health services who could benefit from effective treatment. “Effective treatment exists for many mental disorders, an indicator of need for mental health services (MHS), receive any treatment. This underutilization is more pronounced among African Americans than Non Hispanic whites (Villatoro & Aneshensel, 2014). There is something to be said about the lack of utilization of mental health services amongst African Americans. There are several possible explanations for the state of mental health use in African American communities. While many African Americans do not receive mental health services, those who do receive services are negatively impacted by the institutional bias that exists between them and non-black counselors. In a study of 47 clinicians and 129 African Americans who sought therapy, researchers found that African Americans tend to have a healthy cultural paranoia about their non-black therapists. Interviews with them found Black patients simultaneously engaged in and ‘‘scanned’’ the encounter for feelings of comfort; safety in disclosing personal information; being trustful of the provider; and being listened to, understood, and respected by the provider. For some patients, judgments about the initial encounter seem to have less to do with clinical expertise or experience of the provider and more with perceptions of empathy and the quality of the interpersonal connection between the two individuals (Earl, Alegría, Mendieta, & Diaz Linhart, 2011). In order to improve the outcomes of therapy for African Americans, it is imperative that non-black therapists are culturally competent. Increasing cultural competence of mental health clinicians will help foster an empathetic relationship between clinicians and their clients. In addition, the social environment in which African Americans live in plays a role in their mental health. As it relates to African Americans, it is not enough to deal with them independent of the world they exist in. Mental health clinicians must strive to see their African American clients within the context of the environments they move through. How these social factors impact the African American client must be examined and thoroughly processed by both the clinician and the client. The examination of how social factors influence individual thought and behavior is particularly critical for African Americans. Social environment constructs, psychosocial mediators, and sociodemographic are factors that have to be considered when it comes to African Americans and mental health. Ecological approaches that aim to systematically modify how the world interacts with blackness, life experiences that African Americans perceive as stressful, depression, and