In today’s behavioral health care landscape, a diverse behavioral health workforce isn’t just a nice-to-have—it’s a necessity. Both patients and providers are calling for it, recognizing that true healing begins when individuals feel seen, heard, and understood. Yet, despite this growing awareness, the behavioral health workforce still struggles to reflect the diversity of the communities it serves. This disconnect presents a vital but daunting challenge for organizations seeking to improve population health outcomes, particularly for those historically underserved and underrepresented.
The Historical Challenge of Representation
For decades, the behavioral health field has been marked by the underrepresentation of minority communities among its clinicians. This disconnect has left many patients—particularly from racial, ethnic, and sexual minority groups—without access to culturally competent care. The reality is that minority patients are often met with health care systems that are not equipped to understand their specific cultural contexts, leading to a lack of trust, poor engagement, and suboptimal care outcomes.
As Alice Zhang, co-founder and CEO of Anise Health, points out:
“Diversity can’t be an afterthought. If you think you can hire one or two clinicians to represent that small group that you’re serving and call yourself a culturally responsive provider — it doesn’t quite work out that way.”
Anise Health, which focuses on the unique mental health needs of Asian Americans, has embedded cultural responsiveness into every layer of its business model—offering therapy, coaching, and digital tools tailored specifically to this underserved population. The company has seen significant success with this approach, operating in states such as California, New York, Washington, Massachusetts, and Florida, while also raising a $1.2 million pre-seed funding round to further expand its reach and services.
Zhang’s comments serve as a poignant reminder that cultural responsiveness cannot be a token effort. It requires full commitment at all levels of the organization, from leadership down to the clinicians on the ground. When striving for a truly diverse behavioral health workforce, organizations must acknowledge the importance of holistic and sustained efforts to recruit and retain clinicians who understand the unique needs of the populations they serve.
The Case for Purpose-Driven Models
Despite the broader industry’s ongoing staffing shortages, organizations like Anise Health and FOLX Health—a digital platform offering gender-affirming care—have no shortage of applicants. The reason is clear: these organizations have built a strong, purpose-driven brand and culture that attracts clinicians who are passionate about serving the communities in need of specialized care. Their mission is not generic; it is focused and deeply rooted in the lived experiences of minority groups.
Greg Sottolano, Chief People Officer at FOLX Health, says:
“We frankly have more [talent] than we’re able to hire right now… With them, they bring along a really strong network of individuals that they work with.”
FOLX Health’s workforce is a testament to the power of a focused mission. More than 75% of FOLX Health clinicians identify as LGBTQ+, and more than one-third identify as transgender, nonbinary, or two-spirit. This high level of representation is a direct result of the company’s commitment to offering care specifically designed for the LGBTQ+ community, a mission that resonates deeply with clinicians who share those same lived experiences.
By fostering an environment where clinicians feel valued and connected to the population they serve, FOLX Health has built a workforce that is both passionate and equipped to meet the unique needs of their patients. And the result? High-quality, culturally competent care that helps individuals navigate complex mental health challenges in a supportive, inclusive environment.
Addressing Disparities in Mental Health
The need for a diverse behavioral health workforce is not just a matter of representation; it is a matter of public health. Minority populations in the U.S. experience mental health challenges at higher rates than their majority counterparts, and yet they remain less likely to receive the care they need. The data paints a stark picture:
- Sexual minority females report substance use disorders at rates significantly higher than their straight peers.
- Sexual minority males face mental health struggles that are approximately 1.5 times higher than those who identify as heterosexual.
- Black, Hispanic, and Asian adults, while showing lower rates of mental illness diagnoses compared to their White counterparts, often experience underdiagnosis due to cultural misunderstandings or biases in the health care system. Even when diagnosed, they are less likely to receive adequate mental health services.
The gap in services is even more evident when we look at specialized care. Only 13% of mental health facilities and 18% of addiction treatment centers offer programs tailored specifically for the LGBTQ+ population. This shortage leaves many in these communities without access to competent, culturally informed care—putting their mental health and well-being at risk.
As a result, the need for a diverse behavioral health workforce is not only an ethical issue but a public health imperative. Having clinicians who understand the cultural context of their patients’ struggles is essential for ensuring high-quality, effective care.
The Workforce Diversity Gap
Despite the increasing attention to diversity, the behavioral health workforce remains predominantly White. According to the U.S. Census, the American population identifies as 59% White, 19% Hispanic/Latino, 13% Black, 6% Asian, and 2% two or more races. However, the American Psychological Association reports that 81% of psychologists identify as White, while only 8% identify as Hispanic/Latino, 5% as Black, and 3% as Asian. Similarly, research from Johns Hopkins University indicates that only 10% of psychiatrists identify as Black, Latino, or Native American.
The lack of diversity within the clinical workforce is not only a statistical discrepancy—it creates real barriers for patients who are seeking care from individuals who understand their lived experiences. Furthermore, when minority clinicians are present in the workforce, they tend to face unique challenges, including systemic barriers, cultural biases, and a lack of institutional support, all of which make it harder to recruit and retain them.
Despite these challenges, the number of racially diverse practitioners in the behavioral health workforce has increased by 166% between 2000 and 2019. This positive shift is encouraging, but the journey is far from complete.
Strategies for Recruiting and Retaining Diverse Clinicians
Organizations serious about improving workforce diversity must make sustained, systemic efforts to recruit and retain clinicians from historically underrepresented communities. This requires a combination of internal and external strategies, starting with creating an inclusive culture that values diversity at all levels.
One approach that has proven effective is hyper-local recruitment. By hiring clinicians from the communities they serve, organizations can ensure that the workforce reflects the needs and values of the population. Thriveworks, one of the largest outpatient mental health providers in the U.S., has adopted this strategy. Through a diversity and inclusion council, they have created action plans based on employee feedback and demographic data, which have led to the formation of employee resource groups focused on racial identity, sexual identity, disability, and spirituality.
Heidi Faust, Thriveworks’ Chief Clinical Officer, explains that these efforts are part of a broader commitment to creating an environment where diversity is celebrated, not just tolerated:
“Let’s get a bunch of people that work for the company—clinicians and administrators—that are interested in being thought leaders and get a lay of the land.”
Such efforts foster a workplace where employees feel supported and empowered to bring their authentic selves to work. This, in turn, leads to better patient outcomes and a more engaged, motivated workforce. As organizations continue to prioritize these initiatives, they’ll see that investing in a diverse behavioral health workforce has lasting benefits for both clinicians and patients alike.
Investing in Training and Education
Recruitment alone is not enough. Organizations must also invest in ongoing education and training to ensure clinicians are equipped with the cultural competencies necessary to serve diverse populations. This includes offering specialized training on addressing the needs of racial, ethnic, and sexual minority groups, as well as incorporating cultural humility into clinical practices.
Zhang from Anise Health makes an important point: while it is helpful for clinicians to have a baseline understanding of the cultural context of the communities they serve, it is not sufficient. Cultural competence must be cultivated through continuous learning and an understanding of how to adapt the traditional Eurocentric model to meet the needs of diverse individuals.
The Path Forward: A Call to Action
The road to a more diverse and inclusive behavioral health workforce may be long, but it is one worth traveling. The benefits of a workforce that better represents the population it serves are clear: increased patient satisfaction, better engagement, and ultimately, improved health outcomes. Organizations that want to thrive in the future must commit to not just hiring diverse clinicians, but also fostering an environment where they can succeed and grow.
There is still much work to be done, but with strategic investments in recruitment, retention, training, and culture, the behavioral health field can begin to close the diversity gap. The future of behavioral health care must be one that embraces and celebrates the richness of the communities it serves—because only when we see each other can we truly begin to heal together.
