When people think about mental health, conversations are often focused on therapy, medication, healing, or even finding the right treatment. But there’s another important part of the conversation that doesn’t get nearly as much attention: who is represented in the research that helps shape those treatments in the first place.
In recent years, more Black Americans have openly discussed mental health and become more aware of conditions like PTSD, anxiety, and depression. While those conversations are important, it’s equally important to talk about representation in mental health clinical trials.
When Black patients are included in clinical research, researchers can better understand how mental health conditions affect different communities, evaluate whether treatments are effective across diverse populations, and identify barriers to diagnosis, treatment, and care.
Clinical trials researcher Joyce H.N. Nortey, MPH, MSBH, Sr. Director of Clinical Research & Operations at Evidation Health and Research Advisor for the Fibroid Foundation, spoke with BlackDoctor about why representation in mental health clinical trials matters and what researchers can do to build greater trust within the Black community.
For years, Black Americans have been underrepresented in clinical research for many reasons, including a long history of medical mistreatment, ongoing discrimination within healthcare, limited awareness of research opportunities, and barriers such as transportation, childcare, and time away from work.
“Mistrust is often framed as a problem within the Black community, but it is a rational response to historical mistreatment, ongoing discrimination, and present-day experiences of not being heard or treated equitably within healthcare,” Nortey explains.
She adds that mental health studies often require participants to discuss deeply personal experiences, including trauma, substance use, or suicidal thoughts. Because of this, people need to trust that they’ll be treated with dignity, respect, and confidentiality before deciding to participate.
This is especially important when working with Black communities because some patients may say, “I’m fine, everything’s okay” even when they may be struggling. Researchers should have the cultural competence to recognize these dynamics and understand how to support Black patients throughout the research process.
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According to the U.S. Department of Health and Human Services (HHS), Black adults are less likely than white adults to receive mental health treatment. That means many people may go undiagnosed or untreated, making inclusive research even more important.
When Black patients are represented in mental health clinical trials, researchers can better evaluate how medications, therapies, and treatment approaches work across different populations. Representation also helps researchers identify gaps in diagnosis, treatment outcomes, and access to care.
“Representation is not about filling a diversity quota,” Nortey says. “It is about producing research that clinicians and patients can trust.”
Building trust starts long before researchers begin recruiting participants, and that’s one thing researchers should keep in mind when seeking out Black Americans to join clinical trials.
Nortey says researchers should partner with Black communities early by working with local organizations, healthcare providers, faith-based groups, and community leaders. They should also provide clear information about how clinical trials work, participants’ rights, and how personal information will be protected.
When researchers take the extra step to build rapport with Black communities, the response is different, and patients feel understood and welcomed. Removing practical barriers — such as transportation, childcare, scheduling flexibility, and fair compensation — can also make participation more accessible.
Most importantly, researchers should understand the needs of Black communities before designing studies so the research reflects the issues that matter most to patients, not just researchers.
Conversations about mental health shouldn’t begin and end with therapy or medication. They should also include discussions about who is represented in the research that shapes those treatments. And researchers should keep in mind that when Black individuals are represented in mental health clinical trials, it doesn’t just benefit one community — it strengthens research for everyone.
Diverse participation helps researchers develop treatments that better reflect the experiences of real patients, improves diagnostic tools, and creates evidence that healthcare providers can apply with greater confidence across different populations.
For Black communities, it can also help reduce disparities in diagnosis and treatment while improving access to culturally responsive care. As Nortey explains, representation isn’t just about being included in research — it’s about ensuring that Black communities are included in the progress that makes research possible.
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Ultimately, researchers should consider the importance of including underrepresented communities in mental health clinical trial research. Greater representation can strengthen research while helping ensure future mental health treatments reflect the experiences and needs of Black patients. It can also contribute to more equitable care by improving the evidence researchers and clinicians rely on.
As conversations about mental health continue to grow, experts say ensuring Black communities are represented in clinical trials is an important step toward building research that benefits everyone.
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