An examination of the literature on epidemiology, etiology, and use of services for this population reveals an insufficient application of culturally congruent approaches to intervening with black women. An exploration of the social work practice literature and other relevant fields indicate that black feminist perspectives offer the opportunity to gain a clearer understanding of the intersection and influence of oppression among black women struggling with psychiatric issues and provide a useful framework for mental health practice with this population. This article discusses the evolving black feminist thought and summarizes the scholarship on black women's mental health services needs and utilization issues. The article includes a discussion of black feminisms as an emerging mental health perspective, arguing that black feminist perspectives in therapy provide an ideal framework for services that are responsive to the values and health needs of black women. The article concludes with a case vignette that illustrates some of its points.