When Ashley McGirt-Adair was 9 years old, she began journaling to cope with depression and suicidal thoughts after her grandmother died. What she found instead of care was a white school counselor who didn’t understand what that loss meant for a grieving Black child.
“She didn’t understand the role of grandmothers in Black families, so at a very young age I found myself having to educate a grown white woman on race relations in America,” McGirt-Adair says. “Even in my youth, I knew that wasn’t OK.”
That moment, being unseen in her grief, is one many Black children experience, and what researchers now recognize as an early encounter with racial trauma — the cumulative emotional and psychological harm caused by racism. Decades later, that gap between trauma and culturally competent care sits at the center of her work.
Indeed, as a trauma therapist, nonprofit founder, and author, McGirt-Adair is using her forthcoming book, “The Cost of Healing in Silence,” to name what too many Black people and providers already know: healing is harder when the system erases you.
“The goal of this book is to give a voice to those who have suffered in silence, support the helpers and healers doing this work, and guide communities toward collective liberation,” she says. “It serves as both a testimony and practical guide for transforming how we care for ourselves and one another.”
Eliminating Barriers to Racial Healing
In 2020, McGirt-Adair founded the Therapy Fund Foundation (TFF), a nonprofit providing free mental health services to Black communities in Washington State, with a pilot program expanding into San Diego. Through the foundation, she’s building a model of care rooted in cultural understanding, trust, and community accountability.
“My organization eliminates barriers to healing for Black community members by providing free mental health services, education, and advocacy, all focused on mental health,” she says — and TFF has distributed $60,000 to support Black clinicians in the process.
But healing, she argues, cannot stop at the therapist’s office. Without structural change — in funding, training, and access — it remains out of reach for many Black communities.
She connects this pressure directly to her book’s central argument.
“We deserve wellness. It is our birthright, and through colonization, racism and other oppressive systems, it has been stripped away from us for so many years,” she says. “I can speak to being a Black woman and the trope of the strong Black woman. My grandmother was a strong Black woman and it killed her. I don’t want that for us.”
A Roadmap for Healing
“The Cost of Healing in Silence” doubles as personal testimony and practical guide. Each chapter closes with reflection prompts and actionable strategies, and the book’s roadmap touches on three interconnected challenges: destigmatizing mental illness, confronting bias, and returning to indigenous and African-centered healing practices.
On stigma, McGirt-Adair is direct. “When we see someone behaving erratically or suffering from a disease they did not choose, and then shame them or talk about them, that needs to change,” she says.
She points to public conversations around figures like Kanye West, and Gucci Mane’s recent disclosure of a schizophrenia diagnosis, as examples of how Black communities are conditioned to pathologize rather than support one another.
But racial harm shows up for Black folks in quieter, everyday ways. McGirt-Adair draws from a memory that stuck with her since she was 18, traveling in Thailand and encountering a wide range of skin-toned bandages — something the U.S. brand Band-Aid didn’t offer until after George Floyd’s murder in 2020. It’s a small example, she says, of how medical and mental health systems have long defaulted to whiteness.
“If you are not practicing from a culturally responsive, anti-oppressive psychotherapeutic lens, what are you really even doing?” she asks. “You have to embed culturally responsive care into your practice, and not just in mental health but in medical and physical health as well.”
Building a Movement
Ultimately what McGirt-Adair is building through her practice and foundation is part of a broader vision of what racial healing can look like: care that sees Black people fully, holds their pain without dismissal, and makes room for something beyond survival.
For young professionals entering racial healing-related health work, she points to mentors like Dr. Beverly Tatum and Dr. Joy DeGruy — whose work on “Post Traumatic Slave Syndrome” McGirt-Adair first encountered as an undergraduate, prompting her to write DeGruy a handwritten letter. DeGruy has since become a mentor.
“If this is something you want to focus on, be specific about it. Find the leaders,” McGirt-Adair says. “And reach out to me. I’m willing to walk alongside you on this journey.”
