PsychoHairapy seeks to meet the need for improving Black girls’ and women’s emotional and mental health.

 dr. mbilishaka psychohairapyShare on Pinterest
Photo by Krishaun Janay

Adequate, effective, and accessible mental health support and treatment are essential for optimal mental health, especially for Black women.

Black women often feel pressure to uphold the “strong Black woman” trope that contends that Black women possess unlimited strength when faced with stressful circumstances. Trying to live up to this idea can take a toll physically and mentally.

Black women report feelings of depression more than white women, according to the Black Women’s Health Imperative.

But Black women are often misdiagnosed and undertreated for mental health conditions.

We need new approaches to manage emotional and mental health well-being for Black girls and women. PsychoHairapy is one mental health approach helping to meet this need.

The current supply of psychologists and other mental health professionals is not enough to address the need for mental health services in historically marginalized communities, according to recent survey results from the American Psychological Association (APA) Center for Workforce Studies.

While the survey found that there’s been a 166% increase of racial and ethnic minorities within the psychologist workforce (from 7,140 to 18,986) between 2000 and 2019, Black clinicians represent only about 2% of practicing psychiatrists and 4% of psychologists providing care, according to the APA.

But, Black people are more likely to be diagnosed with schizophrenia and less often diagnosed with mood disorders, and they’re offered medication or therapy at lower rates than the general population.

Depression is one of the most common mental health conditions, and Black women have also been impacted. According to the U.S. Department of Health and Human Services Office of Minority Health (OMH), nearly 10% of Black women feel like “everything is an effort” compared with 6% of white women who feel this way.

In recent years, we’ve also seen a rise in the number of suicides, particularly among Black girls.

  • Black adolescent females, in grades 9 through 12, were 60% more likely to attempt suicide in 2019, as compared with non-Hispanic white females of the same age, according to the OMH.
  • A 2021 study reported a 6.6% increase in suicide from 2003 to 2017 for Black girls between ages 15 and 17 years old.

A new approach to mental health in historically marginalized communities might help lower these numbers.

PsychoHairapy is a unique approach that promotes ritual and centers healing and wellness as a collective way we can create cultural wraparound mental health services, especially when a therapist might not be available.

Rituals are essential for lifestyle change and sustainability. They connect us to our history, our ancestors, and ourselves.

Rituals have sustained the health of historically marginalized communities, even before mental health supports were available. They provided a lineage of wellness whether that was through praying, singing, dancing, or cooking.

Rituals and history offer a different way to address emotional and mental health in our communities.

Afiya Mbilishaka, PhD, therapist, hair historian, and hairstylist, is the owner of Ma’at Psychological Services — a private practice in Washington, D.C., focused on promoting balance and restoring order to the lives of her clients.

She focuses on understanding and using traditional African cultural rituals for contemporary holistic mental health practices. Encouraged by her Aunt Brenda to “do therapy and hair,” Mbilishaka acknowledges the African proverb in her work: “No matter how far the river travels, it will never forget its source.”

Mbilishaka centers Black women’s histories with our hair and as a way to promote healing and wellness.

We can learn so much from the African Diaspora, Mbilishaka says.

The Masai people are known to be warriors, with “strong, strategic, and amazing hair,” notes Mbilishaka. The hair is dyed to evoke fire and blood warrior deities, as part of an initiation process still practiced today in Kenya and Tanzania.

Warriors are required to grow dreadlocks, or locs, when they become a warrior. When they stop fighting, those locs are cut to disconnect from fighting energy.

A popular natural hairstyle today, Bantu knots, are a traditional African hairstyle from the Bantu people — the second largest ethnic group of people in Africa, as well as where the majority of those enslaved in the Americas were born.

Other ways that hair has been used for many centuries as a ritual for healing and liberation include:

  • In ancient Egypt, a healer would mix animal fats, plants, and oils and apply it to the top of the scalp. It would melt into the body system due to sun.
  • A Mauritanian desert bride’s marriage would be blessed with the braiding and twisting of their hair as family and friends wished for fertility and wealth instead of giving gifts.
  • The Taureg group in Mali and Niger would rub the hair with fine black sand and medicinal oils to increase luster. Only the blacksmith’s wife could braid her hair, wishing her a “hot” marriage.
  • Maroons, enslaved people of African descent who escaped, used hair for liberation by braiding their hair and using the designs as maps to find freedom and sovereignty. If they were caught, they would take out their braids.
  • The Black Power Movement in the 1970s in the United States promoted “Black is Beautiful” by embracing natural hair styles.

The use of hair as a ritual for behavior and purpose is particularly relevant for Black people.

Mbilishaka says, “We may not know our history, but our hair does. Our hair will never forget… Africa always comes back every 4 to 6 or 8 weeks.”

This interview has been edited for brevity, length, and clarity.

What’s the relationship between Black women and their hair? Where does this originate?

Hair represents a complex language system for Black folks. Hair is an external and visual cue of how someone approaches self-care and the negotiation of their cultural lens of self-expression.

The language system is ancient and dates back millennia. Specifically, we can see how hair served to gather demographic details and identity influences in ancient African societies.

Every single strand of African hair, all types, is beautiful.

What is PsychoHairapy?

PsychoHairapy is a clinical practice and theoretical orientation that links hair to mental health. [This] lay health advisor model with stylists and barbers trains them to make mental health assessments and interventions.

It’s therapist based in the salon, [offering] microcounseling skills, salon- and barbershop-based group therapy, psychoeducation materials and workshops, [and] web-based interventions.

What is your training and background? And, what made you develop this training?

I was trained as a clinical psychologist. The role of a clinical psychologist is to assess, diagnose, and intervene in all things mental health.

I decided to develop this training because I never met a Black clinical psychologist until my 20s. My undergraduate courses neglected the Black experience and only referenced Black folks in connection to the overdiagnosis of schizophrenia.

I wanted to address these absences and disparities. I realized that there are lay health advisors in the community already — such as barbers and hairstylists — that engage in informal counseling within our communities.

Can you describe the training? How can Black beauticians find out more about the trainings?

According to the National Institute of Mental Health (NAMI), 1 in 5 adults in the United States live with a mental health condition, yet most people don’t get the support they need.

With the global pandemic, racial injustice, and violence against women, there’s an increased urgency for mental health advocacy.

The PsychoHairapy certification equips community members with the skills to administer culturally informed mental health first aid and provides a curated therapist directory of local mental health professionals.

PsychoHairapy certification courses help folks to build awareness, knowledge, and skills in providing support to someone with various symptoms of mental health conditions.

How is this different from other health promotion campaigns that also work with beauticians and barbershops?

The existing programming and literature focus on physical health (cancer, diabetes, hypertension, etc.) but neglect mental health.

How has the Black hair movement changed over the last 50 to 60 years?

We’re presently in the second natural hair movement. My mother always reminds me that she wore “the natural” in the 1970s.

In the 1960s and 1970s, people went from being called ‘negro’ or ‘colored’ to ‘Black’ and ‘African.’ With that change in consciousness, there needed to be a change in physical aesthetics by making a choice to connect to the entire African Diaspora through hair.

Hairstyles reflect the changing political consciousness (and conservatism) of Black people.

What is the CROWN Act and how has this had an impact on Black hair? What are the implications?

The CROWN Act stands for Creating a Respectful and Open World for Natural Hair. It was developed in 2019 to disrupt race-based hair discrimination, specifically protecting Black people from racism related to education, employment, and housing.

Hairstyles such as Bantu knots, twists, braids, locs, and afros are protected under the CROWN Act. Currently, 14 states have successfully passed the CROWN Act, so 36 more to go!

What advice (at least three things) do you have for Black women when caring for their hair and mental health?

People need to recognize that the same behaviors that manage stress also are healthy for the hair:

  • 8 cups of water a day
  • exercising for at least 30 minutes, 4 days a week
  • sleeping 7–9 hours a night
  • eating 4–5 servings of fruits and vegetables a day

What’s your hope for the Black hair movement? Or rather, where do you see the Black hair movement moving?

I hope that the Natural Hair Movement, in particular, becomes fused with healthcare. I hope that it lasts and that Black children will never have to experience hair discrimination within or outside of their racial group.

Mental health conditions can look differently in Black women. If you think you might need help, consider reaching out to a mental health professional.

If you’re not sure where to start, you can try talking with your primary care physician if you have one. They can refer you to a mental health professional if you need one.

If you’re looking for therapy dedicated to the mental health and wellness of Black girls or women, consider trying one of these resources:

The Black Women’s Health Imperative (BWHI) is the first nonprofit organization founded by Black women to protect and advance the health and well-being of Black women and girls. Learn more about BWHI by going to