Eliminating Race-Based Mental Health Disparities by Monnica T. Williams

Author:Monnica T. Williams
Language: eng
Format: epub
Tags: racial bias in mental health care;implicit bias;microaggressions;cultural competence;mental health disparities;treating minorities in mental health care
Publisher: New Harbinger Publications
Published: 2019-11-07T18:33:21+00:00

Knowledge

Assessment and diagnostic processes are most effective when clinicians are able to connect with clients in ways that are congruent with client cultural values and belief systems. To this end, clinicians must educate themselves about the modal experiences of clients from different cultural backgrounds, while remaining open to each client’s unique experiences and life contexts, given that modal experiences do not describe the full range of varied experiences within any racial or ethnic group. This education begins with clinicians learning about the history, beliefs, values, and experiences of oppressed racial and ethnic groups in society to enable clinicians to connect with clients from diverse backgrounds and be more effective in their assessment and diagnostic approaches. In this context, clinicians also need to educate themselves about the historical views of medicine, psychology, and therapy from different cultural perspectives, which includes knowledge about institutional and systemic barriers to mental health treatment that clients of color may experience.

Part of this education includes understanding the ways that racial and ethnic minorities experience marginalization and oppression within one’s societal context. These groups are often set apart and perceived negatively or “less than” in society. Marginalized populations often experience barriers to health care and jobs and experience social injustices and threats to their civil liberties. One example of a threat to the civil liberties of a marginalized group can be seen in women receiving unequal pay for doing the same work as their male counterparts, and receiving even lower pay when they are women of color. In addition, we have seen systemic efforts to disenfranchise voters of color across the United States, including closing specific polling stations and heightening regulations related to voter identification. These are just a few examples of the oppression and marginalization that clients of color may experience based on multiple marginalized statuses (intersectionality). These experiences often play a significant role in clinical presentations and must be attended to during the assessment and diagnostic phases of mental health treatment, and clinicians are advised to stay well informed of such policies and practices.

In addition, it is crucial that clinicians work to become educated about the different forms of discrimination that marginalized groups experience, including both overt and covert forms of discrimination. Racial microaggressions have been described as intentional or unintentional disparaging comments, slights, or environmental indignities based on an individual’s marginalized group status (Pierce, 1970). For people of color, microaggressions can occur in many different forms. For example, a racial microaggression may be a White woman clutching her purse as she walks past a Black man on the sidewalk. Additional examples are a Chinese American woman being asked what country she is from, or a White clinician making the statement “I do not see color.”

Clinicians must not adhere to ideas of colorblindness and sameness, but should acknowledge and appreciate cultural differences in the therapy room with their clients of color. While “color-blind” approaches to assessment and diagnosis are meant to reduce biases, they actually serve to ignore important lived experiences of clients (e.g., exposure

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