By Katherine Zimmerman, NAMI-UW President (2022-2024)
Taking care of your mental health has become crucial throughout the past few unprecedented years. As the increase of those affected with mental illness has become more apparent, it has become even more important to have the proper resources to accommodate growing demands for mental health services. However, the mental health profession has only just begun to respond to the world’s efforts for diversity and inclusion, leading individuals from varied cultural and ethnic backgrounds underrepresented. The lack of diversity within the mental health profession has created adverse effects for minorities working in the mental health field. These problems have prompted the additional development of inclusive mental health services to counter mental health stigma related to marginalized groups.
Due to the lack of diversity within the mental health profession, Black individuals within the profession are more likely to experience microaggressions, leading to a decline in Black mental health professionals. A qualitative study of Black faculty working within counseling and counseling psychology programs found microaggressions were commonly perceived, such as feelings of invisibility/hypervisibility, receiving inadequate mentoring, and difficulties determining whether discrimination was either race or gender-based (Constantine, Smith, Redington, & Owens, 2008). Microaggressions can cause marginalized individuals to feel less motivated to stay within the field and increase the risk for mental health issues. Likewise, within higher education, there is an underrepresentation of female faculty members of color and Black faculty members causing their numbers to decline possibly due to structural racism which is ingrained in many university structural systems (Constantine et al., 2008). The underrepresentation of marginalized groups within the mental health profession is harmful to disempowered individuals wanting to go into the field and has an influence on the lack of diversity within the mental health profession.
Multicultural counseling competence (MCC) is a crucial skill for individuals to possess within the mental health profession; however, a lack of diversity has caused a deficit in this skill throughout the field. In 2004, about 80% of psychology doctoral students were White, even though research suggested racial/ethnic minority counselors had significantly higher levels of MCC than White counselors (Spanierman, Poteat, Wang, & Oh, 2008). Since most psychology doctoral students are White, lack of diversity continues to be problematic for the mental health profession. This lack of diversity is hazardous since White professionals have lower MCC levels which lead to an MCC deficit within the overall field and causes individuals from varied backgrounds to be underrepresented in mental health services.
The negative outcomes created by the lack of diversity within the mental health field have affected important aspects of treatment due to a lack of cultural understanding. To properly diagnose and treat mental illness, mental health professionals must be aware of cultural influences on individuals. However, racial and gender biases are continuing to prevent individuals in need of mental health services from receiving proper care. Garb (2021) stated, that racial and gender biases occur in the diagnosis of conduct disorder, autism spectrum disorder, ADHD, mood disorders, as well as antisocial and histrionic personality disorders. The biases observed within psychological diagnosis are harmful towards destigmatizing mental health within marginalized groups; due to minorities and women being considered marginalized groups, it’s important to acknowledge how racial and gender biases overlap in psychological diagnosis. Moreover, the way symptoms of mental illness are expressed within different cultures also appears to have a significant effect on the process of receiving mental health treatment.
Dana Givens, a writer for the New York Times, explained various first-hand experiences dealing with mental health stigma as a Black woman. She stated, “Growing up in a predominantly Black community in Harlem, therapy was stigmatized as something for people who could not handle challenges.” (Givens, 2020). These potentially harmful cultural influences play a large part in one’s decision to seek mental health services. Shaun J. Fletcher, who researches health disparities among African American men, due to American culture, how African Americans “deal with mental health, or choose not to, is based on how [they] are socialized” (Givens, 2020). American culture has taught Black communities they do not have the privilege of being vulnerable like other communities—reinforced by the evident racial imbalance between mental health professionals and the general population.
The need for diversity within the mental health profession has become increasingly visible due to recent research on how prejudice and discrimination impact one’s mental and physical health. Discrimination is internalized throughout one’s life and correlates with various poor health markers/outcomes and children who experience discrimination have higher rates of mental illness (depression, ADHD, etc.) (Khullar, 2017). The lack of diversity within the mental health field creates unequal social conditions which foster unequal health outcomes for marginalized groups due to a lack of proper representation in mental health services. This leads to individuals not receiving treatment for mental health facilitated by a serious public health crisis experienced by communities who deserve better mental health services.
Currently, efforts to develop more inclusive and diverse mental health services have become the mental health field’s newest priority as they work on strategies to accommodate marginalized groups. There has been an increase in the development of digital companies to assist people in finding a therapist who is skilled and culturally competent. It can be extremely difficult for people of color to locate a therapist with a shared cultural background; however, InnoPsych offers a solution. InnoPsych offers a searchable directory of potential therapists, where users can filter providers in various categories, such as their state; type of insurance accepted; and therapist’s availability, ethnicity, and specialty (Caron, 2021). The creation of these new tools for mental health can help individuals find high-quality mental health services.
Alfiee M. Breland-Noble, a psychologist who teaches cultural competence and multicultural counseling skills stated cultural competence is about behaving “in a way that allows other people to feel welcome, to feel heard and to feel understood” (Caron, 2021). Furthermore, research studies have brought new ideas on how to better MCC within the mental health profession. Spanierman et al. (2008) suggest “affective reactions play a more central role in the process leading to increased multicultural knowledge … multicultural awareness was directly predicted by color-blind racial attitudes and multicultural knowledge, consistent with the extant literature.” Supervisors must be aware of White trainee affective reactions and respond appropriately by necessitating White trainees with low levels of MCC to more intensive multi-cultural training. By doing so, White trainee multicultural knowledge/awareness will increase overall leading to a better cultural understanding and improvement of mental health care for marginalized groups.
In order to have higher quality treatment for those suffering from mental health, diversity is important to have true understanding and empathy towards various cultural backgrounds. Cultural backgrounds have a large influence on mental health stigma experienced by marginalized groups which can manifest into additional challenges, such as an increased risk of future mental illness or exacerbated symptoms of mental illness. Lack of diversity in the mental health profession has created multicultural counseling incompetence due to the lack of racial and ethnic minority professionals within the field. Likewise, the prevalence of White professionals creates a racial imbalance between mental health professionals and the general population. Additionally, Black mental health professionals are discouraged to pursue careers in counseling psychology due to microaggressions experienced within higher educational programs. Consequently, lack of diversity has also influenced racial/gender biases in diagnosing psychological disorders causing mental health stigma related to marginalized groups to increase due to a lack of cultural understanding. However, new developments offer tools for individuals to find mental health services and ways to improve MCC training which may create more cultural and ethnically diverse mental health services and improve diversity within the profession.
Original post & references: https://0zimmermank.wixsite.com/encouragekindness/post/the-importance-of-diversity-within-the-mental-health-profession
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