Millennials have been nicknamed the “therapy generation,” which makes it seem like all of us are spending hours in our therapists’ offices, when in fact, many of us still struggle to access mental health services at all, let alone those that meet our needs. The cost of sessions plus transportation can pose barriers, and mental illness still remains heavily stigmatized in communities of color. People in these and other marginalized groups also often want to find a therapist who shares, and therefore understands, our identities and the challenges we face as a result — yet data shows that the psychology workforce in the US is overwhelmingly white.
To make it easier for marginalized people to get the mental health support they need, Los Angeles-based entrepreneur Eric Coly developed Ayana, a teletherapy app that connects them to therapists who have the same identities as they do. Users fill out a questionnaire that asks about gender, sexual orientation, ethnicity, and disability, among other types of information, and matches them with a therapist based on their responses. The app will be available for Android and Apple devices on March 1 of this year.
"Ayana" is Bengali for "mirror," Coly tells me. “We are trying to mirror whoever you are to honor you." The thought process is: A therapist who mirrors you is more likely to see you through the lens of your chosen identity, better positioning them to meet your mental health needs.
The app was inspired by a phone call Coly had with a friend last year. When she told him she was having trouble finding a therapist who was a Black woman, like herself, he wondered aloud about how great it would be if an app could match people to therapists who shared their identities. She agreed, and the former investment banker spent the next few months researching the market feasibility of such a product. “There was indeed a need for this,” Coly tells Mic.
Coly's friend expressed that she wanted a therapist who could relate to navigating life as a Black woman, so she wouldn't have to provide cultural context that was baked into her decisions, behaviors, and her healing process. It was then that Coly recognized his privilege as a Black man who’d grown up in Senegal — where he didn’t have to constantly confront racism in the same ways as Black Americans do — and felt a responsibility to create spaces that made them feel as safe as he did.
That Coly knew the complex struggle of mental illness firsthand further fueled him to build Ayana. Learning to manage his once-debilitating depression had become a source of strength for him. He wanted to provide the strength he wished he had at his lowest points to others who were suffering.
Ayana's questionnaire not only requests demographic information, but also seeks to capture subtler cultural nuances, differentiating it from Talkspace and other existing teletherapy apps. One item asks users how their families feel about therapy, possibly revealing whether they’re straddling American culture and that of their parents’, in which mental illness may still be regarded as taboo. Another item asks whether they’ve ever felt discriminated against. The idea is to ask marginalized people about issues that matter to them so they can more easily open up to their therapists about them, Coly explains. They can remain anonymous, at that point, if they want.
For Ayana, Coly and his team recruited therapists from organizations such as the National Queer and Trans Therapists of Color Network and Bay Area Muslim Therapists. They also prioritized seeking therapists with intersecting identities, since intersectional people have the most difficulty finding therapists who share their identities.
But with packages tentatively starting at $140 a month for unlimited texting and two half-hour phone sessions, Ayana doesn’t exactly tackle the steep costs that already make therapy less accessible for Black and brown people, especially if they don’t have insurance or their insurance doesn’t cover therapy. Coly says his team is trying various remedies to make its services more affordable, such as collaborating with community-based organizations and selling mental health-related apparel to help subsidize costs.
Even so, experts think money might not be the most challenging reason people of color aren't getting staying in therapy. “There are socioeconomic barriers, but I don’t think those are the biggest barriers,” says Alfiee Breland-Noble, psychologist, professor, and founder of The AAKOMA Project, a nonprofit focused on the mental health needs of youth of color. Even bigger is a willingness to see mental health as worth the cost, even if that means spending less on other things, although she notes that lower-income people may find it harder to prioritize mental health amid housing security and other more urgent, competing demands.
There's often a huge amount of emotional labor that goes into finding a therapist as a marginalized person. When you’re a minority in any way, you already have to cope with a barrage of challenges to your existence, Breland-Noble notes. Intersectional people carry an even heavier burden; someone who’s bisexual and Latinx, for instance, may be figuring out what their bisexuality means to them within their community. “We’re asking people to now have the wherewithal to go out and find a provider… to talk to about those things," she says. Ayana could at least take care of the legwork of researching therapists and connecting users to those they can relate to.
Marginalized people don’t want to have to educate their providers, she adds, or worry that they'll be re-traumatized in the process of seeking care.
“You go into therapy ideally to be safe from the stuff that brings you to therapy in the first place,” Breland-Noble says. Marginalized people don’t want to have to educate their providers, she adds, or worry that they'll be re-traumatized in the process of seeking care.
Greeting a Filipinx patient in Tagalog, or revealing insider knowledge of their identity in some other way, allows them to let their guard down, Breland-Noble says. It sends the message that "you understand just enough about my culture to put me at ease." As a result, the therapist and patient can connect on a deeper level, and the patient receives the same affirmation that their cis, white, hetero peers get all the time: that their lives are "normal" and that inner peace is a right, not a luxury.
Breland-Noble predicts that Ayana will be “super successful for a certain segment of the population”— millennials and Gen Z, mainly because they’re so open to digital engagement. While she believes the app’s focus on this group “is needed and vital,” she's still hyperaware of there are still gaping holes in access to therapy for children and older adults in marginalized communities.
Recent press about the app, Coly tells me, unleashed a deluge of emails from people wanting to sign up, convincing Coly to postpone the release to March. "It speaks to the gravity of the situation," Coly says, "but it also tells me that we have to better prepared.” He worries about letting down those the mental health system has already repeatedly failed, and wants to invest time in getting Ayana right. It’s a tall order, but if he succeeds, it could help shift a disparity that's plagued us for entirely too long.