By Caitlin C. Regan
Over the past two years, the modern civil rights movement has brought to the forefront a long-overdue racial reckoning in the U.S. The advancing conversation about race in America has been powerful for me as a mental health and substance use counselor.
As a white woman, I cannot begin to understand the realities of being a Black person in America, and I recognize the inherent privilege I was born with and have lived with every day since. However, I believe that I — along with other individuals living with mental illness — can empathize with anyone experiencing discrimination and injustice. And I believe I have a responsibility, as a provider, to help dismantle disparities in mental health care and support Black mental health.
As a woman living with Bipolar II disorder, a condition that is often misrepresented in media and misunderstood by the general public, I am familiar with some of the realities of discrimination.
Many of us who live with mental health conditions know the pain of being unjustly deemed “unstable” or “dangerous” by law enforcement. We are familiar with critical stares. We have missed out on job opportunities or lost hard-earned jobs at the judgment of biased hiring managers and employers. We also experience disproportionate rates of incarceration.
Of course, discrimination against people with mental health conditions and discrimination against people of color are not comparable. I have the luxury of “hiding” this part of my identity for my own protection — my mental illness is not (immediately) visible. I do not have to fear for my safety jogging down the street, walking into a store or driving my car.
Not only are they not comparable, these two facets of discrimination often compound each other for people of color with mental illness — who are often the most disadvantaged group in the mental health care system.
So, the question becomes how do we — people living with a mental illness and working in the mental health field — address this inequality and better support Black mental health?
As a former teacher, and currently as a clinician, I work almost exclusively with adolescents — often adolescents of color. My job, as I understand it, is to meet my students and clients wherever they are coming from. I offer my support and acknowledge that while I may have a different lived experience, my goal is to empathize and help. Ultimately, it is not their job to learn to trust me. It is my job to earn their respect and trust.
Here are a few ways providers can earn their clients’ respect and trust and begin to dismantle the disparities in care for the Black community.
Validate Lived Experience
One step toward becoming a better supporter is acknowledging that we won’t always fully understand another person’s experience. Supporting a movement and validating someone’s experience does not require a personal familiarity with their lived experience. Instead, it requires a willingness to listen, learn and change our behavior accordingly.
Mental health care professionals can further support Black mental health by looking into their own practices, acknowledging their biases and altering their care accordingly. Ultimately, every client who walks through the door deserves to be met with empathy and cultural understanding.
Seek Education on Health Disparities
In addition to investigating our own biases, practitioners must educate themselves on health disparities between groups. A 2008 study found that white individuals have more access to quality mental health support and professional help — and they are met with more empathy when seeking treatment.
Consider Providing Affordable Treatment Options
Clinicians should consider socioeconomic inequalities when determining practice fees. Adjusted rates could be a step toward presenting better care opportunities for people of color who seek mental health treatment. Some private practices and facilities currently use sliding fee scales, charging clients based on what is doable for their household income rather than a flat rate fee. This is a start and needs to be adopted by all of the mental health world, including hospitalization facilities.
Use Appropriate Language
The mental health care system also needs to keep up with the appropriate language to use in a clinical setting. Clinicians, support groups and anyone engaging in a dialogue about mental health need to consider the inherent trauma that people of color have lived generationally in order to provide unbiased, nonjudgmental support. Using a dated term or unfamiliar language can be incredibly triggering for someone who has experienced severe discrimination and marginalization.
Engage in Inclusion Trainings
Yearly trainings and seminars can help providers better understand cultural triggers. Clinicians, support groups and non-profits need to continually undergo cultural understanding and awareness trainings to stay at the forefront of the discourse and to provide the best, culturally competent care.
As a clinician who lives with a mental health disorder, I have taken a personal journey to work toward cultural competence and empathy for all my clients. I do not always get it right — and in those moments, it is critical to recognize my mistakes and work to address it with my client. Often, an apology can go a long way. But this means very little without understanding and measurable growth.
In my practice, I continually participate in webinars and trainings for cultural competence, and I devote time to reading on the topic on my own. “Social Justice in Clinical Practice” by Belkin Martinez and Fleck-Henderson has added to my understanding of injustices occurring in the medical space and more broadly, and it has given me a blueprint for how I, as a white clinician, can work to restore social justice in my practice and beyond.
Having cultural competence and empathy, to me, does not mean simply addressing the issue in my practice, but speaking up on a larger scale. It is when those of privilege stay silent that injustice prevails. This always plays in my mind in order to work toward change.
Caitlin Regan is a residential therapist in an adolescent treatment facility in Florida. She was diagnosed with Bipolar II disorder in 2012 and has been living successfully in treatment. Caitlin receives Electroconvulsive Therapy and participates in CBT therapy as her treatment plan — and she finds the support of her husband and her family to be a strong resource. She is an avid reader and enjoys singing in her church choir. Caitlin can be reached on her Mental Health support social media account @caitlins_counseling_corner.
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