black therapists in Ireland, she struggled to find many people to include.
“The Irish Council for Psychotherapy has about 4,000 therapists, and right now I have less than 10 people,” she said, recently, draping a checkered shawl around her shoulders, during a video interview.
Conventional wisdom among African communities often holds that seeking mental-health help signifies weakness and an inability to handle life’s challenges, Ogbevoen says.
“When you talk about mental health, we would immediately think of someone who is locked up in a hospital or who is crazy,” she says.
Historically, being strong or at least shielding behind a veneer of strength has been a matter of pride, says Ogbevoen. “For Black people, being strong has been a part of our journey.”
Some White therapists, she says, are even surprised to see a Black client walking through the door. The wonderment is easy to detect, she says.
If there were more Black therapists, it would help shatter the stigma of seeking counselling among people of African descent, says Ogbevoen.
“I really believe having more Black therapists would encourage Black people to seek therapy,” she says.
Racial inequality worsens mental health problems in people of colour, says Ogbevoen.
Yet because therapy is associated with White people, Black victims of white racism are discouraged from trusting it, says Ogbevoen.
“When you think therapy, you genuinely just think White. So we need more Black people, Africans, Indians, Caribbeans,” she says.
For Musitongo, it’s all about being able to connect. White therapists, she says, are not impacted by racism to relate to their Black clients, on a deep personal level.
“Black therapists should really put themselves out there, I didn’t know there were Black therapists in Dublin,” she says.
Tracy Musitongo, Vicky’s younger sister, says similar.
She sought therapy after she felt symptoms of depression and anxiety as a first-year nursing student in Edinburgh.
She quit her course and returned to Dublin. But she also struggled to connect with White counsellors, she says.
“It’s all about the therapist being able to relate to your experiences, and with white therapists, although they really try, the sense of relatability is not there,” she says.
Is it awkward to bring up race to a White therapist? Ogbevoen says it can be, but it is essential for Black clients to freely vent.
While giving a talk at the African Centre recently, Ogbevoen says she asked the crowd if they liked their therapist to bring up race. Most of the room said yes, Ogbevoen says.
Why So Few?
Mental health services “should be inclusive of all the people in Irish society and should be delivered in a culturally appropriate way”, says the government’s mental-health policy document, A Vision for Change.
There are significant institutional barriers, though, to diversifying the pool of therapists in the country from a generally hostile labour market for Black people in Ireland, to the particular obstacles for those who are migrants.
Counsellors are on theineligible list of jobs for work permits, issued by the Department of Business and Enterprise.
That means non-European counsellors – if their status is such that they need a permit to work – can’t work as therapists in Ireland.
The list is based on vacancies and updated according to labour market needs, said a spokesperson for the Department of Business. The permit system doesn’t discriminate based on nationality or gender, they said.
The list of ineligible jobs is reviewed twice a year, they said. For an occupation to be struck off the list, there needs to be a clear indication of a deficit of skill in that field, they said.
“The review takes into account detailed labour market information, as well as contextual factors such as Brexit and Covid,” said the spokesperson.
People can weigh in now to the latest consultation, the spokesperson said.
Patricia Scully, the chairperson of the Irish Council for Psychotherapy, says that the vast majority of therapists are self-employed.
When it comes to non-European counsellors that makes it difficult.
Many non-EEA nationals hoping to work in Ireland must first get a Stamp 1 immigration permit which does not allow self-employment.
After working under a valid work permit for five years – or two years for those on a critical visa scheme – Stamp 1 holders can apply for a Stamp 4 permit which allows for self-employment.
“Psychotherapy is a self-regulating profession, which makes it even harder for a therapist coming from a different jurisdiction to work here,” says Scully.
Studies of inequalities in the labour market have also pointed to discrimination against all Black people in Ireland, as well as Black immigrants.
“Being Black in the Irish labour market is a strong indicator of un[under]employment and marginalisation,” writes Ebun Joseph, an academic and director of the Institute of Antiracism and Black Studies.
Finding an office and high rents add to the obstacles facing psychotherapists like her, says Ogbevoen, who has been a therapist since 2009. That’s why her counselling services have moved entirely online, she says.
Psychotherapy courses often incorporate diversity training into their programmes, but it’s not the same as having more ethnically diverse people in the field, says Scully.
“The courses are also usually very expensive, which makes them even more out of reach,” she says.
Better for All
Scully’s view is that Ireland’s multicultural journey is still in its infancy.
She says she hopes the government will eventually recognise the importance of training therapists of colour to serve the mental health needs of diverse groups.
“It is all about having a choice when it comes to picking a therapist,” she says.
Therapists of colour can also support White therapists in providing better support for their non-White clients, Ogbevoen says.
“I’m not saying only Black people should come to me, I’m saying the choice should be there,” Ogbevoen says.